{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T17:13:33Z","timestamp":1787505213385,"version":"build-2736575974"},"reference-count":225,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2025,12,9]],"date-time":"2025-12-09T00:00:00Z","timestamp":1765238400000},"content-version":"vor","delay-in-days":8,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2025,12,1]],"date-time":"2025-12-01T00:00:00Z","timestamp":1764547200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["alz-journals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Alzheimer's &amp;amp; Dementia"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:label\/>\n                    <jats:p>Subjective cognitive decline (SCD)\u2014self\u2010perceived cognitive worsening without objective deficits\u2014has emerged as a clinically meaningful, potential early manifestation of Alzheimer's disease (AD). Positioned at the intersection of normal aging, neuropsychiatric symptoms, and preclinical neurodegeneration, SCD offers a unique window for early detection and intervention. However, detection heterogeneity, variable prognostic trajectories, and limited equity in assessment hinder its full clinical utility. This position paper synthesizes current evidence on SCD's diagnostic complexity, neurobiological underpinnings, and modifiable influences. We highlight the need for harmonized assessment frameworks, scalable digital tools, inclusive research, and ethically grounded biomarker disclosure practices. Importantly, we advocate for personalized, (non\u2010)pharmacological interventions targeting this early phase. By refining the conceptualization and operationalization of SCD, we can better identify individuals at heightened AD risk and deliver timely, equitable, and meaningful prevention strategies. SCD represents a pivotal inflection point in the dementia continuum\u2014and a call to shift toward proactive brain health.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Highlights<\/jats:title>\n                    <jats:p>\n                      <jats:list list-type=\"bullet\">\n                        <jats:list-item>\n                          <jats:p>Subjective cognitive decline (SCD) may signal early\u2010stage Alzheimer's despite normal test performance.<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>Diagnostic heterogeneity limits current clinical and research utility.<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>Biomarkers and digital tools could enhance risk stratification in SCD.<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>Mental health and social context shape symptom reporting and outcomes.<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>SCD offers a window for tailored (non\u2010drug) preventive interventions.<\/jats:p>\n                        <\/jats:list-item>\n                      <\/jats:list>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/alz.70847","type":"journal-article","created":{"date-parts":[[2025,12,10]],"date-time":"2025-12-10T05:25:04Z","timestamp":1765344304000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Clinical definition, biological characterization, and detection guidelines of subjective cognitive decline due to Alzheimer's disease and related dementia: A position paper from ISTAART SCD PIA"],"prefix":"10.1002","volume":"21","author":[{"given":"Davide Vito","family":"Moretti","sequence":"first","affiliation":[{"name":"IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli Alzheimer Rehabilitation Operative Unit via Pilastroni 4  Brescia Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth","family":"Kuhn","sequence":"additional","affiliation":[{"name":"German Center for Neurodegenerative Diseases (DZNE) Bonn  Bonn Germany"},{"name":"Department of Cognitive Disorders and Old Age Psychiatry University Hospital Bonn  Bonn Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark A.","family":"Dubbelmann","sequence":"additional","affiliation":[{"name":"Center for Alzheimer Research and Treatment Department of Neurology Brigham and Women's Hospital, Harvard Medical School  Boston Massachusetts USA"},{"name":"Department of Neurology Massachusetts General Hospital, Harvard Medical School  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sietske A. M.","family":"Sikkes","sequence":"additional","affiliation":[{"name":"Department of Clinical Faculty of Movement and Behavioral Sciences Neuro\u2010 and Developmental Psychology, Vrije Universiteit Amsterdam  Amsterdam The Netherlands"},{"name":"Alzheimer Center Amsterdam Department of Neurology Amsterdam University Medical Center  Amsterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raphael Machado","family":"Castilhos","sequence":"additional","affiliation":[{"name":"Cognitive and Behavioral Neurology Center Neurology Service, Hospital de Cl\u00ednicas de Porto Alegre  Porto Alegre Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silvia","family":"Chapman","sequence":"additional","affiliation":[{"name":"Cognitive Neuroscience Division Taub Institute for Research on Alzheimer's Disease and the Aging Brain Columbia University Irving Medical Center  New York New York 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