A Longitudinal Study on Memory Enhancement in Subjective Cognitive Decline Patients: Clinical and Neuroimaging Perspectives

Article type: Research Article

Authors: Na, Seunghee^a | Lee, Chonghwee^b | Ho, SeongHee^c | Hong, Yun Jeong^d | Jeong, Jee Hyang^e | Park, Kee Hyung^f | Kim, SangYun^g | Wang, Min Jeong^h | Choi, Seong Hyeⁱ | Han, SeungHyun^j | Kang, Seung Wan^{k; l} | Kang, Sungmin^m | Yang, Dong Won^b

Affiliations: [a] Department of Neurology, College of Medicine, The Catholic University of Korea, Incheon St. Mary’s Hospital, Incheon, South Korea | [b] Department of Neurology, College of Medicine, The Catholic University of Korea, Seoul St. Mary’s Hospital, Seoul, South Korea | [c] Department of Neurology, Hanyang University Hanmaeum Changwon Hospital, Changwon, Korea | [d] Department of Neurology, College of Medicine, The Catholic University of Korea, Uijeongbu St. Mary’s Hospital, Uijeongbu, South Korea | [e] Department of Neurology, Ewha Womans University Mokdong Hospital, Ewha Womans University School of Medicine, Seoul, South Korea | [f] Department of Neurology, Gachon University Gil Hospital, Incheon, South Korea | [g] Department of Neurology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea | [h] Roa Neurology Clinic, Seongnam, South Korea | [i] Department of Neurology, Inha University School of Medicine, Incheon, South Korea | [j] ROWAN Inc. Seoul, South Korea | [k] Data Center for Korean EEG, College of Nursing, Seoul National University, Seoul, South Korea | [l] iMediSync Inc. Seoul, South Korea | [m] Research and Development, PeopleBio Inc., Seongnam-si, Gyeonggi-do, South Korea

Correspondence: [*] Correspondence to: Dong Won Yang, MD, PhD, Department of Neurology, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul 06591, Republic of Korea. E-mail: [email protected].

Abstract: Background:Subjective cognitive decline (SCD) refers to the self-reported persistent cognitive decline despite normal objective testing, increasing the risk of dementia compared to cognitively normal individuals. Objective:This study aims to investigate the attributes of SCD patients who demonstrated memory function improvement. Methods:In this prospective study of SCD, a total of 120 subjects were enrolled as part of a multicenter cohort study aimed at identifying predictors for the clinical progression to mild cognitive impairment or dementia (CoSCo study). All subjects underwent 18F-florbetaben PET and brain MRI scans at baseline and annual neuropsychological tests. At the 24-month follow-up, we classified SCD patients based on changes in memory function, the z-score of the Seoul verbal learning test delayed recall. Results:Of the 120 enrolled patients, 107 successfully completed the 24-month follow-up assessment. Among these, 80 patients (74.8%) with SCD exhibited memory function improvements. SCD patients with improved memory function had a lower prevalence of coronary artery disease at baseline and performed better in the trail-making test part B compared to those without improvement. Anatomical and biomarker analysis showed a lower frequency of amyloid PET positivity and larger volumes in the left and right superior parietal lobes in subjects with improved memory function. Conclusions:Our prospective study indicates that SCD patients experiencing memory improvement over a 24-month period had a lower amyloid burden, fewer cardiovascular risk factors, and superior executive cognitive function. Identifying these key factors associated with cognitive improvement may assist clinicians in predicting future memory function improvements in SCD patients.

Keywords: Alzheimer’s disease, cohort study, improvement, memory, subject cognitive decline

DOI: 10.3233/JAD-230667

Journal: Journal of Alzheimer's Disease, vol. 97, no. 1, pp. 193-204, 2024