Abstract
Background and Objectives: Interventions targeting the gut-brain axis offer potential for mitigating Subjective Cognitive Decline (SCD), a critical window for Alzheimer's prevention. This study evaluated the effects of a novel probiotic supplement, ExoBDNF, on cognitive function, sleep, and emotional distress in adults with SCD. Materials and Methods: In this 9-week open-label study, participants received ExoBDNF supplementation. Efficacy was assessed using the SCD-Questionnaire (SCD-Q), DASS-21, PSQI, MoCA, and a computerized cognitive battery measuring inhibition (Go/No-Go), flexibility (Task Switching), and working memory. Results: Post-intervention analyses revealed significant improvements in subjective cognition (SCD-Q, p < 0.001), sleep quality (PSQI, p < 0.001), and emotional distress (DASS-21, p < 0.001). Objective cognitive performance also improved, with significant gains in MoCA scores (p = 0.047) and executive function metrics. Spearman correlation analysis indicated a significant link between cognitive and emotional changes: longitudinal reductions in SCD scores correlated with concurrent reductions in emotional distress (rho = 0.471, p = 0.009). Furthermore, higher baseline SCD scores predicted greater improvement in emotional outcomes (rho = -0.540, p = 0.002). Conclusions: ExoBDNF supplementation significantly enhanced cognitive performance, sleep quality, and emotional well-being. The findings demonstrate that improvements in subjective cognition are closely tied to alleviated emotional distress, supporting the gut-brain axis as a viable therapeutic target for early-stage cognitive decline.