Nedelska Z, et al. – Aim of this study is to evaluate whether noninvasive proton magnetic resonance spectroscopy (1H–MRS) tissue metabolite measurements at baseline can predict an increase in the rate of β–amyloid (Aβ) accumulation on serial PET in clinically normal (CN) older adults. Early metabolic alterations on 1H–MRS and APOE ε4 status are independently correlated with an increased rate of Aβ accumulation among CN older adults. Because an increased rate of Aβ accumulation in CN older adults may confer a higher risk for cognitive decline and mild cognitive impairment, the findings can have important implications for early diagnosis and identification of individuals for secondary prevention trials.