Abbreviation (ISO4): Chinese Journal of Alzheimer's Disease and Related Disorders
Editor in chief: Jun WANG
Alzheimer's disease (AD) represents a major global health challenge. In recent years, driven by big data and cutting-edge technologies, precision medicine has been guiding AD research and practice through a profound transformation. The core of this shift moves away from a reactive, symptom-based, "one-size-fits-all" model towards a new paradigm of precise diagnosis and treatment grounded in biological evidence and aimed at early disease modification. This review systematically explores the latest advances in early prevention, diagnosis, and treatment of AD within this framework, aiming to provide new perspectives and feasible pathways towards ultimately conquering the disease.
Objective: To explore the real-world application performance of the urine β-amyloid protein detection kit in screening the risk of cognitive decline in multiple hospitals and communities in China. Methods: In this study, the clinical values of One-Step Dementia Risk Test Kit in early screening were further validated by community health screening in Changsha （n=51 187） and a multi-center, case-control study with a total of 898 participants including 266 healthy age-matched controls, 167 MCI/AD patients and 465 non-AD patients with various comorbidities and age-related diseases. Results: The number of weak positive/ positive/negative in the healthy, non-AD and MCI/AD group was 8/12/246 （positivity 7.52%）, 41/16/409 （12.23%） and 77/44/46 （72.46%）, respectively, resulting in a Kappa value of 0.669 which indicated a good diagnostic performance. Comorbidity analysis identified memory decline as the most significant risk factor （P = 9.6×10-23, Fisher's Exact Test）, followed by hyperlipidemia （P = 3.2×10-12）, history of stroke （P = 0.0011） and hypertension （P = 0.00058）. Therapeutics analysis showed medications for cardiovascular diseases and anti-thrombosis significantly reduced risk of dementia （P = 0.0061 and 0.0081, respectively）. For AD patients, only patients receiving memantine treatment showed a slight reduction in kit positivity （P = 0.0532）. The kit also showed a clear age-dependent increase of positivity from 6.29%-15.40%, in health screening. Conclusions: Our results confirmed the diagnostic value of the kit in MCI and AD-dementia. Moreover, the kit can be used in the real world to assess the risk of various conditions towards AD as well as the treatment efficacy.
Objective: To investigate changes in cardiorespiratory fitness in patients with mild cognitive impairment (MCI) and their correlation with cognitive dysfunction. Methods: A total of 770 elderly patients hospitalized long-term at Zhongren Geriatric Care Hospital in Jinshan District, Shanghai, were screened from March 2024 to March 2025. Ultimately, 91 individuals completed both neuropsychological assessments and cardiorespiratory fitness evaluations. Based on scores from the Montreal Cognitive Assessment-Basic (Moca-B), participants were divided into an MCI group (score 14~20, n=60) and a healthy control group (score 20~30, n=31). Global cognitive function was assessed using the Moca-B; cognitive subdomains were evaluated using the Digit Span Test, Trail Making Test, and Wechsler Digit Symbol Substitution Test. Cardiorespiratory fitness was assessed via grip strength (left and right hand), Timed Up and Go test, and limits of stability. Partial correlation analysis was used to explore the relationship between cardiorespiratory fitness and cognitive function in MCI patients. Results: Compared with the healthy control group, the MCI group showed statistically significant differences in years of education, Moca-B score, Trail Making Test-A, Symbol Digit Modalities Test, backward digit span, verbal fluency test, activities of daily living (ADL), grip strength (both hands), limits of stability, and TUG performance (P < 0.05). Partial correlation analysis revealed a significant positive correlation between grip strength and cognitive function in MCI patients (P < 0.001). Further analysis indicated that grip strength and limits of stability were independent risk factors affecting cognitive function in older adults. Conclusions: Patients with MCI exhibit measurable changes in cardiorespiratory fitness, among which grip strength is closely associated with cognitive function. Both grip strength and limits of stability may serve as early indicators of cognitive decline in older adults.
Objective: To explore the association between sedentary behavior (SB) contexts, characteristics, and cognitive function in older adults. Methods: A face-to-face survey was conducted among 1,485 elderly individuals aged 60-80 years undergoing health check-ups at the Xinchang Community Health Service Center in Pudong New Area, Shanghai. The survey included an SB questionnaire (covering 9 common SB contexts and 2 SB characteristics), MemTrax assessment (measuring the percentage of correct responses [MTx-%C], mean response time [MTx-RT], and a composite index [MTx-Cp, where MTx-Cp = MTx-%C / MTx-RT × 100]), and health examination data. Linear regression analysis was used to examine the association between SB and cognitive function. Stratified analysis was used to explore whether the impact of sedentary behavior (SB) on cognitive function differed by sex. Results: A total of 1,441 participants were included, of whom 630 (43.72%) were male, 454 (31.51%) had primary school education, and 673 (46.70%) had junior high school education. The average daily sedentary time was （6.59 ± 2.78 ）hours. The primary SB context was screen time (2.97 ± 1.55 hours). Participation rates in hobbies (21.10%), reading (5.20%), and listening to the radio (6.94%) were low. Cognitive function was positively correlated with screen time, meals (male), transportation, and hobbies (female) (all P < 0.05), negatively correlated with "thinking/idleness" (male) and socializing (all P < 0.05), but showed no significant association with reading or listening to the radio. The frequency of SB bouts was positively correlated with MTx-%C, but the longest continuous sedentary time had no significant effect. Conclusions: The sedentary time among older adults in Shanghai is higher than the national average, with screen time being the predominant SB context. The effects of different sedentary behavior contexts on cognitive function varied and demonstrated significant sex-specific patterns. Consequently, the future public health strategies should not be limited to advocating for "reducing sedentary time," but should also promote a paradigm shift toward "optimizing sedentary behavior." Furthermore, the influence of sex differences should be fully considered in the design of intervention measures.
Objective: To explore the retrospective risk factors for deep venous thrombosis (DVT) in elderly patients with dementia complicated by post-stroke hemiplegia. Compare the stroke-related indicators, treatment and nursing factors, and laboratory parameters between the two groups, and perform multivariate analysis to identify the risk and protective factors for DVT. Compare the stroke-related indicators, treatment and nursing factors, and laboratory parameters between the two groups, and perform multivariate analysis to identify the risk and protective factors for DVT. Methods: A retrospective analysis was conducted on 100 elderly patients with dementia and post-stroke hemiplegia who visited our hospital from January 2024 to August 2025.They were divided into a thrombosis group (n=40) and a non-thrombosis group (n=60) based on whether they developed DVT. The general characteristics, stroke-related indicators, treatment and nursing factors, and laboratory indicators between the two groups were compared. Multivariate analysis was performed to identify risk and protective factors for DVT.. Stroke severity, severe paralysis, prolonged bed rest, diuretic use, elevated D-dimer, high FIB, and shortened PT/APTT were independent risk factors for DVT. Early rehabilitation and prophylactic anticoagulation were significant independent protective factors (P<0.05). Conclusions: The occurrence of DVT in elderly patients with dementia complicated by post-stroke hemiplegia is closely associated with multiple factors. Severe stroke, profound paralysis, prolonged bed rest, diuretic use, elevated D-dimer, high fibrinogen, and shortened PT/APTT are independent risk factors for DVT, while early rehabilitation and prophylactic anticoagulation represent significant independent protective factors.
Objective: To evaluate the efficacy and safety of acupuncture combined with NMES for treating dysphagia after stroke. Methods: Computerized searches were conducted in Chinese and English databases including CNKI, VIP, WANFANG DATA, Embase, PubMed, Web of Science, and Cochrane Library to identify RCTs on acupuncture combined with NMES for post-stroke dysphagia from database inception to December 2024. Two researchers independently screened studies, extracted data, and performed meta-analysis using RevMan 5.4.1 software. Results: A total of 27 RCTs involving 2 013 patients were included. Results showed that compared with acupuncture alone, acupuncture combined with NMES significantly increased the clinical total effective rate (RR = 1.23, 95% CI: 1.18-1.28, P < 0.00001) and better improved swallowing function measures including the Water Swallow Test (WST), Standardized Swallowing Assessment (SSA), and videofluoroscopic swallowing studies (VFSS) (all P < 0.05), while reducing the incidence of adverse reactions (RR = 0.41, 95% CI: 0.20-0.85, P = 0.02). Conclusion: Acupuncture combined with NMES represents an effective and safe treatment regimen for post-stroke dysphagia, demonstrating superior efficacy compared to acupuncture alone.
Objective: Based on interpretable machine learning methods, to explore the application value of multimodal MRI radiomics in the diagnosis of Alzheimer's disease (AD) and provide imaging tools for accurate clinical diagnosis of AD. Methods: A retrospective study was conducted on 110 subjects, including 48 in the AD group and 62 in the control group (HC), all of whom completed 3D-T1WI, DWI, and T2WI MRI sequence scans. Randomly stratified sampling was conducted at a ratio of 7:3 to divide the data into training and testing sets, and 8 AD related core brain regions (hippocampus, entorhinal cortex, etc.) were segmented. Extract 107 radiomics features, screen the core features, and construct 8 diagnostic models (2 algorithms x 3 sequences, 2 algorithms x 2 sequences combined) based on logistic regression (LR) and random forest (RF) algorithms. Evaluate the model performance using area under the curve (AUC), and analyze the model interpretability using SHAP analysis. Results: 16 core radiomics features were ultimately selected. The joint sequence model has the best diagnostic performance, with AUC values of 0.989 (95% CI: 0.960~1.00) and 0.970 (95% CI: 0.920~1.00) for the LR and RF algorithm test sets, respectively, which are significantly higher than those of the single sequence model; The accuracy, sensitivity, and specificity of the LR joint model test set were 0.882, 0.800, and 0.947, respectively. SHAP analysis shows that the 3D-T1WI sequence with short run length and high grayscale emphasized features, and the DWI sequence with grayscale co-occurrence matrix information measurement are the core indicators for AD diagnosis. Conclusions: The multimodal MRI radiomics model can efficiently achieve AD diagnosis, and the LR combined model has the best comprehensive performance. SHAP analysis can clearly analyze the decision-making basis of the model, providing strong support for the clinical translation of the model and accurate diagnosis of AD.
Pulse pressure (PP), an indicator of arterial stiffness and pulsatile hemodynamic load, may offer superior value in risk assessment compared to static blood pressure indices. Recent studies have reported an association between PP and cognitive impairment or dementia; however, the findings have been inconsistent. This review summarizes the current evidence on the association between PP and cognitive impairment, with particular emphasis on its overall relationship with cognitive function, the modifying effects of age, sex, and APOE ε4 genotype, and the potential underlying mechanisms. Current evidence suggests that persistently elevated PP is associated with an increased risk of cognitive decline, and this association may be partly independent of traditional blood pressure indices and common vascular risk factors. Mechanistically, elevated PP may promote excessive transmission of pulsatile energy into the cerebral microcirculation, leading to perfusion mismatch, impaired cerebral autoregulation, and disruption of the blood-brain barrier. It may also contribute to cerebral small vessel remodeling, white matter microstructural damage, neuroinflammation, and impaired clearance of pathological proteins such as amyloid beta (Aβ) and tau, ultimately compromising brain network integrity and cognitive function. Given its noninvasive, simple, low-cost, and repeatable nature, PP may serve as a useful adjunctive marker for the early identification, risk stratification, and clinical assessment of individuals at high risk of cognitive impairment. However, its risk thresholds, causal relationship with cognitive decline, and therapeutic implications still require further investigation.
Dysregulated metabolism of triglyceride-rich lipoproteins (TRLs) and remnants constitutes a shared risk factor for both cardiovascular disease (CVD) and Alzheimer's disease (AD), with close pathological interconnections between the two conditions. This review synthesizes current evidence on the common mechanisms through which TRLs and their remnants contribute to both CVD and AD, primarily involving the promotion of atherosclerosis, induction of systemic and neuroinflammation, and exacerbation of insulin resistance. By integrating clinical and genetic findings, it highlights the potential bridging role of TRLs between cardiovascular risk and cognitive decline. Furthermore, the review summarizes advances and limitations of current management strategies including lifestyle interventions, conventional pharmacotherapy, and emerging treatments within the framework of cardiocerebral comorbidity. It proposes a patient-centered, multidisciplinary integrated care pathway aimed at optimizing the management of these co-occurring conditions. Future research should focus on novel targets within TRLs metabolism to develop more effective interventions and improve outcomes in this high-risk population.
The comorbidity of Parkinson's disease (PD) and sarcopenia in the elderly has garnered increasing research interest in recent years. This condition can accelerate the decline of motor function and elevate the risk of falls. The underlying pathogenesis is multifactorial, involving processes such as neuroinflammation, oxidative stress, hormonal and metabolic dysregulation, mitochondrial dysfunction, neuromuscular junction impairment, gut microbiota dysbiosis, exosome-mediated propagation of α-synuclein pathology, non-motor symptoms, pharmacological effects, and neurodegeneration. Intervention strategies emphasize a multi-targeted, integrated management approach, including personalized resistance training, nutritional support, and innovative therapies targeting the gut microbiome. Despite accumulating evidence, considerable controversies remain regarding the pathogenic mechanisms, diagnostic criteria, and optimal interventions for this comorbidity. This review summarizes recent advances in the study of PD complicated by sarcopenia, aiming to inform strategies for improving functional outcomes and quality of life in affected patients.
ISSN 2096-5516 (Print)
Started from 2018
Published by: China Association for Alzheimer’s Disease
