Towards the development of a management protocol for Subjective Cognitive Decline: insights from a cross-sectional and longitudinal analyses of multimodal data from a memory clinic
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Introduction
Subjective cognitive decline (SCD) is considered as an early symptomatic stage of Alzheimer’s disease (AD). This study aimed to develop a management protocol for SCD based on cross-sectional and longitudinal analyses.
Methods
We enrolled 440 SCD patients who underwent neurological and neuropsychological assessments, MRI scans, APOE genotyping, and AD biomarker evaluations. Patients were followed for a median of 10 years.
Results
A link was observed between SCD severity, insomnia, and benzodiazepine use. Aβ pathology was identified in 35% of cases. During follow-up, 87 patients progressed to mild cognitive impairment or dementia. The multi-modal clinical profile of each patient was processed by a machine learning model, predicting progression with 74% accuracy and providing a hierarchy of importance of features predicting progression.
Discussion
Our findings support the development of a personalized clinical management protocol for SCD that considers demographic, clinical, cognitive and biological factors for both baseline characterization and prognostic purposes.
