Early diagnosis of Lewy body disease in elderly individuals with subjective cognitive decline

      Many previous clinical trials, including anti-amyloid therapy, showed no benefit to patients with symptomatic Alzheimer's disease (AD). These results imply that therapies should be initiated during earlier stages of AD pathology. Thus, the research focus of identifying individuals with an underlying pathophysiology of AD is shifting to the prodromal or pre-mild cognitive impairment (MCI) stage, where cognitive performance levels are still in the normal range. Because subjective cognitive decline (SCD) has been suggested to be a possible first symptomatic manifestation of AD, research attention has been increasingly focused on SCD as a risk factor for incident AD dementia. The conceptual framework on SCD in pre-MCI was published by the International Working Group in 2014 [
      • Jessen F.
      • Amariglio R.E.
      • van Boxtel M.
      • Breteler M.
      • Ceccaldi M.
      • Chételat G.
      • et al.
      A conceptual framework for research on subjective cognitive decline in preclinical Alzheimer's disease.
      ], and a multicenter follow-up study of individuals with SCD has recently been reported. Although research criteria for SCD were defined in the context of prodromal AD, it is of note that approximately one-third of incident dementia in individuals with SCD has been ultimately diagnosed as non-AD in memory clinics based on findings of the multicenter study (mean follow-up period: 3.5 ± 2.3 years) [
      • Slot R.E.R.
      • Sikkes S.A.M.
      • Berkhof J.
      • Brodaty H.
      • Buckley R.
      • Cavedo E.
      • et al.
      Subjective cognitive decline and rates of incident Alzheimer's disease and non- Alzheimer's disease dementia.
      ]. Considering the disease heterogeneity underlying SCD, it is of considerable importance to identify the specific pathological basis in individuals with SCD in terms of the administration of disease-modifying therapeutics.

      Keywords

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