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To evaluate the relationship between degree of cognitive impairment and gray-matter density changes in the auditory cortex. Retrospective case-control. Six hundred sixty-three patients of a tertiary referral center cognitive disorders clinic. Magnetic resonance imaging. Ratios of gray matter density of the primary auditory cortex (A1) to whole brain and auditory association cortex (AAC) to whole brain in patients with Alzheimer's disease (AD) compared with mild cognitive impairment (MCI) and patients with a mini-mental state exam (MMS