Abbreviation (ISO4): Chinese Journal of Alzheimer's Disease and Related Disorders
Editor in chief: Jun WANG
Alzheimer's disease (AD) is a neurodegenerative disorder characterized by a long preclinical phase and a cascade of pathological events. With recent advances in blood and imaging biomarkers, the dynamic tracking of AD progression has become increasingly feasible. However, most studies have focused on single-modality markers, with limited integration across biological systems and time scales. This review adopts a time-dynamic perspective to summarize the longitudinal evolution of key blood biomarkers (e.g., Aβ42/40 ratio, p-tau217, NfL, GFAP) and imaging markers (e.g., Aβ-PET, Tau-PET, MRI) across the AD continuum. We compare the timing of initial abnormalities, progression patterns, and correlations with cognitive decline. Furthermore, we highlight integrative modeling approaches, including event-based models, and deep learning frameworks, which enable multi-modal risk prediction and individualized disease staging. The clinical potential of such integration in early screening, disease trajectory forecasting, and therapeutic decision-making is discussed, along with current limitations and future directions. This review provides a framework for developing dynamic, biology-driven precision diagnostic strategies in AD.
Objective: To comprehensively evaluate the effectiveness of driving ability as a predictor for Alzheimer's disease (AD), explore relevant data collection and analysis methods, and identify valid early warning indicators. Methods: Computerized searches were conducted in databases including CNKI, CBM, Wanfang, VIP, PubMed, and Web of Science to identify studies using driving ability for AD prediction. Literature meeting inclusion criteria was screened, and data quality was assessed. Relevant information was extracted, and heterogeneous data were integrated. Principal component analysis (PCA) was used to evaluate the importance of indicators in the driving-based warning system. Meta-analysis was performed to assess the effect of AD on driving ability. Subgroup analysis was conducted to reduce intergroup heterogeneity, with stratification based on age, gender, and Mini-Mental State Examination (MMSE) scores to examine differences in effects across groups. A multifactorial interaction subgroup analysis was further proposed to minimize intergroup heterogeneity, analyzing the combined influence of age, gender, and MMSE scores on statistical outcomes. Results: After screening, 12 studies were included. PCA results identified the three most significant indicators: spatial control (9.13%), emotional adaptation (8.78%), and navigation execution (8.36%). Meta-analysis and subgroup analysis revealed that older female patients with low MMSE scores exhibited the most severe driving-related cognitive impairment (SMD = -0.75, P < 0.001). Additionally, among male AD patients, the high-score MMSE group showed a greater absolute effect size (ΔSMD = -0.22, P < 0.001). Multifactorial interaction subgroup analysis explained 78% of the heterogeneity (Q = 12.37, P = 0.006). Conclusion: This study provides preliminary evidence that abnormal driving behavior can serve as a novel biomarker for early AD detection, with spatial orientation, emotional stability, and navigation ability identified as core indicators. However, the warning system must account for population differences (higher sensitivity in older females) and individual baseline variations (longitudinal self-referencing).
Objective: To evaluate clinical phenotypes and nocturnal sleep structure characteristics with mild cognitive impairment due to Alzheimer's disease (AD). Methods: Based on cerebrospinal fluid or positron emission tomography imaging to detect the concentration or deposition status of β-amyloid protein (Aβ) to distinguish between MCI due to AD and control group. All patients underwent polysomnography monitoring (PSG), APOE gene testing, Montreal Cognitive Assessment (MoCA), Hamilton Anxiety Scale (HAMA), and Hamilton Depression Scale (HAMD) assessments. Results: ① Significant differences were found in clinical characteristics such as sleep disturbance, body mass index (BMI), education years, occupations, combined with risk factors, and APOEε4 gene mutation (P<0.05); ② There were statistically significant differences in MoCA and HAMA scores between these two groups (P<0.05); ③Significant differences in N1/total sleep time (TST)%, N2/TST%, N3/TST% and rapid eye movement sleep time (REM)/TST%, average blood oxygen concentration during night-sleep time, sleep-related apnea-hypopnea index (AHI), obstructive sleep apnea (OSA) index between these two groups (P<0.05); ④Clinical phenotypes including sleep disorders, APOEε4 mutation, multiple risk factors, cognitively demanding occupations and sleep microstructural parameters were significantly correlated with MCI due to AD (P<0.05); ⑤Gender, sleep disturbance, APOEε4 gene mutation, BMI and polysomnographic indices (N1/TST%, N2/TST%, REM/TST% and OSA index) were key factors in MCI due to AD (P<0.05); ⑥N1/TST%, N2/TST%, REM/TST% and OSA index demonstrated significant linear correlations with MoCA scores (P<0.01). Conclusion: Patients with MCI due to AD exhibited distinct clinical features, including a higher prevalence of sleep disorders, elevated APOEε4 allele carrier rates, lower prevalence of multiple risk factors, a higher proportion of cognitively demanding occupations and lower BMI. Sleep parameters, including N1/TST%, N2/TST%, REM/TST% and OSA index, demonstrated significant correlations with cognitive impairment. Characteristic changes in the proportion of N1, N2 and REM sleep among MCI patients may serve as potential biomarkers for early identification of MCI due to AD.
Objective: To obtain the clinical basis for non-drug intervention in mild cognitive impairment (MCI) by exploring the efficacy of auricular acupuncture combined working memory (WM) training in patients with MCI. Methods: A total of 40 MCI patients who were hospitalized in the Department of Geriatrics at Hangzhou Wuyunshan Hospital from January to December 2023 were included and randomly divided into an observation group of 20 patients who received 3-week WM training and a control group of 20 patients who did not receive training by drawing lots. The Montreal Cognitive Assessment (MoCA) was used to evaluate the patients' cognitive function. Results: Before training, there was no significant difference in cognitive function between the two groups(P>0.05). In the observation group, the visual-spatial and executive ability and MoCA total scores of patients followed up for 6 months after training were higher than those before training, and the difference was statistically significant (P<0.05). After training, followed up for 6 months, the visual-spatial and executive function and MoCA total scores of patients in the observation group were higher than those in the control group, and the difference was statistically significant (P<0.05). Conclusion: Auricular acupoint stimulation combined with WM training can improve some cognitive functions in MCI population.
Objective: To examine the clinical manifestations, imaging features, potential pathological mechanisms, differential diagnosis, and clinical significance of atypical Alzheimer's disease (AD), with the objective of enhancing comprehension of atypical AD and elevating the standard of clinical diagnosis. Methods: The clinical manifestations, laboratory findings and imaging features, and differential diagnosis of three patients with atypical AD were reviewed, and their pathological mechanisms were analyzed accordingly. Results: There was a decrease in Aβ and an increase in Tau in all three patients' cerebrospinal fluid (CSF) tests. The patient with frontal variant of AD (FvAD) started with memory loss and mental behavior abnormalities, and the brain Magnetic Resonance Imaging (MRI) showed symmetrical atrophy of bilateral frontal lobe, temporal lobe, parietal cortex and hippocampus. The patient with logopenic variant primary progressive aphasia (LvPPA) has the onset of speech clumsiness. Brain MRI shows that the left lateral fissure is wider than the right, and bilateral hippocampal atrophy is relatively mild. The patient with posterior cortical atrophy (PCA) presented with memory loss and visuospatial impairment. Brain MRI showed bilateral partooccipital lobe atrophy, widening of the right lateral fissure, and relatively mild bilateral hippocampal atrophy. Conclusions: Atypical AD are starting with speech impairment, mental behavior abnormalities, and visuospatial disorders. Because the dysmnesia symptoms of atypical AD are not typical, it is not easy to identify them early, and it is easy to be confused with frontotemporal dementia, cortical basal ganglia degeneration and Lewy body dementia. The clinical diagnosis requires a comprehensive consideration of detailed medical history and neurological examination, combined with neuropsychiatric scales, imaging, and biomarkers.
Objective: To evaluate the effectiveness of caregiver group support skills training on coaches' attitudes towards dementia care and their sense of competence. Methods: A total of 56 participants in the dementia caregiver group support skills training (referred to as "coaches"; 10 male and 46 female) completed assessments of their dementia care attitudes and sense of competence before and after the training. Paired t-tests were used to compare the differences in scores for dementia care attitudes and sense of competence before and after the training. Multivariate analysis was conducted to explore the demographic factors associated with the changes in dementia care attitudes and sense of competence. Results: After the training, coaches showed a significant increase in scores for the "hope" and "personhood validation" factors of the dementia care attitude scale, as well as the total scale score (P < 0.05). Additionally, scores for the "professionalism," "relationship building," "managing caregiving challenges," and "maintaining personhood" factors of the dementia care competence scale, as well as the total scale score, significantly increased after the training (P < 0.05). Multivariate analysis indicated that only the occupation was associated with changes in the total score and "relationship building" factor of dementia care competence before and after the training; no other sociodemographic characteristics were associated with the changes in dementia care attitudes and other factors of competence scale. Conclusion: Caregiver group support skills training can improve coaches’ attitudes towards dementia care and enhance their sense of competence in caregiving.
Alzheimer's disease (AD) is a complex neurodegenerative disorder caused by multiple factors, characterized primarily by the deposition of amyloid β-protein (Aβ) plaques and the formation of phosphorylated Tau protein neurofibrillary tangles in the brain, which together lead to memory loss and cognitive impairment. In recent years, microRNAs(miRNAs), as an essential class of non-coding RNA molecules, have demonstrated a pivotal role in the pathogenesis of AD. miRNAs tightly regulate the generation and clearance of Aβ by targeting key genes such as APP and BACE1. Meanwhile, specific miRNAs can significantly influence the phosphorylation state of Tau protein, exerting a profound impact on neuronal stability and survival. However, despite the enormous potential of miRNAs in AD research, numerous challenges remain. For instance, the differences in miRNA expression patterns between AD patients and healthy controls, as well as their biological significance and translational relevance, require further validation. Additionally, there is currently a lack of unified and accurate criteria for assessing the reliability of miRNAs as biomarkers, and miRNA-based therapies have not yet been approved for clinical use. Therefore, future research needs to further delve into the specific mechanisms of miRNAs in AD, systematically evaluate their potential as therapeutic targets, and actively overcome existing technical and methodological challenges, in order to provide new theoretical foundations and practical strategies for the diagnosis and treatment of AD.
Objective: To conduct a meta-analysis on the incidence of frailty in patients with Alzheimer's Disease (AD), in order to provide a scientific basis for the prevention of frailty in AD patients. Methods: By systematically searching CNKI, Wanfang, VIP Chinese databases, PubMed, Web of Science, Embase and Cochrane Library English databases, the epidemiological evidence of the incidence of frailness in AD patients was comprehensively obtained. The literature search period was set from the establishment of the database to March 10, 2025, and literature screening, data extraction and bias risk assessment were carried out by two researchers respectively. Statistical software Stata14.0 was used to conduct a meta-analysis of the included studies. Results: Thirteen studies were included, covering 2806 patients with Alzheimer's disease, and the analysis suggested an overall incidence of frailty of 34% (95%CI: 27%~41%). Study area, measurement tool, study time, sample size and other factors have an impact on the incidence of frailty in patients with Alzheimer's disease. Conclusion: The incidence of frailties in patients with Alzheimer's disease is high. Attention should be paid to frailties in patients with Alzheimer's disease, and early detection and intervention measures should be taken to reduce the occurrence of frailties in this population.
Objective: To evaluate and summarize the relevant evidence for the management of mild cognitive impairment in patients with Parkinson's disease, and provide evidence-based support for the development of scientific and effective management of mild cognitive impairment in Parkinson's disease. Methods: According to the "6S" model of evidence-based resources, the author systematically searched guidelines, expert consensus, clinical decision, evidence summary and systematic review on the management of mild cognitive impairment in Parkinson's disease patients from domestic and foreign guide websites, professional association websites and databases. The search period is up to December 2024. Literature quality assessment, evidence extraction and summary were conducted by two researchers trained in evidence-based systems. Results: A total of 14 literatures were included, including 6 guidelines, 5 expert consensus articles and 3 systematic reviews. The 34 evidences were summarized from 7 aspects: assessment object and time, assessment content and screening tool, risk factor management, safety management, medication management, non-drug intervention and follow-up management. Conclusion: This study systematically summarizes evidences in the field of mild cognitive impairment management in patients with Parkinson's disease, which can provide scientific reference for clinical nursing staff's practice. Nursing staff should select evidence based on the actual clinical situation and individual factors of patients to guide Parkinson's patients to improve mild cognitive impairment.
Deutetrabenazine, a deuterated derivative of tetrabenazine, has emerged as an effective treatment for Huntington's chorea and tardive dyskinesia. By selectively inhibiting vesicular monoamine transporter 2 (VMAT2), it reduces the synaptic release of dopamine and other monoamines, thereby alleviating involuntary movement symptoms. Compared to its precursor, deutetrabenazine demonstrates an improved safety profile, with significantly lower incidences of sedation and depression, enhancing patient adherence and suitability for long-term use. It is especially well-tolerated in vulnerable populations such as children and the elderly, showing better emotional stability and pharmacokinetic advantages. While its therapeutic potential is being explored in other neurodegenerative conditions like Parkinson's and Alzheimer's diseases, its current indications remain limited. Long-term administration poses challenges such as drug resistance and mood-related side effects, underscoring the need for psychological monitoring and individualized treatment plans. Furthermore, its high cost and inconsistent insurance coverage constrain global accessibility. Future strategies involving neuromodulation technologies, optimized reimbursement policies, and precision medicine approaches may expand its clinical utility and improve availability worldwide.
In the context of an aging society, the management of chronic diseases in patients with dementia has become a public health issue that requires urgent attention. This article expounds the current situation of chronic disease management for dementia, analyzes the characteristics of dementia, the process of chronic disease management for dementia, and the management characteristics in medical care institutions. It proposes a series of targeted countermeasures and suggestions from multiple aspects,including improving cognitive abilities, optimizing medication management, managing behavioral and psychological symptoms of dementia (BPSD), building care systems, promoting health, and prevention. These efforts aim to provide new ideas and references for the chronic disease management of dementia patients, aiming to provide more comprehensive and effective chronic disease management services for patients with dementia, improve their quality of life, reduce the burden on families and society, and provide work ideas and references for the management of chronic diseases in elderly dementia patients in China.
ISSN 2096-5516 (Print)
Started from 2018
Published by: China Association for Alzheimer’s Disease
