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.