Development of a Predictive Model for the Progression of Subjective Cognitive Decline: A Longitudinal Study

Area of Science:

• Neuroscience
• Gerontology
• Biomarkers

Background:

• Subjective cognitive decline (SCD) represents a preclinical stage of Alzheimer's disease (AD).
• Factors influencing SCD progression are not fully understood.
• Predictive models for cognitive progression in SCD are needed.

Purpose of the Study:

• To identify risk factors for SCD progression.
• To develop a predictive model for cognitive decline in individuals with SCD.
• To assess the clinical utility of the predictive model.

Main Methods:

• 96 participants with SCD and 36 healthy controls (HCs) were enrolled.
• Clinical, cognitive, and neuroimaging data were collected over approximately 12 months.
• Cox proportional-hazard regression models were used to construct a nomogram.

Main Results:

• SCD participants exhibited poorer sleep quality (higher PSQI scores) and increased cerebral blood flow (CBF) in specific brain regions compared to HCs.
• Poorer sleep quality and lower left precuneus CBF were independently associated with SCD progression.
• The developed nomogram demonstrated good discriminative ability (AUC=0.785) and clinical benefit.

Conclusions:

• A predictive model incorporating Pittsburgh Sleep Quality Index (PSQI) scores and left precuneus CBF accurately predicts SCD progression.
• This model offers valuable insights for early-stage Alzheimer's disease screening.
• The findings highlight the importance of sleep quality and specific neuroimaging markers in AD progression.