阿尔茨海默病（Alzheimer′s disease,AD）是一种常见的老年人慢性神经退行性疾病,而主观认知下降（subjective cognitive decline,SCD）被认为是AD的临床前期症状。早期识别并干预SCD对预防并延缓AD的发生、发展具有重要作用。主观认识下降的影响因素包括人口学因素年龄、婚姻和受教育年限;日常生活习惯中吞咽和咀嚼、睡眠、焦虑抑郁、运动情况与社会及情感支持对主观认知;部分慢性疾病,如口腔疾病、慢性肾脏疾病、心血管疾病也在SCD的发生、发展中起到不同程度的推动作用。SCD筛查、评估方法主要包括影像学检查、体液标志物检查以及神经心理学检查3种。影像学检查为SCD的筛查和评估提供客观数据,然而由于目前其样本量的局限和多为横断面研究,需继续研究。体液标志物检查具有一定的准确性,但其为有创操作,故而推广受限。神经心理学检查具有便捷和低成本的优点,是目前SCD筛查的研究重点,已开发出的针对SCD的特异性筛查评估问卷,其信效度仍有待进一步检验。目前,针对SCD患者的干预措施还非常有限,且缺乏高质量的研究,主要可以分为生活方式改变、认知功能训练和心理健康相关干预。

Alzheimer's disease (AD) is a common chronic neurodegenerative disease in the elderly, and Subjective cognitive decline (SCD) is considered as the pre-clinical stage of AD. Early identification and intervention of SCD play an important role in preventing and delaying the occurrence and development of AD. This article reviews the research progress of influencing factors, evaluation and intervention of SCD. In terms of demographic factors, age, marriage and years of education all affect the occurrence and development of SCD. In our daily habits, swallowing and mastication, sleep, anxiety and depression, exercise and social/emotional support all affected subjective cognition. In addition, some chronic diseases, such as oral diseases, chronic kidney diseases and cardiovascular diseases, play a driving role in the occurrence and development of SCD diseases to varying degrees. The methods of screening and evaluation of SCD mainly include imaging examination, humoral marker examination and neuropsychological examination. Imaging examination provides objective data for the screening and evaluation of SCD. However, due to the limited sample size and mostly cross-sectional studies, more studies are needed. The examination of body fluid marker has certain accuracy, but it has not been spread because of its invasive operation. Neuropsychological examination has the advantages of convenience and low cost, which is the focus of current screening methods. At present, a lot of specific screening assessment questionnaire for SCD has been developed, and further reliability and validity tests need to be carried out. At present, interventions for SCD patients are very limited and lack of high-quality studies, which can be divided into three aspects: lifestyle change, cognitive function training and mental health related interventions, and further intervention studies need to be carried out.