Panorama geral do declínio cognitivo subjetivo no Brasil: uma revisão narrativa

Soares, Isabele Sessa; Studart-Neto, Adalberto; Brucki, Sonia Maria Dozzi

doi:10.1590/1980-5764-DN-2025-0416

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View and Review • Dement. neuropsychol. 20 • 2026 • https://doi.org/10.1590/1980-5764-DN-2025-0416 linkcopiar

Panorama geral do declínio cognitivo subjetivo no Brasil: uma revisão narrativa

Autoria SCIMAGO INSTITUTIONS RANKINGS

O Declínio Cognitivo Subjetivo (DCS) é caracterizado pela autopercepção de piora cognitiva por parte do indivíduo, sem que haja prejuízo funcional e confirmação objetiva em testes neuropsicológicos. O DCS tem sido estudado como um possível marcador clínico de estágios iniciais de doenças neurodegenerativas, em especial a Doença de Alzheimer (DA). O presente artigo é uma revisão narrativa da literatura disponível sobre o contexto do DCS no Brasil, abrangendo aspectos conceituais, realização de diagnóstico, etiologias, medidas avaliativas utilizadas no país, evolução de casos, dados epidemiológicos e preditores de progressão. Foram também elaboradas propostas para avaliação e acompanhamento clínico dos pacientes com DCS. Embora haja crescente interesse científico acerca do tema, ainda há lacunas na abordagem clínica do DCS e escassez de dados nacionais e de ferramentas específicas validadas para a população brasileira.

Palavras-chave:
Cognição; Disfunção Cognitiva; Memória; Fatores de Risco; Demência; Envelhecimento

Study	Test	Population studied	Education (years), mean (SD)		Frequency of complaint individuals (%)	Male (%)		Female (%)		SCD group
Study	Test	Population studied	Total sample	Complaint group	Frequency of complaint individuals (%)	Total sample (%)	Complaint group	Total sample (%)	Complaint group (%)	SCD group
Almeida¹⁸	Single question	220	—	—	59.1	30.4	28.50	69.6	71.5	No
Mattos et al.¹⁹	MAC-Q and single question	71	10.5	—	53.5	11	—	89	—	No
Argimon and Stein²⁰	MAC-Q	66	2.54 (2.61)	—	—	23.9	—	76.1	—	No
Benites and Gomes²¹	MAC-Q and PRMQ	642	13,82 (3.02)	—	—	37	—	63	—	No
Minett et al.²²	MAC-Q and questions to the patient	114	—	8.8	21	22.8	12	77.2	88	No
Caramelli and Beato²³	MAC-Q	60	8.5 (5.5)	8.2 (5.6)	55	35	24.2	65	75.8	No
Lindôso²⁴	MAC-Q	51	—	—	—	19.6	—	80.4	—	No
Lima-Silva and Yassuda²⁵	MAC-Q and Forgetfulness frequency scale	57	—	—	—	12.3	—	87.7	—	No
Brucki and Nitrini²⁶	Single question	163	0.83 (1.55)	0.7 (1.3)	69.9	49.7	43.9	50.3	56.1	No
Paulo and Yassuda²⁷	MAC-Q	67	—	—	—	10.5	—	89.5	—	No
Aguiar et al.²⁸	Single question	28	—	—	50	35.7	28.6	64.3	71.4	No
Kasai et al.²⁹	SMC-scale	26	—	—	100	0	0	100	100	No
Piauilino et al.³⁰	PRMQ	664	—	—	—	51.4	—	48.6	—	No
Santos et al.³¹	MAC-Q	204	—	8.5 (4.4)	49	23.5	24	76.5	76	No
Vale et al.³²	MCS	161	4.6 (3.2)	—	—	41	—	59	—	No
Brum et al.³³	MAC-Q and single question	56	—	—	—	35.7	—	64.3	—	No
Jacinto et al.³⁴	Single question	248	—	—	59.3	—	—	---	—	No
Argimon et al.³⁵	MAC-Q	121	3 (2.73)	—	—	31.4	—	68.6	—	No
Andrade and Novelli³⁶	MAC-Q	90	—	—	71.11	4.4	—	95.5	—	No
Gil et al.³⁷	Sunderland everyday memory questionnaire	79	—	—	100	24.1	—	75.9	—	No
Bourscheid et al.³⁸	Single question	152	12.82 (4.23)	—	48.70	9.2	—	90.8	—	No
Bernardes et al.³⁹	MAC-Q	386	—	—	35.7	4.1	—	95.9	—	No
Rizzi et al.⁴⁰	Single question	45	—	11	26.7	28.9	25	71.1	75	Yes
Almeida et al.⁴¹	MCS (version A)	83	—	5.4 (4.0)	41	32.5	26.5	67.5	73.5	Yes
Dalpubel et al.⁴²	MCS (version A)	100	5.12 (4.21)	5.4 (3.6)	45	32	24.4	68	75.6	No
Pereira et al.¹¹	MAC-Q and single question	91	—	—	15	26.4	46.7	73.6	53.3	Yes
Studart-Neto et al.¹⁵	CFI	72	—	16.0 (5.0)	62.5	33.3	—	66.7	—	Yes
César-Freitas et al.¹⁷	Not specified	290	—	—	32.8	31.4	—	68.6	—	No
Borelli et al. (2022)¹⁰	Questions to the patient	6.687	—	4.8 (3.9)	37	47.5	43.1	52.5	56.9	Yes
César-Freitas et al.¹³	Question to the patient and the informant	215	—	—	40	—	—	—	—	Yes
Merlin and Brucki¹⁴	Not specified	65	12 (4.8)	—	30.77	35.38	—	64.62	—	Yes
Pereira et al.¹⁰	MAC-Q	57	5.49 (4.0)	—	31.6	19.3	—	80.7	—	Yes
Rochetti et al.¹⁶	MCS	71	—	14 (4.0)	23.9	—	35.3	—	64.7	Yes

Test	Number of items	Score minimum maximum	Observation	Cognitive domains assessed (number of items)	Strengths	Weaknesses	Number of studies using the test
MAC-Q	6	7–35 points	Self-reported questions with scores ranging from 1 to 5 points each, with the last question scoring twice. A score of 25 points or higher indicates memory problems	Episodic memory (5), attention (1) and language (1)	Short questionnaire	Without validation and translation into Portuguese	15
Single question	1	Objective question: "Yes" or "No"	Example: "Do you have memory problems?"	Episodic memory	Quick and easy-to apply assessment	Influenced by level of education, low reliability and no validation and translation into Portuguese	12
PRMQ	16	16–80 points	Self-reported questions scored from 1 to 5 points each. High scores reflect high self-reported memory problems	Episodic memory (16) and attention (5)	Validation and translation into Portuguese and evaluation of short term or long-term prospective and retrospective memory	Long application time	2
SMC-Scale	10	0–21 points	Questions with scores ranging from "No"=0 to "Yes"=1–3 points, with some scoring lower than others. The cutoff score is 3 points. A high score reflects a high rate of self-reported memory problems	Episodic memory (5), attention (2), language (2), orientation (2), processing speed (1)	Easy to understand	Without validation and translation into Portuguese	1
MCS	14 (7 for the patient and 7 for the companion)	0–14 points	Questions with scores ranging from 0 to 2 points each. Memory complaint: mild (3–6 points), moderate (7–10 points), severe (1–14 points)	Episodic memory (6), attention (1), activities of daily living (1)	Validation for the Portuguese language and questionnaire answered by the companion as well, useful for SCD-plus classification	Significant abstractness in the questions and validity analysis limited to internal consistency	3
CFI	14 (one version for the patient and the other for the companion)	0–14 points	Possible answers are "No"=0 , "Maybe"= 0.5, "Yes"=1 point and "Does not apply"	Memory, orientation, language and activities of daily living	Validation and translation for the Portuguese language and questionnaire answered by the companion as well, useful for SCD-plus classification	Influenced by the level of education and no consensus on the cutoff score	1

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Academia Brasileira de Neurologia, Departamento de Neurologia Cognitiva e Envelhecimento R. Vergueiro, 1353 sl.1404 - Ed. Top Towers Offices, Torre Norte, São Paulo, SP, Brazil, CEP 04101-000, Tel.: +55 11 5084-9463 | +55 11 5083-3876 - São Paulo - SP - Brazil
E-mail: revistadementia@abneuro.org.br | demneuropsy@uol.com.br

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[T1FN1] Abbreviations: SD, Standard Deviation; MAC-Q, Memory Assessment Questionnaire; PRMQ, Prospective and Retrospective Memory Questionnaire; SMC-Scale, Subjective Memory Complaint Scale; MCS, Memory Complaint Scale; CFI, Cognitive Function Instrument; SCD, subjective cognitive decline.