Judgment in everyday situations is an important aspect of executive functioning that warrants formal assessment during neuropsychological evaluations of older adults with suspected dementia. Knowledge about patients’ judgment skills can inform decisions about diagnosis, functional and cognitive competence, and treatment. The DRJQ evaluates judgment in four content domains: safety, social/ethical, financial, and medical. Participants listen to brief scenarios about everyday judgment problems and report their proposed solutions. Initial psychometric data suggest the reliability, validity, and clinical utility of the DRJQ (Rabin et al., 2005). The purpose of this study was to use voxel-based morphometry (VBM) to assess regional gray matter atrophy related to judgment ability. We hypothesized that the neural basis for impaired judgment skills would involve prefrontal cortical regions. Participants (N=119) were euthymic older adults including patients with mild Alzheimer's disease, patients with amnestic mild cognitive impairment, individuals with cognitive complaints but normal neuropsychological test performance, and demographically-matched healthy controls. Structural MR scanning included a T1-weighted 1.5mm coronal volume, acquired on a GE 1.5T LX scanner. For VBM, SPGR volumes were spatially normalized, segmented, smoothed, and gray matter images analyzed using the GLM approach implemented in SPM. We used SPM to identify brain areas where gray matter was correlated with DRJQ total scores in the entire sample. Using a critical significance threshold of .001 at the voxel level and a minimum cluster size of 50 voxels (1.69 cm3), results indicated that impaired judgment skills correlated with atrophy of bilateral frontal and temporal lobe regions. To control for the apparent relationship with memory in our sample of participants with memory complaints and/or dysfunction, we created an adjusted DRJQ score, factoring out the effects of memory performance (i.e., CVLT-II Total Learning score). Using a critical significance threshold of .005, the remaining correlation was with the right middle frontal gyrus (Figure 1). Results extendprevious validation of the DRJQ as a measure of judgment abilities in older adults by providing evidence of its selective relationship with frontal integrity. Longitudinal assessments are being performed to examine predictive validity of the DRJQ for cognitive progression in our clinical groups.