Subjective Cognitive Decline, Brain Imaging Biomarkers, and Cognitive Functioning in Patients with a History of Vascular Disease: the SMART-Medea Study

We estimated associations of subjective cognitive decline (SCD) with neuroimaging markers of dementia and cognitive functioning in patients with a history of vascular disease without objective cognitive impairment. Within the Second Manifestations of ARTerial disease-Memory, depression and aging study, 599 patients (62 ± 9 years) had 1.5 T brain magnetic resonance imaging and cognitive testing at the 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, and presence of lacunes and with memory, executive functioning, information processing speed, and working memory. SCD was associated with increased risk of lacunes at the baseline (relative risk = 1.48, 95% confidence interval: 1.03; 2.12) but not during follow-up. No significant associations with volumes of white matter hyperintensities, total brain, or hippocampus were observed. SCD was cross-sectionally 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.