TY - JOUR AU - Moretti, Davide Vito AU - Kuhn, Elizabeth AU - Dubbelman, Mark AU - Sam, Sikkes AU - Raphael Machado, Castilhos AU - Chapman, Silvia AU - Gifford, Katie AU - Butterbrod, Elke AU - Nosheny, Rachel TI - 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 JO - Alzheimer's and dementia VL - 21 IS - 12 SN - 1552-5260 CY - Hoboken, NJ PB - Wiley M1 - DZNE-2025-01352 SP - e70847 PY - 2025 AB - Subjective cognitive decline (SCD)—self-perceived cognitive worsening without objective deficits—has 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-)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—and a call to shift toward proactive brain health. LB - PUB:(DE-HGF)16 DO - DOI:10.1002/alz.70847 UR - https://pub.dzne.de/record/282594 ER -