Subjective cognitive decline

Abstract

Subjective cognitive decline (SCD) is a relatively new term for a phenomenon that has been known and acknowlegded for many years. In older literature it was recognized as subjective complaints, known in the 1984 GDS staging as GDS 2, as well as studied in epidemiology research on aging extensively in then 90's. From that reserach it was knwon that people with SCD had a higher likelihood to progress to dementia, were more likely to carry an ApoE4 allel and should be paid attention to and being taken seriously by physicians. The revival of the concept came with the extensive studies on biaomarkers of AD pathology using CSF and imaging. From these studies it became clear that in 10–20% of the cases of SCD, their complaints were caused by the presence of full blown AD pathology. This made the concept of SCD tangible and recognized as the preclinical stage of AD. With the boost in activities around drug development in AD, people with SCD are very interesting candidates to be put in clinical trials, as being the earliest stage of AD in vivo. Meanwhile, operational definitions of SCD have been formulated and clinical recognition made possible, while a plethora of studies have shown which markers determine prgression to dementia. In my talk, I will review all of the above and put them in te context of where we are in drug development of AD.