Blood biomarkers confirm subjective cognitive decline (SCD) as a distinct molecular and clinical stage within the NIA-AA framework of Alzheimers disease
Subjective cognitive decline (SCD) is proposed as an indicator of transitional disease stage 2 in the Alzheimer's disease (AD) continuum. However, molecular and particularly longitudinal fluid biomarker data for this stage are still limited. This study aimed to determine whether blood-based biomarkers in amyloid-positive individuals with SCD (A + SCD) support the notion of stage 2 as a distinct stage between stages 1 and 3 of AD and to identify those at high risk for clinical progression. In a prospective multicenter study (DELCODE) involving 457 participants across the AD continuum, we analyzed plasma phospho-tau 181 (p181) and neurofilament light chain (NfL) and assessed their association with longitudinal cognition, hippocampal atrophy, and AD clinical stage transition. The results showed that baseline plasma p181 levels were elevated and increased more rapidly in A + SCD individuals compared to amyloid-positive cognitively unimpaired (A + CU) individuals (stage 1). NfL levels rose across A + CU, A + SCD, and amyloid-positive mild cognitive impairment (A + MCI, stage 3). In A + SCD, but not in A + CU, higher p181 levels predicted cognitive decline (PACC5) and transition to MCI. In conclusion, plasma p181 provides molecular biomarker evidence supporting A + SCD as a pre-dementia AD stage (stage 2) distinct from A + CU (stage 1) and helps identify individuals at risk for cognitive decline early in the AD continuum.
基金:
The DELCODE study is funded by the German Center for Neurodegenerative Diseases (Deutsches Zentrum fr Neurodegenerative Erkrankungen, DZNE), reference number BN012. This work was additionally supported by the Clinician Scientist program "PRECISE.net
Mengel David,Soter Ester,Ott Julia Maren,et al.Blood biomarkers confirm subjective cognitive decline (SCD) as a distinct molecular and clinical stage within the NIA-AA framework of Alzheimer<acute accent>s disease[J].MOLECULAR PSYCHIATRY.2025,doi:10.1038/s41380-025-03021-0.
APA:
Mengel, David,Soter, Ester,Ott, Julia Maren,Wacker, Madeleine,Leyva, Alejandra...&Synofzik, Matthis.(2025).Blood biomarkers confirm subjective cognitive decline (SCD) as a distinct molecular and clinical stage within the NIA-AA framework of Alzheimer<acute accent>s disease.MOLECULAR PSYCHIATRY,,
MLA:
Mengel, David,et al."Blood biomarkers confirm subjective cognitive decline (SCD) as a distinct molecular and clinical stage within the NIA-AA framework of Alzheimer<acute accent>s disease".MOLECULAR PSYCHIATRY .(2025)