Is the Discrimination of Subjective Cognitive Decline from Cognitively Healthy Adulthood and Mild Cognitive Impairment Possible? A Pilot Study Utilizing the R4Alz Battery

J Alzheimers Dis. 2020;77(2):715-732. doi: 10.3233/JAD-200562.


Background: The early diagnosis of neurocognitive disorders before the symptoms' onset is the ultimate goal of the scientific community. REMEDES for Alzheimer (R4Alz) is a battery, designed for assessing cognitive control abilities in people with minor and major neurocognitive disorders.

Objective: To investigate whether the R4Alz battery's tasks differentiate subjective cognitive decline (SCD) from cognitively healthy adults (CHA) and mild cognitive impairment (MCI).

Methods: The R4Alz battery was administered to 175 Greek adults, categorized in five groups a) healthy young adults (HYA; n = 42), b) healthy middle-aged adults (HMaA; n = 33), c) healthy older adults (HOA; n = 14), d) community-dwelling older adults with SCD (n = 34), and e) people with MCI (n = 52).

Results: Between the seven R4Alz subtasks, four showcased the best results for differentiating HOA from SCD: the working memory updating (WMCUT-S3), the inhibition and switching subtask (ICT/RST-S1&S2), the failure sets (FS) of the ICT/RST-S1&S2, and the cognitive flexibility subtask (ICT/RST-S3). The total score of the four R4Alz subtasks (R4AlzTot4) leads to an excellent discrimination among SCD and healthy adulthood, and to fare discrimination among SCD and MCI.

Conclusion: The R4Alz battery is a novel approach regarding the neuropsychological assessment of people with SCD, since it can very well assist toward discriminating SCD from HOA. The R4Alz is able to measure decline of specific cognitive control abilities - namely of working memory updating, and complex executive functions - which seem to be the neuropsychological substrate of cognitive complaints in community dwelling adults of advancing age.

Keywords: Cognitive control assessment battery; cognitively healthy adults; mild cognitive impairment; normative data; subjective cognitive decline.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Cognition / physiology*
  • Cognitive Dysfunction / diagnosis*
  • Cognitive Dysfunction / epidemiology
  • Cognitive Dysfunction / psychology*
  • Diagnostic Self Evaluation*
  • Female
  • Greece / epidemiology
  • Humans
  • Male
  • Mental Status and Dementia Tests / standards*
  • Middle Aged
  • Pilot Projects
  • Young Adult