Chinese Guidelines for Early Prevention of Alzheimer’s Disease (2024)

Lu LIN, Xin MA, Gang WANG, Hongzheng WANG, Zhiqun WANG, Zhiwen WANG, Xiaoming WANG, Huifang WANG, Feiqi ZHU, Liyan QIAO, Zhaorui LIU, Zhigang QI, Bin TANG, Kuncheng LI, Zhaohui LI, Shifu XIAO, Jintai YU, Xianbo ZHOU, Hexin ZHAO, Mangsuo ZHAO, Hongbin ZHAO, Yun GU, Hong GUO, Ling GUO, Qihao GUO, Liping FU, Min LEI, Weigang PAN, Yong XU, Jun WANG, China association for Alzheimer's disease

Chinese Journal of Alzheimer's Disease and Related Disorders ›› 2024, Vol. 7 ›› Issue (3) : 168-175.

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Chinese Journal of Alzheimer's Disease and Related Disorders

Abbreviation (ISO4): Chinese Journal of Alzheimer's Disease and Related Disorders      Editor in chief: Jun WANG

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Chinese Journal of Alzheimer's Disease and Related Disorders ›› 2024, Vol. 7 ›› Issue (3) : 168-175. DOI: 10.3969/j.issn.2096-5516.2024.03.002
Guide and Consensus

Chinese Guidelines for Early Prevention of Alzheimer’s Disease (2024)

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Abstract

Alzheimer's disease (AD) is a severe neurodegenerative disorder with complex etiology, currently lacking effective treatment options. China is among the countries with the largest and fastest-growing elderly population globally, also identified as a high-risk nation for AD. Consequently, early prevention of AD emerges as one of the most crucial endeavors in the fieldof healthcare today. Building upon domestic and international research, we have formulated a Chinese-specific AD early prevention guideline, integrating evidence-based literature, intervention studies, case analyses, experiential insights, and expert consultations, and showcasing the advantages of traditional Chinese medicine, martial arts, health preservation practices, and community organization. This guideline addresses distinctive features of preventive measures and encompasses strategies at the individual, family, and society levels, advocating for proactive lifestyles, social engagement, cognitive training, physical exercise, tobacco cessation and moderate alcohol consumption, nutritional balance, adequate sleep, management of blood pressure, glucose and lipid levels, weight, and other chronic conditions, along with incorporating traditional Chinese medicine (TCM) into primary prevention efforts against AD. This guideline serves as a reference for individuals, families and communities engaged in AD prevention initiatives.

Key words

Alzheimer's disease / Early prevention / Guideline

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Lu LIN , Xin MA , Gang WANG , et al . Chinese Guidelines for Early Prevention of Alzheimer’s Disease (2024)[J]. Chinese Journal of Alzheimer's Disease and Related Disorders. 2024, 7(3): 168-175 https://doi.org/10.3969/j.issn.2096-5516.2024.03.002

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MIND diet, a hybrid of the Mediterranean diet and the Dietary Approaches to Stop Hypertension diet, is associated with a slower cognitive decline and lower risk of Alzheimer's disease (AD) dementia in older adults.We aim to examine whether the association of the MIND diet with cognition is independent of common brain pathologies.Utilizing data from the Rush Memory and Aging Project (MAP), a longitudinal clinical-pathologic study, we studied 569 decedents with valid dietary data, cognitive testing proximate to death, and complete autopsy data at the time of these analyses. A series of regression analyses were used to examine associations of the MIND diet, dementia-related brain pathologies, and global cognition proximate to death adjusting for age, sex, education, APOEɛ4, late-life cognitive activities, and total energy intake.A higher MIND diet score was associated with better global cognitive functioning proximate to death (β= 0.119, SE = 0.040, p = 0.003), and neither the strength nor the significance of association changed substantially when AD pathology and other brain pathologies were included in the model. The β-estimate after controlling for global AD pathology was 0.111 (SE = 0.037, p = 0.003). The MIND diet-cognition relationship remained significant when we restricted our analysis to individuals without mild cognitive impairment at the baseline (β= 0.121, SE = 0.042, p = 0.005) or in people diagnosed with postmortem diagnosis of AD based on NIA-Reagan consensus recommendations (β= 0.114, SE = 0.050, p = 0.023).MIND diet is associated with better cognitive functioning independently of common brain pathology, suggesting that the MIND diet may contribute to cognitive resilience in the elderly.
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轻度认知障碍的治疗是老年健康需要解决的难题。基于中医“脑病耳治”理论的新型神经调控技术——耳甲电针(taVNS),可辅助治疗多种神经、精神系统疾病,近年研究发现其对轻度认知障碍有效。对目前国内外耳甲电针治疗轻度认知障碍的研究现状进行综述,探讨其疗效、机制,展示其研究成果,提出进一步研究方向。将为MCI非药物疗法提供可借鉴的新思路,为广大老年患者的认知功能改善和生活品质提高提供新技术。
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Mortimer JA, Ding D, Borenstein AR, et al. Changes in brain volume and cognition in a randomized trial of exercise and social interaction in a community-based sample of non-demented chinese elders[J]. J Alzheimers Dis, 2012, 30(4):757-766.
Physical exercise has been shown to increase brain volume and improve cognition in randomized trials of non-demented elderly. Although greater social engagement was found to reduce dementia risk in observational studies, randomized trials of social interventions have not been reported. A representative sample of 120 elderly from Shanghai, China was randomized to four groups (Tai Chi, Walking, Social Interaction, No Intervention) for 40 weeks. Two MRIs were obtained, one before the intervention period, the other after. A neuropsychological battery was administered at baseline, 20 weeks, and 40 weeks. Comparison of changes in brain volumes in intervention groups with the No Intervention group were assessed by t-tests. Time-intervention group interactions for neuropsychological measures were evaluated with repeated-measures mixed models. Compared to the No Intervention group, significant increases in brain volume were seen in the Tai Chi and Social Intervention groups (p < 0.05). Improvements also were observed in several neuropsychological measures in the Tai Chi group, including the Mattis Dementia Rating Scale score (p = 0.004), the Trailmaking Test A (p = 0.002) and B (p = 0.0002), the Auditory Verbal Learning Test (p = 0.009), and verbal fluency for animals (p = 0.01). The Social Interaction group showed improvement on some, but fewer neuropsychological indices. No differences were observed between the Walking and No Intervention groups. The findings differ from previous clinical trials in showing increases in brain volume and improvements in cognition with a largely non-aerobic exercise (Tai Chi). In addition, intellectual stimulation through social interaction was associated with increases in brain volume as well as with some cognitive improvements.
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脑认知健康管理中国专家共识制定委员会, 中华健康管理学杂志编辑委员会. 脑认知健康管理中国专家共识[J]. 中华健康管理学杂志, 2023, 17(12):881-892.
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Zhang H, Hu Z, Jiang S, et al. Social frailty and the incidence of motoric cognitive risk syndrome in older adults[J]. Alzheimers Dement, 2024.
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