SUBJECTIVE COGNITIVE DECLINE was associated with a high burden of modifiable dementia risk factors, according to new real-world data from a Brain Health Service cohort.
Researchers analysed baseline data from 186 consecutive individuals attending a Brain Health Service, including 132 individuals with subjective cognitive decline.
The study aimed to characterise the population and investigate differences according to plasma p-Tau217 status, a blood biomarker associated with amyloid pathology.
Among participants with subjective cognitive decline, the most common potentially modifiable dementia risk factors were sleep impairment (70%), smoking (51%), physical inactivity (50%), and hypertension (46%).
Researchers also found a positive relationship between cumulative dementia risk and the number of modifiable risk factors present.
These findings highlight the substantial opportunity for preventive interventions in individuals seeking assessment for cognitive concerns before objective impairment becomes evident.
Among 84 participants with subjective cognitive decline who underwent plasma biomarker testing, 27 (32%) had plasma p-Tau217 concentrations at or above 0.15 pg/mL.
This group was older and demonstrated poorer performance on cognitive screening despite remaining within the normal range overall.
Participants with elevated plasma p-Tau217 also showed higher concentrations of glial fibrillary acidic protein and other biomarkers associated with neurodegenerative processes.
Neuroimaging findings further revealed greater global cortical atrophy and parietal cortical atrophy in this group.
Cluster analysis identified two distinct profiles. One cluster was characterised by lower biological and modifiable risk alongside stronger cognitive performance.
The second cluster included older individuals with higher biomarker levels, greater dementia risk burden, and lower cognitive scores.
Researchers also assessed responses to disclosure of biomarker and dementia risk information in 42 participants with subjective cognitive decline.
Most individuals reported that the process was informative and useful, and satisfaction scores were high regardless of biomarker status.
Around two thirds of participants reported increased motivation to adopt lifestyle changes following disclosure.
Although individuals with elevated p-Tau217 demonstrated slightly higher event related distress scores, no significant differences were observed in anxiety or depression outcomes compared with participants with lower biomarker levels.
The researchers concluded that elevated plasma biomarkers may identify individuals with subjective cognitive decline who already exhibit biological and structural hallmarks of early neurodegeneration.
They also reported that structured biomarker disclosure was feasible and generally well tolerated, supporting the integration of plasma biomarkers into Brain Health Services alongside personalised dementia prevention strategies.
Reference
Pozzi FE et al. Dementia risk factors and biomarkers in subjective cognitive decline: real world evidence from the monza brain health service. Neurol Sci. 2026;DOI:10.1007/s10072-026-09426-1.
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