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<p><b>Objective.</b> To evaluate the dynamics of cognitive functioning over 15 years in first-degree relatives of patients with Alzheimer’s disease (AD) who had subjective complaints of memory decline but did not receive drug therapy. <b>Materials and methods.</b> The study cohort consisted of 66 first-degree relatives of AD patients (treated at the Mental Health Research Center) with subjective cognitive decline (SCD) who agreed to routine psychometric and in-depth neuropsychological examination and subsequent participation in a prolonged observation program but refused to use any methods of drug intervention. <b>Study.</b> An open 15-year observational study of cognitive functioning in first-degree relatives of AD patients with subjective complaints of memory decline (SCD) was conducted. Baseline measures of cognitive functioning were compared with analogous measures after 5, 10, and 15 years. The following scales were used for psychometric evaluation: Mini Mental State Examination, Montreal Cognitive Assessment Scale, Clock Drawing Test, General Impairment Scale, 10-Word Memory Test, Boston Naming Test, Wechsler Test Subtest 6, Five Geometric Figures Memory Test, Benton Test, Sound and Categorical Association subtest, and Munsterberg test, a rapid method for assessing the memory and intellectual domains in old age with quantitative and qualitative assessment of cognitive functions (the “express method”). <b>Results.</b> This prospective study of a cohort of first-degree relatives of patients with AD who had subjective complaints of cognitive dysfunction showed a high risk of subsequent deterioration in the cognitive domain, to the level of dementia. After five years of follow-up, mild cognitive impairment (MCI) syndrome developed in 16.7% of patients. By study year 10, MCI syndrome was diagnosed in 42.4% of cases and AD was diagnosed in 7.6%; no progression of the clinical condition occurred in 50.0%. By the 15th year of observation, 30.3% of patients were diagnosed with AD dementia, 34.85% with MCI syndrome; the condition remained at the SCD level in 34.85% of cases. <b>Conclusions.</b> The results of a 15-year study of the cognitive domain in first-degree relatives of AD patients with SCD who did not receive preventive therapy showed significant decreases in measures of cognitive functioning with a fairly high rate of conversion to MCI and/or AD dementia. Further analysis of a set of demographic, clinical, neuropsychological, and other risk factors for the development of dementia due to AD will allow us to formulate a concept for determining the hereditary risk of progression of SCD and use this as the basis for development of personalized approaches to preventing dementia in individuals with a genetic risk of AD.</p>

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Dynamics of Subjective Cognitive Decline in First-Degree Relatives of Patients with Alzheimer’s Disease: Results of a 15-Year Prospective Study

  • 期刊论文

  • 发表日期：

    2025年9月11日

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  • N. D. Selezneva,
  • I. F. Roshchina,
  • I. V. Kolykhalov,
  • S. I. Gavrilova

摘要

Objective. To evaluate the dynamics of cognitive functioning over 15 years in first-degree relatives of patients with Alzheimer’s disease (AD) who had subjective complaints of memory decline but did not receive drug therapy. Materials and methods. The study cohort consisted of 66 first-degree relatives of AD patients (treated at the Mental Health Research Center) with subjective cognitive decline (SCD) who agreed to routine psychometric and in-depth neuropsychological examination and subsequent participation in a prolonged observation program but refused to use any methods of drug intervention. Study. An open 15-year observational study of cognitive functioning in first-degree relatives of AD patients with subjective complaints of memory decline (SCD) was conducted. Baseline measures of cognitive functioning were compared with analogous measures after 5, 10, and 15 years. The following scales were used for psychometric evaluation: Mini Mental State Examination, Montreal Cognitive Assessment Scale, Clock Drawing Test, General Impairment Scale, 10-Word Memory Test, Boston Naming Test, Wechsler Test Subtest 6, Five Geometric Figures Memory Test, Benton Test, Sound and Categorical Association subtest, and Munsterberg test, a rapid method for assessing the memory and intellectual domains in old age with quantitative and qualitative assessment of cognitive functions (the “express method”). Results. This prospective study of a cohort of first-degree relatives of patients with AD who had subjective complaints of cognitive dysfunction showed a high risk of subsequent deterioration in the cognitive domain, to the level of dementia. After five years of follow-up, mild cognitive impairment (MCI) syndrome developed in 16.7% of patients. By study year 10, MCI syndrome was diagnosed in 42.4% of cases and AD was diagnosed in 7.6%; no progression of the clinical condition occurred in 50.0%. By the 15th year of observation, 30.3% of patients were diagnosed with AD dementia, 34.85% with MCI syndrome; the condition remained at the SCD level in 34.85% of cases. Conclusions. The results of a 15-year study of the cognitive domain in first-degree relatives of AD patients with SCD who did not receive preventive therapy showed significant decreases in measures of cognitive functioning with a fairly high rate of conversion to MCI and/or AD dementia. Further analysis of a set of demographic, clinical, neuropsychological, and other risk factors for the development of dementia due to AD will allow us to formulate a concept for determining the hereditary risk of progression of SCD and use this as the basis for development of personalized approaches to preventing dementia in individuals with a genetic risk of AD.