Based on current literature and expert panel discussions, the recommendations for drug treatment of Alzheimer's disease (AD) have been updated in accordance with previous guidelines on the diagnosis and treatment of dementia and cognitive impairment. The update emphasizes the advancements in anti-Aβ immunotherapy, with the aim of providing a reference for early and comprehensive intervention for AD. The content covers the following key aspects: the principles of AD treatment; symptomatic medications, including cholinesterase inhibitors and NMDA receptor antagonists; management of behavioral and psychological symptoms; disease-modifying therapies such as Aducanumab, Lecanemab, and Donanemab; the use of Sodium Oligomannate; and the use of traditional Chinese medicine.

Objective: This study aims to explore the application of toys and games in non-pharmacological interventions of Alzheimer's disease, and analyze the current research status, in order to provide guidance for future studies. Methods: This paper adopts literature review and thematic analysis methods. Literature searches were conducted on CNKI, Wanfang, Google Scholar, SCOPUS, Pubmed, and Science Direct using keywords such as "Alzheimer's disease," "dementia," "non-pharmacological intervention," "toys," and "games." Relevant literature from 2020 to 2024 was collected and subjected to thematic analysis. Results: The research indicates that non-pharmacological interventions for Alzheimer's disease are continuously emerging, among which a significant form of treatment is to use toys and games to enhance patients' quality of life. These toys and games stimulate cognitive and sensory functions, improve patients' social interaction abilities, promote physical activity, and alleviate negative emotions such as depression and anxiety. Conclusion: Currently, the toys used in occupational therapy for Alzheimer's disease patients mostly come from existing children's toys on the market or are simple toys developed by researchers in psychology and medicine, lacking research on how to design more tools for occupational therapy for Alzheimer's disease patients from a design perspective. Future research can start from the field of design to explore its principles and methods, in order to provide more beneficial insights and guidance for non-pharmacological interaction of Alzheimer's disease patients.

Alzheimer's disease (AD) occurs in elderly and pre-elderly, with comorbidities being a common feature throughout its whole course. This article summarized the comorbidities of AD patients across the whole course and explored the characteristics of comorbidities in three stages of AD: the preclinical stage, the mild cognitive impairment stage, and the dementia stage.It is emphasized that a holistic assessment of AD patients' health status and comorbidities is essential, with an emphasis on whole-course and individualized interventions targeting modifiable risk factors.

Objective: To observe the clinical effect of butylphthalide soft capsule combined with donepezil tablets in the treatment of patients with post-stroke cognitive impairment (PSCI). Methods: Sixty patients with PSCI were randomly divided into treatment group and control group, 30 patients in each group. The control group was given oral donepezil tablets, one tablet after meals (10 mg) every night, and the treatment group was given oral butylphthalide soft capsules on the basis of the control group, taking 2 capsules before meals, 0.2 g each. All patients were treated for 4 weeks. The levels of mini-mental state examination (MMSE), Montreal cognitive test (MoCA), modified Barthel index (MBI) and brain-derived neurotrophic factor (BDNF) were measured before and after treatment. The data were recorded and analyzed. Results: After treatment, the MMSE, MoCA and MBI scores of the two groups were higher than those before treatment, and the scores of the treatment group were higher than those of the control group, the differences were statistically significant (P<0.05). After treatment, there was no significant difference in the BDNF level of the control group compared with that before treatment, while the BDNF level of the treatment group was significantly higher than that before treatment and that of the control group (P<0.05). Conclusion: Butylphthalide soft capsule combined with donepezil tablets is superior to donepezil tablets alone in the treatment of PSCI. The combined treatment can improve the cognitive function and daily living ability of PSCI patients faster, which is worthy of further clinical recommendation.

With the continuous exacerbation of the global aging trend, the prevalence of Alzheimer's disease (AD) is increasing year by year, significantly affecting people's quality of daily life. Among the known genetic factors causing AD, APOE is one of the more significant factors that play a crucial role in the development of AD. Additionally, abnormal levels of thyroid hormones, whether too high or too low, may have a negative impact on people's cognitive function. This impact, through a series of complex developmental mechanisms, ultimately leads to the progression of AD. Exploring the relationship between the two may find new ways to prevent or delay the progression of AD, providing better protection for the elderly population's health.

Alzheimer's disease (AD) is the most common neurodegenerative disease worldwide and a leading cause of dementia. Currently, there are no highly effective treatments for this condition. The imbalance between the production and clearance of Aβ(amyloid-beta) protein is considered a primary pathogenic mechanism of AD. Enhancing the clearance of Aβ in the brain during the early stages can delay the onset and progression of AD. In recent years, with the introduction of the concept of the glymphatic system and the discovery of meningeal lymphatic vessels, the directional transport of fluids within the central nervous system has become a research hotspot. The glymphatic system plays a crucial role in clearing amyloid-beta protein and holds promise as a novel approach to combat neurodegenerative diseases. This review aims to summarize the current research progress on the role of the brain's glymphatic system in AD treatment and explore its potential applications in disease management.

Objective: Global has dealing with Alzheimer's disease. By sorting out major countries' strategic plans and project funding, we can learn systematically about the prevention and treatment of Alzheimer's disease in different countries. Methods: Research on policies, and the global scientific research project database was used to search for projects related to Alzheimer's disease. The retrieved projects were analyzed by a combination of measurement and content analysis. Results: At present, the United States has energetically built Alzheimer's disease research centers with different functions; Europe has focused on signaling pathways/regulation and discovering drug targets; Canada values biomarkers and drug targets; China has invested a lot as well. Conclusion: Some countries have made legislation on how to deal with AD. Signaling pathways/regulation, target discovery and drug development are the main contents of AD research, and effective marker screening and popular science dissemination are the future development trends of AD research.

Objective: To investigate the effect of cognitive reserve (CR) proxy variables on cognitive function in pre dementia patients with Alzheimer's disease (AD). Methods: 25 normal controls (NC) and 45 patients with mild cognitive impairment (MCI) were selected.All enrolled patients received Cognitive Reserve Index questionnaire (CRIq) to obtain the total score, education, work activities and leisure time scores, and completed the cognitive function scale assessment.Finally, correlation analysis and linear regression analysis were carried out on the proxy variables of cognitive reserve and the scores of each cognitive domain of the cognitive function scale. Results: ①Total score, education and leisure time were positively correlated with Mini-mental State Examination (MMSE) score(r=0.506, P<0.001, r=0.398, P<0.001, r=0.448, P<0.001)and Montreal Cognitive Assessment (MoCA) score(r=0.492, P<0.001, r=0.353, P=0.002, r=0.403, P<0.001) reflecting overall cognition. ② Education and number symbol conversion test, auditory word learning test, delayed recall and Boston Naming test were positively correlated (both P<0.05);The work activity was positively correlated with the number symbol test, the auditory word learning test, the delayed memory, and the number span positive memory test (both P<0.05).Leisure time was positively correlated with the total score of auditory word learning test and delayed recall, number span test, number symbol conversion test, animal word fluency and Boston naming test (both P<0.05).The total score was positively correlated with the total score of auditory word learning test and delayed recall, number span forward memorization test, animal word fluency test, number symbol conversion test and number span backward memorization test (both P<0.05). Conclusion: ① There is a correlation between comprehensive cognitive reserve and overall cognitive function in AD patients in the pre-dementia stage. ② Education level and lifelong leisure activities are correlated with the comprehensive cognitive scale, memory and language ability, while occupational complexity was correlated only with comprehensive cognitive scale and memory.

Alzheimer’s disease is a huge societal issue and places a serious economic burden on the ever-aging society. Although tremendous progresses have been made in the early detection, diagnosis and treatment which bring new options and hope for patients and their families, transformative early detection, diagnosis and treatment are still being developed. Here we report the current state of AD early detection, diagnosis and drug development where promising progress are made and hopefully revolutionary therapies will be developed soon to solve this global issues with the help of timely detection, early diagnosis and precision neurology through targeting immunoneurology/multi-mechanisms and cocktail medicine.

Different isoforms of Apolipoprotein E (ApoE) lead to different risks of Alzheimer's disease (AD). ApoE2 reduces the risk of AD, whereas ApoE4 is the main genetic risk factor for AD. The role of glia-secreted ApoE in the pathogenesis of AD has been extensively studied, whereas the contribution of neuronal ApoE remains largely unexplored. Recent studies have found that ApoE is also expressed in neurons, where it plays important roles in the pathogenesis of AD, including regulation of amyloid plaque seeding and growth, phosphorylation of Tau, and neurodegeneration, etc. Based on these studies, a gene therapeutic strategy using adeno-associated virus (AAV) to express ApoE2 in neurons is now in that phase II clinical trials for AD treatment. This article summarizes the knowledge about the emerging role of neuronal ApoE in AD pathogenesis.

Objective: This study aims to apply bibliometric methods to explore the global and domestic research status, trends, and emerging topics related to apolipoprotein E (APOE) and Alzheimer's disease (AD) from 2009 to 2023. Methods: We searched the Web of Science for literature on APOE and Alzheimer's disease from January 2009 to December 2023. The retrieved data were analyzed using CiteSpace (6.2.R6) software, with visualizations generated for authors, keywords, countries, institutions, and more. Results: From 2009 to 2023, the number of research articles on APOE and Alzheimer's disease increased steadily, with a total of 4,452 publications. The United States had the highest volume of publications. Keyword co-occurrence and clustering analyses revealed "APOE" "mild cognitive impairment" and "age" as major research topics globally. Conclusion: Future research on APOE and AD will primarily focus on the genetic phenotypes of APOE and their relationship with AD, as well as exploring clinical applications of treatments targeting APOE phenotypes or altering these phenotypes to treat AD.

Objective: We aimed to explore the association of liver fibrosis markers with cognitive decline. Methods: In this cross-sectional study, there were 8669 participants over 60 years old from 51 Community Health Centers in the Luohu District of Shenzhen from 2017 to 2018. All participants were divided into a cognitive low-risk group (n=8202) and a cognitive high-risk group (n=467) according to their scores of mini-mental state examination and education status. Blood routine examination and liver function markers were tested from fasting blood samples. The liver fibrosis markers FIB-4 and APRI were calculated with parameters such as ALT, AST, and PLT using specific formulas. We used the t-test, Mann-Whitney test, and Chi-square test to analyze the differences in general statistical characteristics and live fibrosis markers between the two groups, and binary Logistic regression analysis was used to analyze each parameter. The association between the liver fibrosis markers and alcohol drinking habits was tested by Spearman rank correlation. Results: FIB-4 was significantly higher in the cognitive high-risk group than the cognitive low-risk group [1.40 (1.13,1.78) vs. 1.49 (1.21,1.88), Z=3.595, P<0.001] but FIB-4 was not an independent risk factor of cognitive decline [OR (95%CI): 0.718 (0.444~1.159), P=0.175]. For alcohol drinkers, FIB-4 was significantly positively correlated with the age of starting drinking (r_s=0.089, P=0.005) and frequency of drinking (r_s=0.149, P<0.001). There was a positive correlation between APRI and frequency of drinking (r_s=0.078, P=0.013) as well. For people abstaining from alcohol, FIB-4 exhibited a positive correlation with the age of abstinence (r_s=0.172, P=0.014). Conclusion: FIB-4 was elevated in people with cognitive decline, and increased frequency of drinking was correlated with raised FIB-4 and APRI, and giving up drinking as soon as possible might be beneficial to prevent the cognitive decline by liver health.

Cognitive impairment is the primary symptom of Alzheimer's disease (AD), manifesting as memory loss and changes in other cognitive functions. Currently, cognitive tools such as the mini-mental state examination (MMSE) and the montreal cognitive assessment (MoCA) are widely used to evaluate overall cognitive function in patients. However, these scales are time-consuming and require experienced clinicians to conduct face-to-face testing. This review aims to introduce MemTrax, a computerized continuous recognition task, and its application in cognitive assessment. In this test, subjects are required to complete a picture recognition task within approximately 90 seconds to assess their cognitive functions, mainly episodic memory, including memory processing, storage, retrieval, and reaction time.Previous studies have confirmed that its efficacy in identifying normal individuals, mild cognitive impairment (MCI), and AD patients is superior to MoCA. Moreover, combining with other biomarkers can further enhance its diagnostic efficacy, and it is also potential for assessment of treatment efficacy. Here we also introduce the application of MemTrax in various types of cognitive disorder diseases. Finally, this article proposes that MemTrax can be used as a digital tool to establish a systematic neuroscience database in the future, combining machine learning and other biomarkers to predict early dementia, as well as for large-scale cognitive screening and continuous cognitive monitoring.

Alzheimer's disease(AD), as a neurodegenerative disease,has an abnormally complex pathogenesis and involves various biological processes. In recent years, the role of miRNA and NLRP3 inflammasome in AD,Which has been increasingly drawing attention,is becoming more and more significant.Based on the research background and significance,the article summarizes the current understanding of the role and mechanisms of miRNA-mediated NLRP3 inflammasome in the progression of AD.It is hoped that it may provide useful reference for deeply understanding the pathogenesis of AD and exploring new treatment methods as well as bring new breakthroughs for the therapy of AD.

Objective: Exploring cognitive function in patients with acute ischemic stroke and analyzing its influencing factors. Methods: We collected 192 patients with acute ischemic stroke (AIS) who attended the Department of Neurology of the First Affiliated Hospital of Anhui Medical University from December 2021 to November 2022, and collected the general data of the patients, and evaluated all the patients with AIS by using the Changsha version of the Montreal Cognitive Function Assessment Scale (MoCA), the Pittsburgh Sleep Quality Index (PSQI), and the ability of daily living activities to explore whether the sleep quality and the ability of daily living activities are the influencing factors of cognitive function. Results: The 192 AIS patients had a cognitive function score of (22.89±3.77) and a Pittsburgh Sleep Quality Index score of (7.20±4.21).Correlation analysis shows that; The cognitive function of acute ischemic stroke patients was negatively correlated with pittsburgh sleep quality index, sleep duration, sleep efficiency and daytime dysfunction (P<0.05), and positively correlated with activities of daily living (P<0.05).Multivariate analysis showed that educational level and ability of daily living were the influencing factors of cognitive function in patients with acute ischemic stroke (P<0.05). Conclusion: The incidence of overall cognitive function decline in AIS patients is high, and cognitive function is affected by educational level and ability of daily living activities.

The meningeal lymphatic vessels (mLVs) play a crucial role in the complex circulation and exchange of soluble contents between the cerebrospinal fluid (CSF) and the interstitial fluid (ISF). It has been confirmed that mLVs can drain intracranial CSF and immune cells to extracranial deep cervical lymph nodes (dCLNs), thereby establishing a direct link between the central nervous system (CNS) and the peripheral immune system. Given the limited therapeutic options for Alzheimer's disease (AD), enhancing brain lymphatic flow to improve the clearance of toxic waste has emerged as a new approach to alleviating cognitive impairment. This article briefly introduces the discovery process, structure, and location of mLVs, and thoroughly discusses their physiological functions. It focuses on the relationship between mLVs and the pathogenesis of AD, aiming to provide reference for emerging therapeutic mechanisms of AD.

Objective: To analyze the associations between blood brain barrier permeability and plasma orexin-A in Dementia with Lewy bodies (DLB). Methods: A total of 69 patients with probably DLB who were hospitalized in the cognitive impairment department, and 40 healthy controls in the health management center of Beijing Tiantan Hospital from January 2021 to December 2022 were retrospectively included. Demographic and clinical information and neuropsychological assessments were collected from medical records. Cerebrospinal fluid (CSF) levels of Aβ_1-40, Aβ_1-42, t-Tau and p-Tau181 and APOE genotypes were recorded. CSF/serum albumin quotient (Q-alb) was calculated to reflect the blood-brain barrier permeability, and plasma orexin-A levels were determined. Pearson and Partial correlation analysis were used to evaluate the associations between plasma orexin-A and Qalb. Results: The scores of MMSE (P < 0.001) and MoCA (P < 0.001) in DLB group were lower than those in control group, and CDR (P < 0.001), ADL (P < 0.001), NPI (P < 0.001), and the levels of plasma orexin-A (P =0.015) and Qalb (P < 0.001) were significantly higher than those of control group.In the control group, the plasma orexin-A level was significantly different in different body mass index (BMI, P =0.034) and whether there was a history of hypertension (P=0.049). Qalb level was different from BMI level (P=0.012). In DLB group, the plasma orexin-A level of subjects with stroke history was significantly lower than those without (P=0.025). Qalb levels were significantly higher in women than in men (P=0.034). In the control group, Pearson correlation and Partial correlation analysis showed a positive correlation between plasma orexin-A level and Qalb (Pearson correlation: r=0.589, P < 0.001; Partial correlation: r=0.561, P < 0.001). In DLB, Pearson correlation and Partial correlation analysis did not find significant correlation between plasma orexin-A level and Qalb and neuropsychological assessment scores (P > 0.05). Conclusion: The plasma orexin-A and Qalb levels in patients with DLB were higher than controls. The elevated plasma orexin-A level in cognitively normal elderly people is associated to the increase of blood-brain barrier permeability, suggesting that the dysfunction of orexin-A system may be a potential mechanism of blood-brain barrier disorders..

Objective: To investigate the effect of Guide Care management model on self-management of Parkinson's disease patients.Methods: A total of 90 patients with Parkinson's disease who were hospitalized in the Department of Geriatric Neurology of our hospital from November 2021 to December 2022 were selected as the research objects. According to the random principle, they were divided into an experimental group and a control group, with 45 cases in each group. The control group was given routine nursing intervention, while the experimental group was given Guided Care management model intervention. The self-management ability, quality of life, disease progression, anxiety and depression of the two groups were evaluated. The intervention lasted for 6 weeks. Results: After intervention, the scores of three dimensions of self-management (daily behavior management, management cognition and disease management) in the experimental group were higher than those in the control group. The total scores of self-management and daily behavior management in the experimental group were higher than those in the control group (P< 0.001). The scores of UPDRS in both groups decreased before treatment, and the scores of motor examination, activities of daily living, mental behavior and emotion in the experimental group were significantly lower than those in the control group (P< 0.001). After intervention, the PDQ-39 scores of the two groups were significantly decreased, and the score of the experimental group was significantly lower than that of the control group (P< 0.05). After intervention, the SAS and SDS scores of the experimental group were significantly lower than those of the control group (P< 0.05). Conclusion: The Guide Care management model can improve the self-management ability of patients with Parkinson's disease and improve the clinical prognosis..

Alzheimer's disease (AD) is a neurodegenerative disorder characterized by progressive cognitive decline and represents the most common form of dementia. Acupuncture have shown promising potential in the treatment of AD. In recent years, functional magnetic resonance imaging (fMRI) has been increasingly employed to investigate the mechanisms underlying the effects of acupuncture on brain function in AD patients. Evidence from studies indicates that acupuncture may enhance cognitive function and memory by activating specific brain regions and modulating the functional connectivity of brain networks. This review provides an overview of fMRI-based research on the application of acupuncture in AD treatment, aiming to summarize current findings and highlight areas for future investigation.

To better address the severe challenges of Alzheimer's disease (AD) prevention and control in China, the national government has published the National Action Plan for Addressing the elderly people with dementia. In order to accelerate the achievement of its core objectives, the Chinese Expert Consensus on Multidisciplinary Rehabilitation Interventions for Alzheimer's Disease has been formulated by integrating multidisciplinary expert opinions and evidence-based findings, using the Delphi method combined with GRADE evidence grading. This consensus advocates a “hospital-community-family” tripartite collaborative management model to standardize systematic and multidimensional approaches for the prevention, treatment, rehabilitation, and care of AD.This consensus deliver evidence-based guidance for tripartite stakeholders (healthcare providers, community networks, and family care systems) to operationalize healthy aging strategies through standardized AD management protocols.. For preventive strategies, AD risk factors are categorized into low-, medium-, and high-risk tiers to guide the formulation of personalized prevention and intervention strategies. For therapeutic management, treatment regimens are stratified by AD clinical stages (mild/moderate/severe), incorporating Western pharmacotherapy, traditional Chinese medicine and neuromodulation techniques. Rehabilitation requires individualized protocols based on multidimensional assessments encompassing functional disability evaluations, personal preferences, and familial support systems, with active rehabilitation prioritized during early/mid-stages and passive interventions dominating advanced AD care. Rehabilitation measures include cognitive therapies (including cognitive training, cognitive stimulation, and cognitive rehabilitation), lifestyle modifications (featuring nutritional guidance and exercise regimens that combine aerobic, strength, and mind-body training), humanistic approaches (such as reminiscence and immersive technologies), art-based therapies (applying music, dance, and visual arts), nature-assisted therapies (through horticultural and animal-assisted interaction), as well as sensory modulation techniques (utilizing light therapy and aromatherapy). For moderate-to-advanced stage AD patients presenting with behavioral and psychological symptoms of dementia or profound cognitive-functional decline, care strategies should implement person-centered care frameworks to preserve self-identity, deliver integrated palliative support, and manage comorbidities through multidisciplinary coordination.

The continuous growth of Chinese economy and population, as well as the changes in social structure, have made China one of the countries with the fastest growing elderly population. The prevention and prognosis of geriatric diseases are facing great challenges. Alzheimer's disease (AD) is the most common age-related neurodegenerative disease. The pathological characteristics of AD are the long-term (more than 20 years) deposition of neurofibrillary tangles and amyloid plaques, which lead to the death or loss of function of neurons. At present, clinical diagnosis is mainly based on cognitive tests, imaging and cerebrospinal fluid (CSF) tests, which limits the application of these diagnostic methods in the early detection of AD. Although biomarkers such as the ratio of amyloid-β (Aβ_40/42) in blood and proteins such as phosphorylated Tau-181 and Tau-217 have received widespread attention, their application is usually limited to the assessment of disease progression, because changes in Tau protein are generally considered to be secondary reactions to Aβ deposition and are not suitable for early detection. Urine contains a variety of biomolecules, and its composition can reflect the physiological and pathological changes of the body in real time, which makes urine an ideal choice for biomarker discovery and early screening of diseases. The value of urine as a non-invasive peripheral metabolite biological fluid in the early detection of AD is gradually being promoted and applied. This article mainly summarizes and prospects the research progress in developing urine biomarkers as a means of early detection of AD.

Objective: To explore the effects of human umbilical cord mesenchymal stem cells (hUC-MSCs) with or without sulforaphane (SFN) on the biomarkers of the brain from APP/PS1 transigenic mice of Alzheimer's disease (2xTg-AD mice), and to provide a basis for further study or treatment strategies to AD. Methods: 8-week-old males, 24 APP/PS1 transgenic mice were randomly divided into four groups and respectively treated with PBS, SFN, hUC-MSCs, or hUC-MSCs with SFN. The cells were injected into the ventricles of the brain while SFN was delivered by i.p. to 2xTg-AD mice. The mice were euthanized at 14 days after the treatment. Aβ, Tau as biomarkers of AD in the brains, were subjected to immunofluorescence staining and Western Blot Analysis. Results: hUC-MSCs or SFN could downregulate the levels of Aβ or Tau protein in the cerebral cortex, with a better effect when they were used at the same time to 2xTg-AD mice. Conclusion: The application of hUC-MSCs with SFN may have a good therapeutic effect on early AD, and further study be needed.

Objective:To analyze the direct economic burden of patients with dementia comorbidities and its influencing factors, and to provides a reference basis for economic cost calculation and family care burden assessment in patients with comorbid dementia. Methods: Using a self-designed questionnaire, the sociodemographic characteristics, treatment status, and direct economic burden of dementia comorbid patients in Guangzhou were collected. The Charlson Comorbidity Index (CCI) was used to assess the comorbidity burden. The direct economic burden costs were estimated using the direct method, and after a normality test showed a skewed distribution, logarithmic transformation was applied to approximate normalization before using it in a multiple linear regression model. Results: The per capita direct economic burden of dementia patients in Guangzhou in the past year was 7180.00 (3600.00, 15 568.67) yuan, of which the per capita direct medical cost was 6150.00 (3185.00, 12 590.00 ) yuan. The per capita direct non-medical cost was 0.00 (0.00, 2082.50) yuan, and Charlson Comorbidity Index (CCI) was 5.00 (5.00, 6.00), indicating a heavy comorbidity burden as well as a significant direct economic burden. The results of the multiple linear regression analysis showed that the primary factors influencing the direct economic burden of the disease were the patient's region, place of treatment, comorbid Chronic Obstructive Pulmonary Disease (COPD) or senile chronic bronchitis, comorbid heart disease, and types of dementia medications taken. Conclusion: The direct economic burden of dementia comorbid patients in Guangzhou is heavy, and the influencing factors are multi-dimensional and complex, which requires the joint efforts and complex, which requires the joint efforts and exploration of the government, society and medical institutions.

With the intensifying global aging population, the number of patients with Alzheimer's disease (AD) is expected to increase sharply. Phase 3 clinical trials of anti-Aβ antibodies, lecanemab and donanemab have shown positive results, successfully slowing the progression of AD by approximately 30%. Although this progress is encouraging, we still need to explore more innovative treatment strategies to achieve a complete cure for AD. In recent years, the characterization of tRNA modification deficiency has become one of the hotspots in the field of AD research due to the rapid development of tRNA sequencing technology. As an important participant in protein translation, the deficiency of tRNA modification leads to a decrease in tRNA structural stability, protein translation efficiency and accuracy. The deficiency of tRNA modification can participate in AD progression through abnormal accumulation of misfolded proteins and mitochondrial dysfunction. Studies have shown that overexpression of low-modification tRNAs can restore protein homeostasis and treat peripheral neuropathy, so combing out the deficiency of tRNA modifications in AD could help to discover new therapeutic treatments. Recent advances in the deficiencies of U34, m5C, and m1A modifications of tRNAs in AD are reviewed, emphasizing the importance of targeting tRNAs for the treatment of AD.

Cerebral stroke, a severe cerebrovascular disease causing acute brain dysfunction, imposes a heavy burden on families and society due to its high incidence and disability rates. Patients often develop post-stroke cognitive impairment (PSCI) after stroke, which affects multiple cognitive dimensions including memory, executive function, attention, language, and visuospatial abilities. Traditional rehabilitation therapies, although somewhat effective in promoting cognitive recovery, generally suffer from slow onset, long treatment cycles, and patient compliance issues. In recent years, repetitive transcranial magnetic stimulation (rTMS), as an emerging neuromodulation technique, has shown positive effects on the cognitive function of PSCI patients by continuously applying high-intensity, transient magnetic pulses to the brain tissue, effectively modulating the excitatory state of the cerebral cortex. This review aims to summarize the mechanisms of action and clinical research progress of rTMS in the treatment of PSCI, providing a scientific basis for clinical treatment planning and inspiring future research directions.

Objective: To evaluate the effect of non-pharmacological intervention in AD patients. Methods: Relevant Chinese and English databases were searched to collect randomized controlled trials of non-drug intervention effect in Alzheimer's disease patients and conduct statistical treatment using Review Manager 5.3 software. Results: In 7 articles, non-pharmacological intervention improved the Mini-Mental State Examination(MMSE) score of Alzheimer's patients (WMD=-1.91,95%CI:-3.10,-0.70,Z=3.13,P=0.002) and Activity of Daily Living Scale(ADL) score (WMD=-0.09,95%CI:-0.86,0.67,Z=0.24,P=0.81). Conclusion: Compared with drug intervention or control measures, non-drug intervention can improve the intelligence and daily living function of Alzheimer's disease patients to a certain extent, but more long-term clinical data with large sample size are still needed for further verification.

Objective: To explore the relationship between apolipoprotein A1 (ApoA1), apolipoprotein B (ApoB) and executive function in people with early cognitive impairment (EMCI), late mild cognitive impairment (LMCI), and early Alzheimer's disease (AD) patients, and to establish a group of Normal Control (NC) as a control group, in order to provide help for clinical intervention in the AD patients. Methods: A total of 142 people aged 50-80 years were recruited from Chengdu Fourth People's Hospital, including 35 cases of EMCI, 17 cases of LMCI, 26 cases of AD and 64 cases of NC. Each patient collected the following scales for executive function assessments using The Shape Trail Test part A (STT-A), The Shape Trail Test part B (STT-B), The Animal Fluency Test (AFT), The Symbol Digit Modalities Test (SDMT), Digit Span Test (DST) at baseline. The laboratory collected morning fasting blood to detect ApoA1 and ApoB levels. Spearman correlation test was used to analyze the correlation between ApoA1, ApoB and executive function, and linear regression analysis of the influencing factors of ApoA1 and ApoB on executive function. Results: The years of education in AD group were significantly lower than that in the NC group (P<0.05); In the NC group，the time spent on STT-A and STT-B were significantly lower than that in the EMCI group, LMCI group and AD group(P<0.05); in the EMCI group, the time spent on STT-A was significantly lower than that in the AD group(P<0.05), and the AFT and SDMT scores were significantly lower than those in the NC group(P<0.05) ; in the AD group, the AFT score was significantly lower than that in the NC group and LMCI group(P<0.05) ; the SDMT and DST score was significantly lower than that in the NC group (P<0.05) ; the ApoA1 level in the AD group was significantly lower than that in the NC group and EMCI group(P<0.05) ; there was no statistically significant difference in the ApoB levels among the four groups. ApoA1 levels were positively correlated with AFT, SDMT, and DST (P<0.05), and negatively correlated with STT-A and STT-B (P<0.05) ; ApoB levels had no correlation with executive functions; after adjusting for confounding factors, the multiple linear regression results of ApoA1 and executive function showed that ApoA1 significantly positively affected SDMT (P<0.05). After diagnosis stratification, the results of linear regression between ApoA1 and SDMT showed that ApoA1 could significantly positively affect SDMT in the NC group, LMCI group, and AD group (P<0.05). Conclusion: The connection between ApoB and executive function has not been found;. ApoA1 is mainly significantly related to information processing speed in the NC group, LMCI group, and AD group, indicating that the combination of ApoA1 and information processing speed can become an important tool for exploring cognitive impairment..

Extracellular vesicles are collectively referred to as various vesicle structures with membrane structures released by cells. Their contents include transmembrane proteins, lipids, cytoskeletal structural proteins, enzymes, transcription factors, DeoxyriboNucleic Acid, Ribonucleic Acid, and other substances.It is widely found in blood, cerebrospinal fluid and other body fluids.EV can promote intercellular communication, affect the homeostasis and function of the brain, and promote the progression of neurodegenerative diseases such as Alzheimer’s disease.This review discusses the research of EV in AD in this field.

Alzheimer's disease (AD) is a degenerative disease characterized by cognitive impairment, affecting over 50 million people worldwide. In recent years, the research progress of AD biomarkers and imaging diagnosis has brought new hope for the early detection and diagnosis of AD. The discovery of new pathways such as the brain-gut axis has led to the successful launch of new drugs such as GV-971, which has brought new options for the treatment of AD. But human understanding of AD is still the tip of the iceberg. Therefore, the anti-aging advantages of TCM are particularly important in the intervention of brain aging and AD. AD belongs to the category of "dementia" in traditional medicine, and traditional doctors have been fighting against it for more than 1,000 years, so TCM has a deep understanding of the treatment of "dementia", and many TCM theories coincide with modern medicine such as the brain-gut axis, which can provide more basis for the treatment of AD.

Alzheimer's disease (AD) is the most common type of dementia in the elderly. The main pathogenesis of AD includes brain Aβ deposition, tau protein hyperphosphorylation, neuroinflammation, neuronal oxidative stress, and cerebral microcirculation disorders. In recent years, increasing evidence suggests that the liver is closely related to the pathogenesis of AD. The liver is not only the main organ for peripheral Aβ clearance, but also can affect the pathological changes of AD in the brain through a variety of ways, including cognition, emotion, cerebral perfusion and brain metabolism. This article summarizes the research on the liver's roles in the pathogenesis and treatment of AD, hoping to find more effective treatment methods for AD from the perspective of liver intervention.

Objective: Investigate the diagnostic value of cerebrospinal fluid (CSF) growth-associated protein 43 (GAP-43) in AD and the predictive value of AD transition from mild cognitive impairment (MCI) to dementia through a cross-sectional and longitudinal observational study. Methods: 787 subjects with CSF GAP-43 data were divided into normal group (n=247), MCI group (n=413) and dementia group (n=127) based on cognitive status. Kruskal-Wallis test was used to compare the differences of CSF GAP-43 between groups. Multiple logistic model was used to test the correlation between CSF GAP-43 and different cognitive states. The diagnostic efficacy of CSF GAP-43 level for AD was evaluated by receiver-operating curves (ROC) and the area under curves (AUC). The diagnostic efficacy of AD was compared with that of CSF core markers (Aβ, t-tau, p-tau). Patients with MCI were divided into stable MCI (sMCI) and progressive MCI (pMCI) according to whether they progressed to dementia within 5 years. Mann-Whitney u test was used to compare CSF GAP-43 between groups. Cox regression model was used to test the correlation between CSF GAP-43 and the progression of MCI to dementia. The predictive value of CSF GAP-43 levels in predicting MCI progression to dementia was evaluated by ROC curve. The association of CSF GAP-43 level with the risk of progression to dementia was evaluated using Kaplan-Meier survival curves. Results: The results of cross-sectional study showed that the level of CSF GAP-43 was significantly higher in the dementia group than in the normal group and the MCI group (P<0.0001). CSF GAP-43 was an independent risk factor for the onset of AD dementia (P=0.002). The AUC of CSF GAP-43, Aβ, p-tau and t-tau for the diagnosis of AD were 0.64, 0.68, 0.64 and 0.63. Follow-up analysis showed that the level of CSF GAP-43 in pMCI patients was significantly higher than that in sMCI patients (P<0.0001), and CSF GAP-43 was an independent risk factor for the progression of MCI to dementia (P=0.012). The AUC for CSF GAP-43 predicting MCI progression to dementia was 0.75 (P<0.0001, 95%CI: 0.69~0.80). The risk of progression to dementia was 3.45 times greater in MCI patients with high CSF GAP-43 levels than in MCI patients with low CSF GAP-43 levels (P<0.0001, 95%CI: 2.17~5.43).Conclusion: CSF GAP-43 level can be used in the diagnosis of AD dementia, and its diagnostic efficacy is comparable to that of CSF core biomarkers (Aβ, t-tau, p-tau). CSF GAP-43 can predict the progression of MCI to dementia and is an independent risk factor for the progression of MCI to dementia.

As one of the most disabling non-motor symptoms of Parkinson's disease, cognitive impairment lacks clear drug treatment, which seriously affects the quality of life of patients and increases the burden on caregivers and social families, so it should be paid attention to. As an objective indicator, neuroimaging can help clinicians and researchers detect the occurrence of Parkinson's-related cognitive impairment as early as possible. From the perspective of neuroimaging, the research progress of Parkinson's disease-subjective cognitive decline (PD-SCD), Parkinson's disease-mild cognitive impairment (PD-MCI), and Parkinson's dementia (PD-D) is reviewed. After the search, it was found that the current diagnostic criteria for PD-SCD are not clear, but a wide range of objective functional and structural changes can be found; In addition to being clearly related to the function of the Parkinson's dopamine system, the white matter changes of PD-MCI have been related to memory-related structures such as the hippocampus. On the basis of PD-MCI, the white matter lesions of PD-D were further deepened, the gray matter atrophy was obvious, and the changes in brain network function included the impairment of the basic perceptual system.

Objective: To explore the effect of mindfulness-based stress reduction therapy on the burden of illness of home caregivers of AD. Methods: From May 2019 to October 2022, 78 AD home caregivers were randomly divided into observation group and control group, with 39 cases in each group.The observation group was intervened with mindfulness decompression therapy, while the control group was intervened with conventional health education.The intervention of disease burden in the two groups was compared by independent sample t test, repeated test analysis of variance and x2 test. Results: The disease burden scores of the observation group and the control group were analyzed by independent sample t test before intervention, 4 weeks after intervention and 12 weeks after intervention.The results showed that there was no significant difference between the two groups before intervention (P > 0.05).The burden of disease in the observation group was significantly lower than that in the control group after intervention for 4 weeks and 12 weeks, and the difference was statistically significant (P < 0.01).The disease burden scores of the two groups were compared at three time points: before intervention, 4 weeks after intervention and 12 weeks after intervention by using repeated measures analysis of variance.There was a significant difference in disease burden between the two groups (P < 0.05);In addition, the burden of disease of caregivers in both groups decreased significantly with the intervention time (P < 0.01);The interaction of time factor and grouping factor showed that the effect of time factor was different in different groups (P < 0.01). Conclusion: Mindfulness-Based Stress Reduction can reduce the disease burden of home caregivers of AD.

Objective:TDP-43 pathology is featured in many neurodegenerative diseases, including Alzheimer's disease (AD). Its contribution to these diseases remains unclear. One fundamental question is whether the neurotoxic effects from TDP-43 abnormalities result from its abnormal aggregation in the cytoplasm or its deficiency in the nucleus. To address this question, we investigated the mechanisms underlying TDP-43 abnormality-induced synaptic loss by analyzing how TDP-43 mutants contribute to spine abnormalities. Methods: Truncated mutants of TDP-43 were analyzed for their aggregation, effects on endogenous TDP-43, effects on dendritic spine density in cultured rat hippocampal neurons, and whether nuclear TDP-43 replenishment could prevent spine loss induced by TDP-43 abnormalities. Results: The ∆NLS∆R2 mutation of TDP-43 could mimic pathological abnormalities of TDP-43, including the formation of ThS-positive, highly phosphorylated cytoplasmic aggregates, and induction of nuclear depletion of endogenous TDP-43 in HEK 293T cells. ∆NLS∆R2 significantly reduces dendritic spine density of CA1 neurons in rat hippocampal slice cultures. This reduction in dendritic spine density can be partially blocked by co-expression of nuclear-localized TDP-43 mutant (NLS-TDP-43). Conclusion: The ∆NLS∆R2 mutation of TDP-43 recapitulates pathological abnormalities of TDP-43 and reduces dendritic spine density of CA1 neurons. Compensation for nuclear depletion of TDP-43 partially blocks the decrease in dendritic spines caused by ∆NLS∆R2, indicating that nuclear depletion of endogenous TDP-43 is a partial cause of spine loss induced by TDP-43 pathology.

The early treatment of Alzheimer's disease (AD) has made a breakthrough, making it urgent for early and accurate diagnosis of AD. Blood biomarkers are ideal tools for early diagnosis and have promising application prospects. Great research progresses have been made in recent years, but a series of challenges still exist in the translational application of blood biomarkers. Here, we dissected these challenges and proposed strategies to facilitate AD blood biomarkers to clinical practice.

Alzheimer's disease is a neurodegenerative disease with insidious onset, and Electroacupuncture is one way to treat Alzheimer's disease. Therefore, this article intends to summarize the experimental research on electroacupuncture treatment of Alzheimer's disease in mice in recent years, in order to provide reference for further exploring the pathogenesis of electroacupuncture treatment of Alzheimer's disease.