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Volume 15
Issue 17
10.3390/diagnostics15172158
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This is an early access version, the complete PDF, HTML, and XML versions will be available soon.
Article

Early Detection of Cognitive Decline: Executive Functioning Index R4Alz-pc Predicts Memory-Related Concerns in Community Adults

by
Eudokia Emmanouilidou
1,*,
Despina Moraitou
1,2,
Nikoleta Frantzi
1,
Eleni Poptsi
2,3,
Emmanouil Tsardoulias
4,
Andreas L. Symeonidis
4,
Georgia Papantoniou
5,
Maria Sofologi
5,
Elvira Masoura
1,
Glykeria Tsentidou
1,2,3,
Ioanna-Giannoula Katsouri
6 and
Magda Tsolaki
2,3,*
1
Laboratory of Psychology, Department of Cognition, Brain and Behavior, School of Psychology, Aristotle University of Thessaloniki (AUTh), 54124 Thessaloniki, Greece
2
Laboratory of Neurodegenerative Diseases, Center for Interdisciplinary Research and Innovation, Aristotle University of Thessaloniki (CIRI—AUTh), 54124 Thessaloniki, Greece
3
Greek Association of Alzheimer’s Disease and Related Disorders (GAADRD), Petrou Sindika 13 Str., 54643 Thessaloniki, Greece
4
School of Electrical and Computer Engineering, Faculty of Engineering, Aristotle University of Thessaloniki (AUTh), 54124 Thessaloniki, Greece
5
Laboratory of Psychology, Department of Early Childhood Education, School of Education, University of Ioannina, 45110 Ioannina, Greece
6
Department of Occupational Therapy, Faculty of Health and Caring Sciences, University of West Attica, 12243 Athens, Greece
*
Authors to whom correspondence should be addressed.
Diagnostics 2025, 15(17), 2158; https://doi.org/10.3390/diagnostics15172158
Submission received: 6 July 2025 / Revised: 22 August 2025 / Accepted: 23 August 2025 / Published: 26 August 2025
(This article belongs to the Special Issue Neurological Diseases: Novel Biomarkers for Diagnosis and Management)
Versions Notes

Abstract

Background/Objectives: Early identification of preclinical Alzheimer’s disease (AD) is critically important. This study investigates whether early cognitive decline in preclinical AD can be detected through the executive functioning index R4Alz-pc by predicting memory-related worry and negative affect. Methods: A sample of 105 cognitively healthy, community-dwelling older adults (M = 59.25 years) completed the Multifactorial Memory Questionnaire (MMQ) and the R4Alz-pc index battery. Results: Lower performance on the R4Alz-pc index was significantly associated with increased negative affect related to memory. Mediation analysis indicated that memory-related worry mediated the relationship between executive dysfunction and negative affect. Conclusions: This study highlights the importance of early, objective cognitive assessment using easy-to-administer and non-invasive tools like the R4Alz-pc, enabling timely detection and intervention for preclinical AD. Such methods may reduce reliance on costly biomarker-based diagnostics.
Keywords: affect about memory; Alzheimer’s disease (AD); executive functions; memory concerns; memory worry; mild cognitive impairment (MCI); preclinical Alzheimer’s disease (pcAD); subjective cognitive decline (SCD) affect about memory; Alzheimer’s disease (AD); executive functions; memory concerns; memory worry; mild cognitive impairment (MCI); preclinical Alzheimer’s disease (pcAD); subjective cognitive decline (SCD)

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MDPI and ACS Style

Emmanouilidou, E.; Moraitou, D.; Frantzi, N.; Poptsi, E.; Tsardoulias, E.; Symeonidis, A.L.; Papantoniou, G.; Sofologi, M.; Masoura, E.; Tsentidou, G.; et al. Early Detection of Cognitive Decline: Executive Functioning Index R4Alz-pc Predicts Memory-Related Concerns in Community Adults. Diagnostics 2025, 15, 2158. https://doi.org/10.3390/diagnostics15172158

AMA Style

Emmanouilidou E, Moraitou D, Frantzi N, Poptsi E, Tsardoulias E, Symeonidis AL, Papantoniou G, Sofologi M, Masoura E, Tsentidou G, et al. Early Detection of Cognitive Decline: Executive Functioning Index R4Alz-pc Predicts Memory-Related Concerns in Community Adults. Diagnostics. 2025; 15(17):2158. https://doi.org/10.3390/diagnostics15172158

Chicago/Turabian Style

Emmanouilidou, Eudokia, Despina Moraitou, Nikoleta Frantzi, Eleni Poptsi, Emmanouil Tsardoulias, Andreas L. Symeonidis, Georgia Papantoniou, Maria Sofologi, Elvira Masoura, Glykeria Tsentidou, and et al. 2025. "Early Detection of Cognitive Decline: Executive Functioning Index R4Alz-pc Predicts Memory-Related Concerns in Community Adults" Diagnostics 15, no. 17: 2158. https://doi.org/10.3390/diagnostics15172158

APA Style

Emmanouilidou, E., Moraitou, D., Frantzi, N., Poptsi, E., Tsardoulias, E., Symeonidis, A. L., Papantoniou, G., Sofologi, M., Masoura, E., Tsentidou, G., Katsouri, I.-G., & Tsolaki, M. (2025). Early Detection of Cognitive Decline: Executive Functioning Index R4Alz-pc Predicts Memory-Related Concerns in Community Adults. Diagnostics, 15(17), 2158. https://doi.org/10.3390/diagnostics15172158

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