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A Metadata Extraction Approach for Clinical Case Reports to Enable Advanced Understanding of Biomedical Concepts
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Clinical Manifestations.

Yi Jin Leow1, Justin Jit Hong Ong2, Nagaendran Kandiah2

  • 1nil, nil, nil, Nicaragua.

Alzheimer'S & Dementia : the Journal of the Alzheimer'S Association
|December 26, 2025
PubMed
Summary
This summary is machine-generated.

Subjective Cognitive Decline (SCD) patients with both amyloid and vascular issues show the worst cognitive decline. Amyloid positivity alone may cause early emotional changes, highlighting SCD as a critical preclinical stage for intervention.

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Area of Science:

  • Neurology
  • Neuroscience
  • Gerontology

Background:

  • Subjective Cognitive Decline (SCD) is a key early phase of Alzheimer's disease (AD).
  • Understanding SCD mechanisms is vital for early Alzheimer's intervention.
  • This study examines amyloid pathology, cerebrovascular burden, and cognitive-behavioral phenotypes in SCD.

Purpose of the Study:

  • Investigate the combined impact of amyloid and vascular pathology on cognitive and behavioral outcomes in SCD.
  • Delineate preclinical Alzheimer's disease trajectories using fluid biomarkers, neuroimaging, and neuropsychological tests.
  • Identify distinct patterns associated with different combinations of amyloid and vascular burden.

Main Methods:

  • Stratified 270 cognitively normal individuals with SCD into four groups based on amyloid-beta (Aβ42/40) and vascular burden (Fazekas score).
  • Utilized ANOVA and chi-square tests to analyze group differences.
  • Assessed cognitive function (MoCA, ROCF, TMT-B), biomarkers (GFAP, p-tau181/Aβ42), neuroimaging (Fazekas, lacunes, atrophy), and behavioral aspects (DASS, MBI-C).

Main Results:

  • The amyloid-positive/vascular-positive (A+V+) group was oldest and showed the most severe cognitive impairments (global, visuospatial, executive function).
  • Vascular-positive groups had higher prevalence of cardiovascular risk factors and neuroimaging markers of cerebrovascular disease.
  • Amyloid positivity alone (A+V-) was associated with elevated stress and apathy, and higher GFAP levels.

Conclusions:

  • Coexisting amyloid and vascular pathology in SCD synergistically worsen cognitive function.
  • Amyloid positivity alone may contribute to early emotional and behavioral changes in SCD.
  • Integrating cognitive, biomarker, and behavioral assessments in SCD is crucial for identifying high-risk individuals and guiding interventions.