Subjective cognitive decline, brain imaging biomarkers, and cognitive functioning in patients with a history of vascular disease: the SMART-Medea study

Abstract We estimated associations of subjective cognitive decline (SCD) with neuro-imaging markers of dementia and cognitive functioning in patients with a history of vascular disease without objective cognitive impairment. Within the SMART-Medea study, 599 patients (62±9 years) had 1.5T brain MRI and cognitive testing at baseline and after 8 years of follow-up. Using multiple regression analyses, we estimated cross-sectional and longitudinal associations of SCD according to research criteria with volumes of total brain, hippocampus, white matter hyperintensities (WMH), and presence of lacunes; and with memory, executive functioning, information processing speed, and working memory. SCD was associated with increased risk of lacunes at baseline (RR=1.48, 95% CI: 1.03; 2.12), but not during follow-up. No significant associations with volumes of WMH, total brain or hippocampus were observed. SCD was cross-sectional associated with poorer executive functioning and speed, but not during follow-up. More prospective studies are needed to further elucidate the relationship between SCD, brain imaging markers, and cognitive decline and the role of SCD in the preclinical stage of Alzheimer’s disease.