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Amyloid and SCD jointly predict cognitive decline across Chinese and German cohorts.

Alzheimer's & dementia : the journal of the Alzheimer's Association

Authors: Kai Shao, Xiaochen Hu, Luca Kleineidam, Melina Stark, Slawek Altenstein, Holger Amthauer, Henning Boecker, Ralph Buchert, Katharina Buerger, Michaela Butryn, Yanning Cai, Yue Cai, Nicoleta Carmen Cosma, Guanqun Chen, Zhigeng Chen, Marcel Daamen, Alexander Drzezga, Emrah Düzel, Markus Essler, Michael Ewers, Klaus Fliessbach, Florian C Gaertner, Wenzel Glanz, Tengfei Guo, Niels Hansen, Beiqi He, Daniel Janowitz, Ingo Kilimann, Bernd J Krause, Guoyu Lan, Catharina Lange, Christoph Laske, Yuxia Li, Ruixian Li, Lin Liu, Jie Lu, Fansheng Meng, Matthias H Munk, Oliver Peters, Robert Perneczky, Josef Priller, Alfredo Ramirez, Boris-Stephan Rauchmann, Matthias Reimold, Axel Rominger, Ayda Rostamzadeh, Nina Roy-Kluth, Anja Schneider, Annika Spottke, Eike Jakob Spruth, Pan Sun, Stefan Teipel, Xiao Wang, Min Wei, Yongzhe Wei, Jens Wiltfang, Shaozhen Yan, Jie Yang, Xianfeng Yu, Mingkai Zhang, Liang Zhang, Michael Wagner, Frank Jessen, Ying Han, Elizabeth Kuhn

INTRODUCTION: Subjective cognitive decline (SCD) in amyloid-positive (Aβ+) individuals was proposed as a clinical indicator of Stage 2 in the Alzheimer's disease (AD) continuum, but this requires further validation across cultures, measures, and recruitment strategies.

METHODS: Eight hundred twenty-one participants from SILCODE and DELCODE cohorts, including normal controls (NC) and individuals with SCD recruited from the community or from memory clinics, underwent neuropsychological assessments over up to 6 years. Amyloid positivity was derived from positron emission tomography or plasma biomarkers. Global cognitive change was analyzed using linear mixed-effects models.

RESULTS: In the combined and stratified cohorts, Aβ+ participants with SCD showed steeper cognitive decline or diminished practice effects compared with NC or Aβ- participants with SCD. These findings were confirmed using different operationalizations of SCD and amyloid positivity, and across different SCD recruitment settings.

DISCUSSION: Aβ+ individuals with SCD in German and Chinese populations showed greater global cognitive decline and could be targeted for interventional trials.

HIGHLIGHTS: SCD in amyloid-positive (Aβ+) participants predicts a steeper cognitive decline. This finding does not rely on specific SCD or amyloid operationalization. This finding is not specific to SCD patients recruited from memory clinics. This finding is valid in both German and Chinese populations. Aβ+ older adults with SCD could be a target population for interventional trials.

© 2024 The Author(s). Alzheimer's & Dementia published by Wiley Periodicals LLC on behalf of Alzheimer's Association.

PMID: 39072956

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