Deciphering the Prodrome: Synergistic Amyloid and Vascular Pathologies in Subjective Cognitive Decline – Insights from the Southeast Asian BIOCIS Study

This study highlights the impact of coexisting amyloid and vascular pathology in SCD, demonstrating that cognitive, structural, and behavioral differences between pathologies. A+V+ individuals exhibited the most severe cognitive impairments, underscoring the synergistic effects of amyloid and vascular burden. Meanwhile, behavioral findings suggest that amyloid positivity alone, as observed in A+V-, may drive early emotional changes, potentially reflecting neural network disruptions associated with amyloid deposition. The findings reinforce SCD as a key preclinical stage where integrating cognitive, biomarker, and behavioral assessments can help identify high-risk individuals. Targeted interventions addressing vascular risk and neuropsychiatric symptoms may offer opportunities to slow progression to dementia.