Alzheimer's disease (AD) is currently a major disease that affects human life. Exploring the causes of Alzheimer's disease and seeking treatment methods are an important work for scholars in this field. Currently, a flicker stimulation therapy, which reduces β-amyloid protein through gamma oscillations to achieve the treatment of AD, has made preliminary progress, and is expected to become a new direction of AD treatment. This study introduces the scheme and principle of flicker frequency therapy for Alzheimer's disease, expounds the effect of 40Hz flicker stimulation on cerebral cortex activity, and analyzes the current limitations of this scheme, aiming to provide ideas and references for further clinical research.

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.

The non-benzodiazepine sedative-hypnotic drug (Zolpidem) is used for the short-term treatment of insomnia. However, long-term high-dose use may lead to serious adverse reactions such as dizziness, headache, and falls, and may even result in cognitive decline and abnormal behavior.Furthermore, long-term use of Zolpidem may lead to drug tolerance, dependence, rebound phenomena, and withdrawal symptoms, making discontinuation difficult. Therefore, this review aims to provide a review of the mechanism of action, adverse reactions, tolerance, and special use of Zolpidem. To elucidate the mechanism of Zolpidem's adverse effect to cognitive function,in order to help chronic insomnia patients who use zolpidem long-term to avoid cognitive decline.

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.

Objective: To systematically evaluate the effect of computer aided cognitive rehabilitation training on the overall cognitive function of patients with cognitive impairment after stroke. Methods: Pubmed, EMbase, Wanfang and CNKI databases were searched by computer to collect randomized controlled trials on the effect of computer aided cognitive rehabilitation training on the improvement of overall cognitive function in patients with cognitive impairment after stroke. The time limit was from the establishment of the database to May 2022. Literature screening, data extraction and bias risk assessment of included studies were completed by two researchers independently. Finally, RevMan5.3 software was used for Meta-analysis. Results: Nine RCTs involving 467 patients were included. Meta-analysis results showed that the effect size of MMSE was 1.97 [0.52, 3.42]. Meta-analysis results showed that the effect size of MoCA was 3.24[2.41, 4.07].In terms of cognitive function improvement, computer aided cognitive rehabilitation training is better than artificial cognitive rehabilitation training. Conclusion: Computer aided cognitive rehabilitation training for more than 4 weeks has advantages in improving the cognitive function of stroke patients. Rehabilitation programs can be made according to the specific conditions of different patients and different hospitals, so as to improve the cognitive function effectively. Limited by the quantity and quality of the included studies, the conclusions need to be verified by more high-quality studies.

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.

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 test the feasibility of the implementation of cognitive stimulation therapy (CST) among patients with mild to moderate dementia in urban nursing homes. Methods: Totally 55 patients with mild and moderate dementia in a nursing home in Tianjin were selected and received a 7-week CST treatment, twice a week. The cognitive function and quality of life were evaluated by community screening instrument for dementia (CSID), Mini-mental State Examination (MMSE), Alzheimer’s Disease Assessment Scale-Cognitive Section (ADAS-Cog) and dementia quality of life questionnaire (DEMQOL) at the baseline and the end of the seventh week. Results: After 7 weeks of CST treatment, the scores of CSID and MMSE of the 55 dementia patients increased, while the ADAS-Cog scores decreased, with statistically significant differences (P<0.05). Conclusion: CST can be scaled up in urban nursing homes.

Alzheimer's Disease (AD) is a devastating neurodegenerative condition that warrants attention from all individuals, given its widespread prevalence and profound societal burden. As the population of elderly individuals continues to rise, the incidence of AD is steadily increasing. Conventional pharmacotherapeutic interventions offer only transient amelioration of certain AD symptoms, failing to halt the inexorable progression of the disease. Over the past two decades, extensive efforts have been made to develop anti-AD drugs with disease modifying potentials but all of which have been failed. Consequently, AD has long been perceived as an incurable affliction. However, lecanemab, a monoclonal antibody that targets aggregated amyloid-beta (Aβ), has demonstrated efficacy in slowing the progression of AD in a rigorously conducted randomized, double-blind, multi-center phase 3 clinical trial. This landmark advancement signifies AD as a modifiable condition, with aberrant Aβ aggregation serving as a pivotal etiological factor. This breakthrough holds epochal significance for both theoretical understanding and therapeutic modalities, heralding a transformative epoch in humanity's pursuit to conquer AD. In this review, we endeavor to summarize the cutting-edge advancements in AD research, with the aim of augmenting societal awareness and comprehension of this disease.

Dementia/cognitive impairment in elderly persons is often caused by more than one common age-related brain diseases. Alzheimer’s disease (AD) is the most common neurodegenerative disease that leads to or contributes to dementia/cognitive impairment. It is the only one of the 10 top deadliest diseases globally that has no curative nor long lasting effective symptom treatments. AD places tremendous burdens on individuals, their families, and the economies of essentially all societies. Early and timely detection and intervention has been increasingly considered to be the best strategy to combat AD. Over the last 3 decades, numerous studies have suggested approaches to reducing the risk of dementia, and up to 40% of dementia cases could be prevented or delayed by addressing risk factors, which are outlined in the 2020 Lancet report on dementia prevention. However, the current global healthcare system is not equipped sufficiently to detect AD early or in a timely fashion. For example, a recent study found that less than 10% of mild cognitive impairment (MCI) is diagnosed in primary care setting. Recently, with the full approval of the anti-Amyloid beta (Aβ) antibody drug lecanemab and donanemab for early AD and the publications of ~20-year follow-up studies establishing that modification of risk factors could markedly reduce AD-dementia incidence and increase life span, there is rapidly growing interest in early AD recognition. The Chinese Association of Alzheimer’s Disease (CAAD) recognizes the importance of early and timely detection of AD in an at-home setting and has assembled a global panel of association professionals, clinicians and researchers who are expert in different areas of AD to reach the consensus reported here with the following goals: 1) to provide individuals, family, community, associations and organizations with expert guidance, 2) on the digital tools and available resources for the screen of cognitive impairment/dementia at home and describe a work flow for the next steps for those at risk or suspected of AD, 3) discuss current available or future resources for AD biomarker as at-home screen, and 4) to establish a framework for future improvement and worldwide application if results warrantee such a direction. The experts reviewed the current available evidence, tools, resources and considered the significance of screening for AD at home and the consensus recommendations are reported here.

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.

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.

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.

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: 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: 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.

This review aims to explore the molecular mechanism and pathophysiological characteristics of neuroinflammation in AD, and summarize the latest advances in drug treatment of neuroinflammation in including glial cell inhibitors (such as non-steroidal anti-inflammatory drugs, glucocorticoids, etc.), inflammatory mediator inhibitors (such as monoclonal antibodies, TNF-α inhibitors, etc.), anti-inflammatory siRNA therapy, anti-inflammatory Chinese medicine，etc. The clinical efficacy of the above drugs in the treatment of AD is compared, and their potential mechanisms of action and adverse effects are discussed, which provides a valuable reference for future research and clinical practice.

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.

Objective: The objective of this study is to examine the nutritional status of individuals diagnosed with Alzheimer's disease by assessing protein energy and micronutrient levels, and subsequently analyze its association with cognitive function. Methods: According to the predefined inclusion and exclusion criteria, a total of 100 patients diagnosed with Alzheimer's disease and an equal number of non-AD patients were meticulously selected as the control group.Based on the CDR score, the AD group was stratified into three subgroups: mild (34 cases), moderate (32 cases), and severe (34 cases) AD groups.The protein energy, and micronutrient levels of each group were assessed, and an analysis was conducted on the relevant nutritional factors influencing the progression of AD. Results: Compared to the control group, the AD group exhibited significant reductions in BMI, MNA-SF, ALB, HGB, FA, 25-(OH)D3, TC and TG levels; meanwhile, MMA and HCY levels were significantly elevated(all P<0.05).The levels of NNA-SF, HGB, and FA exhibited a declining trend across the mild AD group, moderate AD group, and severe AD group, whereas MMA demonstrated an increasing trend (all P<0.05).The severe AD group exhibited lower levels of BMI and ALB, while the mild AD group showed lower levels of HCY and 25-(OH)D3 (all P<0.05).The logistic regression analysis revealed significant correlations betweenMNA-SF, and FA with the degree of AD development (all P<0.05). Conclusion: The nutritional status of patients with Alzheimer's disease (AD) is generally poor, and there is a progressive.

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.

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: To assess the potential relationship between lipoprotein(a) levels and the risk of developing different types of dementia (Alzheimer's disease, dementia with Lewy bodies, frontotemporal lobe dementia, Parkinson's disease-associated dementia, and vascular dementia) using a two-sample Mendelian randomization study approach. Methods: Genetic loci closely associated with lipoprotein(a) levels were obtained as instrumental variables (IVs) from the genome-wide association study (GWAS) pooled dataset, and two-sample Mendelian randomization (TSMR) analysis was performed with different types of dementia, with the results of the random-effects inverse variance weighting (IVW) method main. The reliability of the data was verified by multiple validity analysis using the MR-Egger method and sensitivity analysis using the leave-one-out method. Results: Elevated lipoprotein(a) levels were positively correlated with Lewy body dementia (OR = 1.67, P= 0.0005) and negatively correlated with the development of Alzheimer's disease (OR=0.95, P=0.036), and no significant correlation was found with vascular dementia, frontotemporal lobe dementia, and Parkinson's-related dementia. Conclusion: Lipoprotein(a) levels may be positively associated with the risk of developing dementia with Lewy bodies, may be negatively associated with the risk of developing Alzheimer's disease, and are not significantly associated with other types of dementia.

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 and analyse the diagnosis and treatment of patients with frontotemporal lobar degeneration (FTLD) before their visits to the memory clinic, and to improve the awareness of non-cognitive subspecialty clinicians about this disorder. Methods: Clinical data of FTLD patients registered at the memory clinic of Shengjing Hospital of China Medical University between January 2017 and December 2022 were retrospectively collected, mainly including demographic data, clinical and imaging data, previous consultation experience, previous diagnosis, and the data were grouped and analysed according to behavioural variant and aphasia type. Behavioural variant refers to behavioural variant of frontotemporal dementia (bvFTD), and aphasia type includes progressive non-influent aphasia (PNFA) and semantic dementia (SD). The data were also compared with those of 100 consecutive patients with Alzheimer's disease (AD) registered in our dementia clinic. Results: A total of 75 patients with FTLD were registered during the study period, including 39 (52.0%) patients with behavioural variant bvFTD and 36 (48.0%) patients with aphasic type. The aphasic type included 14 (18.7%) patients with PNFA and 22 (29.3%) patients with SD.The age of the FTLD patients was 62.7 ± 7.5 years, which was significantly younger than that of the AD group (67.8 ± 6.6 years) (P < 0.05).Seventy of the 75 patients with FTLD had been seen in non-memory clinics at all hospital levels, but only three patients with bvFTD were correctly diagnosed, a correct diagnosis rate of 4.3%. 63 of the 100 AD patients had previously attended a non-memory clinic, with a correct diagnosis rate of 44.4%, a significant difference between the two (P < 0.05). The proportion of patients with all types of FTLD who had undergone cognitive scales at previous visits was significantly lower than that of AD patients. bvFTD patients had significantly lower rates of self-perception of illness and structural imaging than the aphasic FTLD and AD groups (P < 0. 05). bvFTD patients were most likely to be diagnosed with psychiatric disorders (48.7%) and AD (26.5%), aphasic FTLD were easily diagnosed as unclear (38.2%) or diagnosed with AD (26.5%) and cerebrovascular disease (23.5%). Conclusion: Patients with FTLD have an earlier age of onset than AD and a higher rate of misdiagnosis in non-memory clinics, which is associated with lack of awareness of the disease among clinicians and inadequate investigations..

The prevalence of depression in the oldest-old population is higher. The symptoms are dominated by somatic manifestations and are easily overlooked and misdiagnosed, becoming a critical mental health situation. Routine assessment of mood status can help to develop adequate interventions for these old people, and appropriate psychotherapy and antidepressants are commonly recommended for old patients with depressive disorders. This review focuses on the developments of clinical research on old-elderly depression, hoping to provide a reference for clinical management.

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: 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) 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.

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..

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.

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.

Human olfactory is inextricably linked to cognition and emotion. The dysfunction of the three is almost simultaneously appeared and accompanied by the whole disease process of Alzheimer 's disease (AD). However, the role of olfactory dysfunction in the pathological mechanism of AD and its impact on cognitive and emotional disorders have not been clearly elucidated. Based on the anatomy and physiological mechanism of olfaction, combined with the research progress of olfaction in the field of AD in recent years, this paper expounds the role of olfaction pathology in the pathological mechanism of AD, and discusses the application prospect of accurate identification technology of olfactory disorder and olfactory therapy in the prevention and treatment of AD.

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.

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 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 report a case of frontotemporal dementia who was misdiagnosed as primary psychosis. Methods: To analyze the clinical and neuroimaging features of a patient with behavioral variant frontotemporal dementia. Results: This case included a middle-aged female with mental abnormality at first, and was diagnosed as depression and schizophrenia successively in other hospitals. After treatment with related drugs, the effect was poor. Head MRI in our hospital showed bilateral frontotemporal lobe atrophy, with the left side obvious. Cranial 18F-FDG PET showed decreased metabolism in bilateral lateral frontal and temporal lobes. Ftd-related genetic testing found that the patient had a susceptibility gene mutation. Conclusion: This is a typical case of bvFTD, which was misdiagnosed as primary psychosis at an early stage, suggesting that the possibility of bvFTD should be considered in the diagnosis of mental disorders.

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.

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.

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.