Hong Yun Jeong, Choi Seong Hye, Kim SangYun, Jeong Jee Hyang, Park Kee Hyung, Wang Min Jeong, Kang Sungmin, Yang Dong Won
Neurology, Uijeongbu St. Mary's Hospital, The Catholic University of Korea, Seoul, Republic of Korea.
Neurology, Inha University College of Medicine, Incheon, Republic of Korea.
Alzheimers Dement. 2025 Feb;21(2):e14473. doi: 10.1002/alz.14473. Epub 2024 Dec 28.
Alzheimer's disease (AD) is now diagnosed biologically. Since subjective cognitive decline (SCD) may indicate preclinical AD, assessing AD-biomarkers is crucial. We investigated cognitive and neurodegenerative trajectories in SCD over 24 months based on biomarker positivity, and evaluated the predictive value of plasma biomarkers.
The CoSCo prospective cohort included older adults with SCD. Participants were categorized into high- and low-risk groups based on plasma biomarkers (amyloid beta [Aβ] 42/40, phosphorylated tau 181 [p-tau181], and glial fibrillary acidic protein [GFAP]), and magnetic resonance imaging (MRI) findings to compare outcomes.
High-risk SCDs (n = 23, 23%) revealed greater decline in general cognition, memory recall, frontal function, and hippocampal volumes compared to low-risk SCDs. Combined scores of plasma and MRIs yielded the best predictions compared with other biomarker categories.
SCD participants with high-risk experience faster cognitive and neurodegenerative declines. A combination of plasma biomarkers and MRIs could be used for screening and prognosis.
This is part of a multicenter prospective cohort study in Korea. We investigated cognitive and atrophic trajectories in SCD over 24 months. High risk SCDs revealed greater cognitive decline and hippocampal atrophy. Integration of plasma and MRIs yielded better predictions than other categories. Risk stratification using plasma and MRIs can be used for screening and prognosis.
阿尔茨海默病（AD）目前通过生物学手段进行诊断。由于主观认知衰退（SCD）可能预示着临床前AD，因此评估AD生物标志物至关重要。我们基于生物标志物阳性情况，对SCD患者24个月内的认知和神经退行性轨迹进行了研究，并评估了血浆生物标志物的预测价值。
CoSCo前瞻性队列研究纳入了患有SCD的老年人。根据血浆生物标志物（淀粉样β蛋白[Aβ]42/40、磷酸化tau蛋白181[p-tau181]和胶质纤维酸性蛋白[GFAP]）以及磁共振成像（MRI）结果，将参与者分为高风险组和低风险组，以比较结果。
与低风险SCD患者相比，高风险SCD患者（n = 23，23%）在总体认知、记忆回忆、额叶功能和海马体积方面的衰退更为明显。与其他生物标志物类别相比，血浆和MRI的综合评分预测效果最佳。
具有高风险的SCD参与者经历更快的认知和神经退行性衰退。血浆生物标志物和MRI的组合可用于筛查和预后评估。
这是韩国一项多中心前瞻性队列研究的一部分。我们研究了SCD患者24个月内的认知和萎缩轨迹。高风险SCD患者显示出更明显的认知衰退和海马萎缩。血浆和MRI的综合应用比其他类别产生了更好的预测效果。使用血浆和MRI进行风险分层可用于筛查和预后评估。
