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Subjective cognitive decline and stage 2 of Alzheimer disease in patients from memory centers
Frank Jessen1,2, Steffen Wolfsgruber1,3, Luca Kleineindam1,3
1German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany.
Introduction:
It is uncertain whether subjective cognitive decline (SCD) in individuals who seek medical help serves the identification of the initial symptomatic stage 2 of the Alzheimer's disease (AD) continuum.
Methods:
Cross-sectional and longitudinal data from the multicenter, memory clinic-based DELCODE study.
Results:
The SCD group showed slightly worse cognition as well as more subtle functional and behavioral symptoms than the control group (CO). SCD-A+ cases (39.3% of all SCD) showed greater hippocampal atrophy, lower cognitive and functional performance, and more behavioral symptoms than CO-A+. Amyloid concentration in the CSF had a greater effect on longitudinal cognitive decline in SCD than in the CO group.
Discussion:
Our data suggests that SCD serves the identification of stage 2 of the AD continuum and that stage 2, operationalized as SCD-A+, is associated with subtle, but extended impact of AD pathology in terms of neurodegeneration, symptoms and clinical progression.
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