Alzheimer's disease (AD) is a neurodegenerative disorder, by the time clinical symptoms manifest, irreversible pathological changes have already occurred in the brain; therefore, early diagnosis and intervention are critical to improving patient prognosis. With the advantages of being minimally invasive, convenient, and low-cost, blood-based testing has overcome the limitations of traditional diagnostic methods and has become a research hotspot in the early diagnosis of AD. Based on key domestic and international research findings in recent years, this paper systematically reviews the types, mechanisms of action, and relevant detection technologies of blood biomarkers for AD. The main biomarkers include core pathological markers (Aβ-related markers, phosphorylated tau protein), nerve injury markers (NfL, GFAP), and genetic risk markers (APOE ε4). Detection technologies cover fully automated immune detection platforms, high-sensitivity single-molecule array technology, and high-throughput detection techniques. As systematically reviewed, blood biomarkers and their detection technologies exhibit important clinical significance and application prospects in the early screening, accurate diagnosis, disease progression evaluation, and new drug development of Alzheimer's disease.

Alzheimer's disease (AD) is the most prevalent neurodegenerative disorder. Its pathogenic framework has evolved beyond the conventional amyloid-β (Aβ) cascade hypothesis toward a multifactorial interactive network model. Aβ, tau, neuroinflammation, synaptic dysfunction, the microbiota-gut-brain axis, and epigenetic regulation collectively form a complex pathological loop that drives progressive cognitive decline. In addition to cerebrospinal fluid and molecular imaging biomarkers, emerging blood-based biomarkers show considerable promise for clinical application. Therapeutic strategies targeting Aβ clearance have demonstrated disease-modifying effects, yet amyloid-related imaging abnormalities demand improved risk prediction and management. Concurrently, novel approaches including anti-tau antibodies, TREM2 agonists, and multi-target agents are advancing rapidly. Evidence also supports multimodal lifestyle interventions in delaying disease onset. Moving forward, elucidating the intricate interactions within AD pathological pathways using cutting-edge technologies, integrating and expanding the clinical implementation of multimodal biomarkers, and addressing therapeutic bottlenecks arising from pathological heterogeneity will be pivotal to achieving effective risk prediction, early detection and interception, and personalized treatment in AD.

Accurate early diagnosis of Alzheimer’s disease (AD) represents a major challenge against the backdrop of global aging. This paper reviews research advances combining generative Artificial Intelligence (AI) with multimodal neuroimaging (including MRI and PET) to achieve early and accurate diagnosis of AD. This review systematically analyzes the applications of generative models in AD diagnosis across key areas: brain image data augmentation, pathological feature representation learning, and brain network modeling. We provide a detailed analysis of how these technologies effectively overcome critical challenges such as neuroimaging data scarcity and class imbalance. These technologies enhance the models’ classification performance on AD datasets and its ability to predict the progression of AD. Specifically, in the analysis of functional and structural brain networks, generative AI offers a new paradigm for understanding AD pathological mechanisms and enabling early prediction by constructing high-fidelity networks. Furthermore, this paper discusses the clinical translation prospects of these technologies in personalized prognosis and treatment monitoring, as well as the technical and ethical challenges in implementation. This review provides a comprehensive framework to understand the potential and development trends of generative AI, multimodal neuroimaging, and their derived functional brain network features in the auxiliary diagnosis of early AD.

Alzheimer's disease (AD) is a progressive neurodegenerative disorder characterized by gradual decline in cognition and daily functioning. Its pathological basis involves β-amyloid (Aβ) deposition, tau hyperphosphorylation, neuroinflammation, and synaptic dysfunction. This review summarizes recent advances in integrative Chinese and Western medicine for AD. In Western medicine, symptomatic pharmacotherapy remains the cornerstone, mainly included cholinesterase inhibitors and N-methyl-D-aspartate (NMDA) receptor antagonists, while disease-modifying strategies targeting Aβ（such as anti-Aβ monoclonal antibodies) are being actively explored. In addition, non-pharmacological interventions, including cognitive training, transcranial magnetic stimulation (TMS), and comprehensive management of modifiable risk factors, are widely applied to slow functional decline and optimize long-term care. From the perspective of traditional Chinese medicine (TCM), AD is generally considered a condition with "root deficiency and branch excess," with kidney essence deficiency as the root and phlegm turbidity and blood stasis as major contributing factors; common syndromes include kidney essence deficiency and phlegm obstruction of the orifices. TCM interventions such as herbal formulas and bioactive constituents may exert multi-target effects by modulating Aβ-related processes, reducing oxidative stress and inflammatory responses, and improving synaptic plasticity. Acupuncture has also been reported to benefit cognitive performance potentially through improving cerebral perfusion and regulating neural networks. Available clinical studies suggest that combining Chinese herbal medicine and/or acupuncture with standard Western therapy may improve cognitive scale scores, activities of daily living, and neuropsychiatric symptoms. Regarding outcome assessment, beyond conventional scales such as the Mini-Mental State Examination (MMSE), integrating biomarker-based evaluation (e.g., Aβ and tau-related biomarkers) with TCM syndrome differentiation may help refine stratification and monitoring of therapeutic response. Future research should prioritize high-quality clinical studies with standardized outcome measures and longer follow-up to strengthen evidence for integrative management strategies in AD.

Objective: To systematically evaluate the efficacy and safety of repetitive transcranial magnetic stimulation (rTMS) in the treatment of vascular dementia(VaD). Methods: Randomized controlled trials (RCTs) investigating rTMS for VaD were retrieved from Chinese and English databases from inception to May 2025. After screening based on predefined inclusion and exclusion criteria, a meta-analysis was performed using RevMan 5.4 software. Results: A total of 15 eligible RCTs involving 1,296 patients were included. The meta-analysis demonstrated that, compared with the control group, rTMS significantly improved clinical response rate [RR=1.26,95%CI(1.18,1.35),P<0.00001], Montreal Cognitive Assessment (MoCA) score [MD=1.84,95%CI(1.27,2.41),P<0.00001], Mini-Mental State Examination (MMSE) score [MD=3.81,95%CI(3.43,4.19),P<0.00001], Hasegawa Dementia Scale (HDS) score [MD=3.48,95%CI(2.94,4.03),P<0.00001], National Institutes of Health Stroke Scale (NIHSS) score [MD=-1.23,95%CI(-1.47,-0.99),P<0.00001], and Activities of Daily Living (ADL) score [MD=6.72,95%CI(5.70,7.74),P<0.00001]. All differences were statistically significant. Adverse effects of rTMS were mild, with good patient tolerance and high safety. Conclusion: rTMS demonstrates significant efficacy in improving cognitive function, activities of daily living, andneurological deficits in VaD patients, while maintaining high treatment safety.

Alzheimer’s disease (AD) is a prevalent neurodegenerative disorder characterized by progressive memory loss and cognitive decline. Sleep disorders, recognized both as an early clinical manifestation and as an important risk factor for AD, have attracted increasing attention in recent years. A growing body of evidence indicates that impaired sleep quality and reduced sleep duration are closely associated with the accumulation of amyloid-β (Aβ) and tau protein in the brains of AD patients. Microglia, the resident immune cells of the central nervous system, play pivotal roles in maintaining neural homeostasis, clearing Aβ, and regulating neuroinflammation. Sleep disturbances can activate microglia by disrupting circadian rhythms and inducing inflammatory responses, driving them toward a pro-inflammatory phenotype while impairing their phagocytic and clearance capacities. These alterations exacerbate Aβ deposition, promote tau pathology, and thereby accelerate AD progression. This review systematically summarizes current findings on the interplay among sleep disorders, microglial dysfunction, and AD pathogenesis, with a particular focus on mechanistic links and bidirectional regulation. In addition, we highlight recent advances in non-pharmacological interventions, pharmacotherapies, and related emerging regulatory strategies targeting sleep disorders and AD. A deeper understanding of these mechanisms may provide early clues for AD onset and offer novel targets for its prevention and treatment.

Objective: To evaluate the clinical efficacy of low-frequency transcranial magnetic stimulation (TMS) combined with mirror therapy (MT) in patients with hemiplegia and cognitive impairment following hemorrhagic stroke.Methods: Between February 2022 and February 2025, 92 patients with hemiplegia and cognitive impairment following hemorrhagic stroke admitted to our hospital were enrolled. They were randomly assigned to either the TMS group or the combined group, each comprising 46 subjects. The TMS group received conventional therapy plus low-frequency TMS, while the combined group added mirror therapy to the TMS regimen. Upper limb motor function, balance function, neurophysiological indicators, cognitive function, and activities of daily living were compared between the two groups. Results: Baseline upper limb FMA, BBS, MMSE, MBI scores, MEP amplitude, and CMCT were comparable between the TMS and combined groups, with no statistically significant differences (P > 0.05). After 4 weeks of treatment and 1 month post-treatment, both groups showed significant improvements in upper limb FMA, BBS, MMSE, and MBI scores compared to baseline (P < 0.05). Post-treatment scores in the combined group were significantly higher than those in the TMS group (P < 0.05). Additionally, at 4 weeks and 1 month post-treatment, the combined group showed greater improvements in MEP amplitude and CMCT (P < 0.05). Conclusion: Combined TMS and MT therapy promotes upper limb motor function and balance recovery in patients with hemiplegia and cognitive impairment following hemorrhagic stroke. It improves neuroelectrophysiological indicators, enhances cognitive function, and increases activities of daily living capabilities.

Objective: To evaluate the effectiveness of Wuling capsule in the treatment of cognitive impairment through meta-analysis, thereby providing evidence-based reference for clinical practice. Methods: Major Chinese and English databases were searched to collect randomized controlled trials (RCTs) on Wuling Capsule for cognitive impairment. The Cochrane Risk of Bias Tool (version 2.0) was used to assess the methodological quality of the included studies. Meta-analysis was performed using STATA 16.0 and RevMan 5.4. Results: A total of 20 studies involving 2531 patients were included. The meta-analysis results showed that the Wuling capsule intervention significantly improved patients' Mini-Mental State Examination (MMSE) scores [MD = 2.06, 95%CI (0.98, 3.13), P = 0.0002] and Montreal Cognitive Assessment (MoCA) scores [MD = 0.91, 95%CI (0.47, 1.35), P < 0.0001]. It also significantly increased the amplitude of the event-related potential (ERP) P3amp [MD=2.10, 95%CI (1.13, 3.07), P <0.0001) and shortened the latencies of ERP N1 [MD=-4.34, 95%CI (-5.81, -2.87), P <0.00001), N2 [MD=-14.13, 95%CI (-21.69, -6.56), P =0.0003), P2 [MD=-7.94, 95%CI (-13.20, -2.68), P=0.003), and P3 [MD=-21.15, 95%CI (-31.67, -10.62), P <0.0001]. In addition, Wuling Capsule effectively improved patients' activities of daily living as measured by the Barthel Index (MD = 6.44, 95%CI (1.46, 11.42), P = 0.01). Subgroup analysis indicated that the improvement was particularly evident in patients with post-stroke and depression-related cognitive impairment. Conclusions: Wuling capsule combined with conventional therapy may have an adjunctive effect in improving cognitive function and daily living ability in patients with cognitive impairment, especially reflected in improvements in MMSE, ERP, and BI. However, due to the methodological limitations and high heterogeneity of the included studies, further high-quality RCTs with long-term follow-up are needed to verify its efficacy and safety.

Objective: To observe values of the third generation sequencing（TGS）in detecting tandem repeats of NIID（neuronal intranuclear inclusion disease). Methods: Peripheral blood samples were collected from 10 confirmed NIID patients (confirmed group), 10 clinically suspected cases (suspected group), and 10 healthy controls (control group) between January 2017 and December 2023. The NOTCH2NLC GGC repeats were amplified by long-range PCR (LR-PCR) and repeat-primed PCR (RP-PCR). The amplification products were first screened using capillary electrophoresis (CE). Results: The ten confirmed cases were again found with clinically significant GGC repeats in all cases, but in the earlier testing lab and the current testing lab the exact sequence repeats number were not available in 2 cases when the repeats were estimated to be more than 110. In the suspected group, there were 4 cases found with significant GGC repeats, but there were also two cases where CE platform could not give exact numbers of GGC repeats when the repeat numbers were estimated to be more than 110. In contrast,TGS could give exact numbers of GGC repeats, including the four cases where CE could not give the exact numbers of GGC repeats. There were no false positive or negative result in either platforms.Conclusions: This study confirms that TGS effectively overcomes the technical limitations of CE in quantifying highly repetitive sequences in NIID, enabling precise quantification and structural resolution of sequences, thereby providing more reliable technical support for molecular subtyping and precise diagnosis and treatment of NIID.

The comorbidity of Parkinson's disease (PD) and sarcopenia in the elderly has garnered increasing research interest in recent years. This condition can accelerate the decline of motor function and elevate the risk of falls. The underlying pathogenesis is multifactorial, involving processes such as neuroinflammation, oxidative stress, hormonal and metabolic dysregulation, mitochondrial dysfunction, neuromuscular junction impairment, gut microbiota dysbiosis, exosome-mediated propagation of α-synuclein pathology, non-motor symptoms, pharmacological effects, and neurodegeneration. Intervention strategies emphasize a multi-targeted, integrated management approach, including personalized resistance training, nutritional support, and innovative therapies targeting the gut microbiome. Despite accumulating evidence, considerable controversies remain regarding the pathogenic mechanisms, diagnostic criteria, and optimal interventions for this comorbidity. This review summarizes recent advances in the study of PD complicated by sarcopenia, aiming to inform strategies for improving functional outcomes and quality of life in affected patients.

Alzheimer's disease (AD) represents a major global health challenge. In recent years, driven by big data and cutting-edge technologies, precision medicine has been guiding AD research and practice through a profound transformation. The core of this shift moves away from a reactive, symptom-based, "one-size-fits-all" model towards a new paradigm of precise diagnosis and treatment grounded in biological evidence and aimed at early disease modification. This review systematically explores the latest advances in early prevention, diagnosis, and treatment of AD within this framework, aiming to provide new perspectives and feasible pathways towards ultimately conquering the disease.

Alzheimer's disease is a neurodegenerative disorder characterized by β-amyloid deposition and pathological phosphorylation of tau protein. Traditional population-level sequencing has been limited in resolving the highly heterogeneous cellular populations and their spatiotemporal dynamics in brain tissue due to resolution constraints. In recent years, single-cell sequencing technologies—including single-cell RNA sequencing, single-cell assay for transposase-accessible chromatin sequencing, single-cell whole-genome sequencing, and spatial transcriptomics—have overcome these limitations. These technologies enable systematic exploration of subpopulation heterogeneity and pathological response mechanisms in neurons, microglia, astrocytes, and oligodendrocytes at single-cell resolution, offering novel insights into the cellular and molecular mechanisms underlying Alzheimer's disease. Studies demonstrate that single-cell RNA sequencing combined with spatial topological information can map cell-specific distributions of β-amyloid plaques and neurofibrillary tangles. Multi-omics integrative analyses have revealed the epigenetic mechanisms by which APOE ε4 regulates microglial phagocytic function and delineated the brain-gut axis and neuroinflammatory network atlas. Although single-cell technologies still face challenges in sensitivity, cost, spatial resolution, and data analysis, their integration with artificial intelligence algorithms and high-throughput microfluidic platforms is driving a paradigm shift in Alzheimer's Disease research—from pathological description to systems biology and precision medicine. Future advancements in detection efficiency, multi-omics integration, three-dimensional spatial mapping, and clinical validation are essential to enable ultra-early diagnosis and personalized therapies for Alzheimer's Disease. This review systematically summarizes the progress of single-cell sequencing technologies in elucidating key cell types in AD and discusses their technical limitations and future prospects.

Objective: To explore the real-world application performance of the urine β-amyloid protein detection kit in screening the risk of cognitive decline in multiple hospitals and communities in China. Methods: In this study, the clinical values of One-Step Dementia Risk Test Kit in early screening were further validated by community health screening in Changsha （n=51 187） and a multi-center, case-control study with a total of 898 participants including 266 healthy age-matched controls, 167 MCI/AD patients and 465 non-AD patients with various comorbidities and age-related diseases. Results: The number of weak positive/ positive/negative in the healthy, non-AD and MCI/AD group was 8/12/246 （positivity 7.52%）, 41/16/409 （12.23%） and 77/44/46 （72.46%）, respectively, resulting in a Kappa value of 0.669 which indicated a good diagnostic performance. Comorbidity analysis identified memory decline as the most significant risk factor （P = 9.6×10^-23, Fisher's Exact Test）, followed by hyperlipidemia （P = 3.2×10^-12）, history of stroke （P = 0.0011） and hypertension （P = 0.00058）. Therapeutics analysis showed medications for cardiovascular diseases and anti-thrombosis significantly reduced risk of dementia （P = 0.0061 and 0.0081, respectively）. For AD patients, only patients receiving memantine treatment showed a slight reduction in kit positivity （P = 0.0532）. The kit also showed a clear age-dependent increase of positivity from 6.29%-15.40%, in health screening. Conclusions: Our results confirmed the diagnostic value of the kit in MCI and AD-dementia. Moreover, the kit can be used in the real world to assess the risk of various conditions towards AD as well as the treatment efficacy.

Creutzfeldt-Jakob disease is one of the most common diseases causing rapid progressive dementia. How to identify Creutzfeldt-Jakob disease at an early stage and reduce misdiagnosis is a challenge faced by our medical staff. This article reports the clinical characteristics and auxiliary examination results of a patient who is highly likely to have Creutzfeldt-Jakob disease and combines literature to explore methods for early identification and diagnosis of Creutzfeldt-Jakob disease.

Alzheimer's disease is a common neurodegenerative disease with pathological features including amyloid beta deposits and neurofibrillary tangles. Microglia-mediated neuroinflammation plays an important role in the occurrence and development of AD, mainly manifested by microglial activation and release of pro-inflammatory factors. Recent studies have found that microglia activate and differentiate into a variety of phenotypes and interact with Aβ and Tau, jointly affecting the pathology of AD. The expression of various inflammatory molecules in activated microglia is up-regulated, and NF-kB and NLRP3 are involved in the regulation. Recent treatments targeting microglia activation, phenotypic transformation, and inflammatory signals have been fruitful: new drug formulations such as LNP have enhanced the ability to penetrate the blood-brain barrier, and many natural ingredients derived from Chinese herbal medicines have also been effective. In this review, we will introduce the pathogenesis and treatment of AD from two aspects: activation and phenotypes of microglia, and activation of microglia-related inflammatory molecules(mainly NF-kB and NLRP3).

Alzheimer’s disease (AD) is a prevalent neurodegenerative disorder. Air pollution, characterized by its complex composition, diverse pollutant types, and significant spatiotemporal variability, poses both localized and long-range threats due to atmospheric transport. Certain pollutants exhibit persistence and bioaccumulative properties, exerting profound impacts on human health and social equity. These effects are further modulated by natural geographical and meteorological conditions, rendering them uniquely complex. An increasing body of evidence identifies air pollution as a significant environmental risk factor for AD. In response to growing interest, this paper provides a comprehensive review of the epidemiological evidence, pathophysiological mechanisms, and emerging methodological approaches related to air pollution's role in AD. Furthermore, it explores how compounded social determinants interact with environmental exposure to influence AD risk.

Objective: To expolre the changes in cerebral white matter microstructure and cerebral blood flow (CBF) in patients with plateau Alzheimer's disease (AD) using multimodal MRI. Methods: A total of 18 AD patients with long-term plateau residence and 20 healthy subjects were prospectively enrolled. 3.0T MRI scanner was used to acquire diffusion tensor imaging (DTI), T1-weighted, and arterial spin labeling (ASL) sequences. DPABI Pro post-processing software was applied to obtain tract-based spatial statistics (TBSS) images based on fiber tractography and region of interest (ROI) images.Comprehensive analysis of the characteristics of white matter microstructure changes in plateau AD patients was performed by combining CBF data and cognitive scales. Results: 1. TBSS results showed that the regions of white matter fiber tract damage in plateau AD patients were basically consistent with those in plainland AD patients. Compared with the normal control (NC) group, ROI analysis revealed that axial diffusivity (AD), mean diffusivity (MD), and radial diffusivity (RD) in the AD group were significantly increased in multiple brain regions (P < 0.05). 2. In plateau AD patients, decreased CBF coexisted with abnormal DTI findings in regions including the temporal lobe, corona radiata, parietal lobe, precuneus, cingulate gyrus, prefrontal lobe, and thalamus. 3. In plateau AD patients, AD and MD values of the cingulate gyrus were positively correlated with ADL scores; AD and MD values of the thalamus were significantly negatively correlated with MMSE scores; RD value of the hippocampus was negatively correlated with MMSE scores. Conclusions: Widespread and significant damage to global cerebral white matter and fiber tracts is observed in plateau AD patients, with regional specificity characterized by extensive involvement of the visual cortex, thalamus, and motor cortex. Additionally, there is substantial overlap between regions of decreased CBF and abnormal DTI indices in plateau AD patients, reflecting that the "blood flow-microstructure" synergistic damage mechanism caused by neurovascular coupling (NVC) impairment may exacerbate the pathological progression of plateau AD, and is closely related to global cognitive function and daily living ability.

Objective: To explore the application effect of rapid sedation combined with Cognitive Arousal Therapy in the emergency treatment of agitation in Alzheimer's disease patients. Methods: A total of 115 Alzheimer's disease patients admitted to our hospital from January 2023 to December 2025 were selected as subjects and randomly divided into a conventional group and an experimental group using a random number table method. The conventional emergency agitation treatment was administered to 57 cases in the conventional group, while rapid sedation combined with cognitive awakening therapy was applied to 58 cases in the experimental group. The intervention outcomes were compared. Results: The total effective rate of agitation control in the experimental group was 94.83%, significantly higher than that in the conventional group (80.70%), with a statistically significant difference (P < 0.05). Compared with the conventional group, the experimental group exhibited faster onset of sedation and longer duration of sedation, with a statistically significant difference (P < 0.05). At 24 hours post-intervention, the Confusion Assessment Method (CAM) scores were significantly lower in the experimental group than in the conventional group (P < 0.05). The overall compliance rate in the experimental group was 93.10%, significantly higher than that in the conventional group (77.19%), with a statistically significant difference (P < 0.05). The adverse reaction rate in the experimental group was 6.90%, significantly lower than that in the conventional group (21.05%), with a statistically significant difference (P < 0.05). Conclusion: Combining rapid sedation with cognitive awakening therapy in the emergency treatment of agitation in Alzheimer's disease patients can achieve rapid and sustained sedation, maintain good compliance, and improve disease control effectiveness.

Pulse pressure (PP), an indicator of arterial stiffness and pulsatile hemodynamic load, may offer superior value in risk assessment compared to static blood pressure indices. Recent studies have reported an association between PP and cognitive impairment or dementia; however, the findings have been inconsistent. This review summarizes the current evidence on the association between PP and cognitive impairment, with particular emphasis on its overall relationship with cognitive function, the modifying effects of age, sex, and APOE ε4 genotype, and the potential underlying mechanisms. Current evidence suggests that persistently elevated PP is associated with an increased risk of cognitive decline, and this association may be partly independent of traditional blood pressure indices and common vascular risk factors. Mechanistically, elevated PP may promote excessive transmission of pulsatile energy into the cerebral microcirculation, leading to perfusion mismatch, impaired cerebral autoregulation, and disruption of the blood-brain barrier. It may also contribute to cerebral small vessel remodeling, white matter microstructural damage, neuroinflammation, and impaired clearance of pathological proteins such as amyloid beta (Aβ) and tau, ultimately compromising brain network integrity and cognitive function. Given its noninvasive, simple, low-cost, and repeatable nature, PP may serve as a useful adjunctive marker for the early identification, risk stratification, and clinical assessment of individuals at high risk of cognitive impairment. However, its risk thresholds, causal relationship with cognitive decline, and therapeutic implications still require further investigation.

Objective: Based on interpretable machine learning methods, to explore the application value of multimodal MRI radiomics in the diagnosis of Alzheimer's disease (AD) and provide imaging tools for accurate clinical diagnosis of AD. Methods: A retrospective study was conducted on 110 subjects, including 48 in the AD group and 62 in the control group (HC), all of whom completed 3D-T1WI, DWI, and T₂WI MRI sequence scans. Randomly stratified sampling was conducted at a ratio of 7:3 to divide the data into training and testing sets, and 8 AD related core brain regions (hippocampus, entorhinal cortex, etc.) were segmented. Extract 107 radiomics features, screen the core features, and construct 8 diagnostic models (2 algorithms x 3 sequences, 2 algorithms x 2 sequences combined) based on logistic regression (LR) and random forest (RF) algorithms. Evaluate the model performance using area under the curve (AUC), and analyze the model interpretability using SHAP analysis. Results: 16 core radiomics features were ultimately selected. The joint sequence model has the best diagnostic performance, with AUC values of 0.989 (95% CI: 0.960~1.00) and 0.970 (95% CI: 0.920~1.00) for the LR and RF algorithm test sets, respectively, which are significantly higher than those of the single sequence model; The accuracy, sensitivity, and specificity of the LR joint model test set were 0.882, 0.800, and 0.947, respectively. SHAP analysis shows that the 3D-T₁WI sequence with short run length and high grayscale emphasized features, and the DWI sequence with grayscale co-occurrence matrix information measurement are the core indicators for AD diagnosis. Conclusions: The multimodal MRI radiomics model can efficiently achieve AD diagnosis, and the LR combined model has the best comprehensive performance. SHAP analysis can clearly analyze the decision-making basis of the model, providing strong support for the clinical translation of the model and accurate diagnosis of AD.

Alzheimer's disease (AD) is a chronic neurodegenerative disease with an insidious onset, often occurring in old age or pre old age. The main symptoms of the disease are a decline in memory and cognitive function, accompanied by language disorders, spatial orientation disorders, and behavioral impairments. AD is a common type of irreversible dementia, and its pathophysiological processes are initiated decades before clinical symptoms appear. Therefore, exploring biomarkers that can reveal early functional changes in AD and establishing objective and accurate auxiliary diagnostic tools have become the forefront and core of current research. Resting state functional magnetic resonance imaging (rs-fMRI) provides a unique window for non-invasive, in vivo evaluation of the functional integration and separation characteristics of large-scale brain networks by capturing spontaneous fluctuations in blood oxygen level dependent signals. This article reviews the research on combining artificial intelligence technology (AI) with rs-fMRI to achieve early auxiliary diagnosis of AD. This review first systematically introduces the biomarker potential of rs-fMRI in early diagnosis of AD; Secondly, the AI methodology applied to rs-fMRI analysis was elaborated, and the evolution of these AI methodologies, as well as multimodal fusion and interpretable AI strategies, were analyzed in detail; Finally, this article discusses the current challenges of these technologies, such as model generalization, data heterogeneity, interpretability barriers, and clinical translation obstacles, and provides prospects for the future development of this field. The deep integration of AI and rs-fMRI is driving a profound transformation in the early diagnosis of AD from an experience-based paradigm toward a data-driven, quantitative, and personalized paradigm. It will assist clinical doctors to cultivate and optimize medical decision-making, improve clinical diagnosis and treatment levels, and promote precision medicine.

Objective: To retrospectively investigate the correlation between the monocyte to high-density lipoprotein cholesterol ratio（MHR）, tumor necrosis factor（TNF-α）, and brain-derived neurotrophic factor （BDNF） levels in the serum of early stroke patients and post-stroke cognitive impairment（PSCI）, and to explore the role of early serum MHR, TNF-α, and BDNF levels in predicting and evaluating PSCI. Methods: Stroke patients who were hospitalized in the Department of Neurology of the Fourth People's Hospital of Wujiang District, Suzhou City from January 2022 to June 2025 and returned to our hospital for follow-up within 6 months were selected. The cognitive function of all patients was evaluated using the Mini-Mental State Examination（MMSE）. According to the MMSE results and educational background, the patients were divided into the PSCI group and the non-PSCI group. All patients had detailed blood tests. The differences in MHR, TNF-α, and BDNF levels between the two groups were statistically analyzed. Results: A total of 60 patients were collected, with 30 patients in each group. Statistical analysis showed no significant differences in gender, age, and MHR between the two groups. There were significant differences in TNF-α and BDNF levels between the two groups（P<0.05）. Pearson correlation analysis showed that TNF-α level was negatively correlated with MMSE score （rs = -0.256, P = 0.048）, while BDNF level was not correlated with MMSE score （rs=0.198,P=0.129）. Logistic regression analysis showed that TNF-α （P<0.05, OR=0.903, 95% CI: 0.854 - 0.956） was an independent risk factor for PSCI. The area under the ROC curve for TNF-α level in predicting PSCI was 0.819 （0.711 - 0.928）, and the critical value was 36.965 ng/L when the Youden index was at its maximum value of 0.600. Conclusions: The TNF-α level in early stroke patients is significantly negatively correlated with the occurrence of PSCI. A higher TNF-α level is an independent risk factor for PSCI. The TNF-α level has certain predictive and diagnostic value for the occurrence of PSCI. A serum TNF-α level higher than 36.965 ng/L may increase the risk of PSCI.

Objective: Frontotemporal dementia（FTD） and Alzheimer's disease（AD） exhibit overlapping clinical symptoms and neuroimaging features, complicating differential diagnosis and increasing misdiagnosis risks. This study aimed to explore gray matter volume（GMV） patterns between FTD and AD using 3D high-resolution T1-weighted MRI and machine learning to establish an objective diagnostic method. Methods: Voxel-based morphometry（VBM） was applied to analyze whole-brain GMV differences in 20 FTD and 35 AD patients. The relationships between GMV exhibiting significant differences and cognitive scores（MMSE, MoCA, CDT, ADAS-cog, CDR, ADL） were assessed. A support vector machine（SVM） classifier was constructed using GMV features from significant regions. Results: Significant GMV differences in FTD versus AD were observed in the right hemisphere（FWE-corrected, cluster level, P<0.05）, including the occipital（superior/middle/inferior gyri）, parietal（superior parietal lobule, supramarginal gyrus, angular gyrus）, and temporal lobes（superior/middle/inferior gyri）. GMV in the right occipital and temporal regions was significantly and positively associated with MMSE, MoCA and CDT scores（beta = 0.263-0.399, P<0.05）. The SVM model achieved moderate classification accuracy（60.00%, AUC = 0.6729）. Conclusion: VBM combined with cognitive assessment identified neuroimaging biomarkers distinguishing FTD from AD. Although the SVM model shows moderate performance, these findings provide objective evidence for clinical differentiation. This work not only advances understanding of neuroanatomy but also lays a foundation for optimizing machine learning models to improve diagnostic accuracy, demonstrating promising clinical translation potential.

To report a case of Alzheimer's disease (AD) mainly manifesting as corticobasal syndrome, share the diagnosis and treatment experience, and improve clinicians' understanding of this atypical type of AD. The medical history, results of neurocognitive assessment tests, and cranial structure and molecular neuroimaging data of a patient with corticobasal syndrome due to Alzheimer’s disease (AD-CBS) were collected, and discussions were made referring to relative articles. The patient mainly presented with motor dysfunction, apraxia and alien limb phenomenon of the left limb, accompanied by progressive cognitive impairments and sensory somatic cortical disorder. Cranial magnetic resonance imaging (MRI) showed obvious atrophy of the right parietal lobe, and cranial positron emission tomography (PET) showed abnormal deposition of Aβ and tau in the cerebral cortex, which was consistent with the characteristic manifestations of AD-CBS. Corticobasal syndrome (CBS) is mainly characterized by asymmetric atrophy of the cortex and extrapyramidal symptoms clinically. Due to the relatively late onset of cognitive impairment compared to motor dysfunctions, it is prone to misdiagnosis. Early diagnosis and medication can help slow the progression of AD-CBS. Meanwhile, due to the diverse causes of CBS, neuroimaging and laboratory examinations are required for differential diagnosis in clinical practice, and the possibility of co-pathology should be considered, raising the importance of long-term follow-up.

Objective: To explore the impact of geriatric syndrome on cognitive function in patients with mild cognitive impairment. Methods: This study included 422 elderly people who completed outpatient physical examinations at Hangzhou Wuyunshan Hospital from January to December 2022. All subjects were evaluated using the Montreal Cognitive Assessment (MoCA) and the Comprehensive Geriatric Assessment (CGA). The clinical data and geriatric syndromes of the two groups were compared, and the impact of geriatric syndromes on cognitive function in patients with mild cognitive impairment was observed. Results: A total of 422 elderly patients were enrolled, with 157 in the observation group (MoCA < 26) and 265 in the control group (MoCA ≥ 26). The observation group had significantly lower decreased grip strength, decreased calf circumference, 3-meter stand and walk, normal gait speed, comorbidity index, number of teeth, dentures, dental problems affecting eating, gum pain, and sleep disturbances than the control group (P < 0.05). Binary logistic regression analysis showed that comorbidity index (OR = 2.093, P = 0.012), decreased grip strength (OR = 19.488, P < 0.001), dental problems affecting eating (OR = 4.591, P = 0.001), gum pain (OR = 2.798, P = 0.009), and sleep disturbances (OR = 2.253, P = 0.031) were risk factors for cognitive function in patients with MCI. The number of teeth (OR = 0.740, P < 0.001) and wearing dentures (OR = 0.021, P < 0.001) were protective factors for cognitive function in patients with MCI. Conclusion: Geriatric syndrome has a certain degree of impact on the cognitive function of MCI patients. CGA should be emphasized in the MCI population and attention should be paid to geriatric syndrome to improve the quality of life of the elderly.

Objective: To explore the association between the levels of adaptor protein complex 2 (AP2) in cerebrospinal fluid (CSF) of patients with Alzheimer's disease (AD) and AD pathology, brain structural changes, and cognitive function. Methods: This study enrolled 138 patients with Alzheimer's disease (AD), 403 patients with mild cognitive impairment (MCI), and 167 cognitively normal (CN) subjects from the Alzheimer's Disease Neuroimaging Initiative (ADNI) database. Levels of AP2 (α2 and β1 subunits) in the cerebrospinal fluid (CSF) were measured. Data on core AD biomarkers, including amyloid-beta 1-42 (Aβ₄₂), total tau protein (t-Tau), and phosphorylated tau at threonine 181 (p-Tau₁₈₁), brain structural measures including ventricular volume, hippocampal volume, and entorhinal cortex thickness, and cognitive scores, including the Mini-Mental State Examination (MMSE) and the Clinical Dementia Rating - Sum of Boxes (CDRSB) were collected at baseline and over a five-year follow-up period. Statistical analyses were performed using one-way analysis of covariance, multiple linear regression models, and linear mixed-effects models. Results: At baseline, there were no significant differences in CSF AP2 levels among the CN, MCI, and AD groups, but they were significantly elevated in apolipoprotein (APOE) ε4 carriers. CSF AP2 levels increased with age, consistent with AD pathology progression. Elevated CSF AP2 levels were significantly associated with increased CSF Aβ42, T-tau, and p-Tau181 concentrations and smaller ventricular volume, especially in the CN and MCI stages. CSF AP2β1 was negatively correlated with CDRSB and positively correlated with hippocampal volume and entorhinal cortex thickness. Additionally, CSF AP2 affected longitudinal changes in brain structure and cognition, particularly in the non-AD group. Conclusion: CSF AP2 may be involved in early Aβ and tau pathology and is closely related to changes in ventricular volume, hippocampal volume, entorhinal cortex thickness, and cognition, especially in the preclinical and prodromal stages of AD.

Objective: To evaluate the predictive performance of biomarkers for the conversion of mild cognitive impairment（MCI） to Alzheimer's disease（AD）. Methods: A literature review summarized the predictive accuracy of individual and combined biomarkers for MCI-to-AD progression.Results: CSF amyloid-beta 42（Aβ42） showed 81% sensitivity at 64% specificity, while Aβ-PET sensitivity ranged 83%-100% and specificity 46%-88%. Phosphorylated Tau217 （P-tau217） had an accuracy of 0.88. Medial temporal lobe MRI demonstrated 0.65-0.7 sensitivity and 0.64-0.68 specificity. CSF total tau（T-tau） showed 75% sensitivity at 72% specificity, and FDG-PET 76% sensitivity at 82% specificity. Plasma neurofilament light chain（NfL） had high sensitivity （98.1%） but low specificity（16.1%）, accuracy 0.631; plasma GFAP accuracy was 0.77-0.84. Multi-biomarker models achieved accuracy 0.72-0.96, sensitivity 0.56-0.85, and specificity 0.56-0.91. Conclusions: Aβ biomarkers showed higher sensitivity than FDG-PET, while FDG-PET had higher specificity. Multi-biomarker combinations, particularly cognitive scales with MRI, provided superior prediction for MCI-to-AD conversion.

Alzheimer’s disease (AD) is characterized by key pathological features including amyloid-β (Aβ) deposition, abnormal tau hyperphosphorylation, and persistent neuroinflammation. Neuroinflammation runs throughout the disease course and is closely associated with synaptic injury and cognitive decline. In recent years, accumulating evidence has indicated that the gut microbiota (GM) is closely linked to the onset and progression of AD, and that it can modulate neuroinflammatory responses via the gut-brain axis, thereby exerting an important influence on AD. Therefore, based on available clinical association studies and mechanistic insights from experimental research, this review focuses on the multi-step, integrated mechanisms by which GM-mediated neuroinflammation contributes to AD, and systematically summarizes the key mechanisms and potential intervention strategies targeting the “GM-neuroinflammation-AD” axis, aiming to provide therapeutic references and a theoretical basis for the clinical prevention and treatment of AD.

Objective: To investigate the relationship between limb motor dysfunction and white matter structural changes in patients with Alzheimer 's disease (AD). Methods: A total data of 66 AD patients admitted to the hospital from January 2022 to September 2025 were retrospectively collected. Six cases were excluded according to the inclusion and exclusion criteria, and 60 cases were finally included. According to whether the patients were accompanied by limb motor dysfunction, they were divided into group A (simple AD) 33 cases and group B (with limb motor dysfunction) 27 cases. All subjects underwent MRI scans, including cross-sectional T1W1, T2W1, ASL sequences, and DWI. Imaging indicators included deep subcortical white matter hyperintensity (DWMH), white matter hyperintensity (PVWMH), and WMH. The clinical data and imaging indexes of the two groups were compared. Spearman correlation analysis was used to explore the correlation between each index and limb motor dysfunction. Multivariate Logistics regression was used to analyze the independent influencing factors of limb motor dysfunction in AD patients. Results: The albumin level, scores of Berg balance scale (BBS), Montreal cognitive assessment scale (MoCA) score and walking ability in activities of daily living (ADL) in group B were lower than those in group A (P<0.05). DWMH, PVWMH and WMH in group B were higher than those in group A (P<0.05). Albumin level, BBS score, MoCA score and walking score were negatively correlated with limb motor dysfunction (P<0.05), while DWMH, PVWMH and WMH were positively correlated with limb motor dysfunction (P<0.05). The increase of DWMH, PVWMH and WMH was an independent influencing factor of limb motor dysfunction (P<0.05). Conclusions: The occurrence of limb motor dysfunction in AD patients is closely related to the structural changes of white matter. DWMH, PVWMH and WMH values are key imaging markers for predicting limb motor dysfunction in AD. In clinical practice, for high-risk AD patients with these imaging changes, interventions such as establishing individualized exercise plans or adopting task-oriented gait training and balance training systems should be adopted to delay the decline of motor function.

Objective: To evaluate the efficacy and safety of acupuncture combined with NMES for treating dysphagia after stroke. Methods: Computerized searches were conducted in Chinese and English databases including CNKI, VIP, WANFANG DATA, Embase, PubMed, Web of Science, and Cochrane Library to identify RCTs on acupuncture combined with NMES for post-stroke dysphagia from database inception to December 2024. Two researchers independently screened studies, extracted data, and performed meta-analysis using RevMan 5.4.1 software. Results: A total of 27 RCTs involving 2 013 patients were included. Results showed that compared with acupuncture alone, acupuncture combined with NMES significantly increased the clinical total effective rate (RR = 1.23, 95% CI: 1.18-1.28, P < 0.00001) and better improved swallowing function measures including the Water Swallow Test (WST), Standardized Swallowing Assessment (SSA), and videofluoroscopic swallowing studies (VFSS) (all P < 0.05), while reducing the incidence of adverse reactions (RR = 0.41, 95% CI: 0.20-0.85, P = 0.02). Conclusion: Acupuncture combined with NMES represents an effective and safe treatment regimen for post-stroke dysphagia, demonstrating superior efficacy compared to acupuncture alone.

Senile dementia has attracted much attention due to its complex pathogenesis and the increasing incidence rate along with the aging population. Currently, modern medicine is confronted with problems such as low early recognition rate, limited treatment methods and high costs. In contrast, traditional Chinese medicine (TCM) has advantages in emphasizing syndrome differentiation and treatment, as well as treating different diseases with the same therapy. In recent years, many studies on the treatment of different syndrome types of senile dementia with Chinese patent medicines have been published. Based on the core pathogenesis theory of "deficiency at the root and excess at the surface" in TCM, this article screens the existing research literature on clear syndrome types of this disease, aiming to provide evidence-based support for the clinical application of Chinese patent medicines.

Objective: To analyze the differences in the triglyceride-glucose index (TyG) and its combination with obesity indicators in the assessment of cognitive function, and to further explore their mediating effects between physical activity (PA) and cognitive function. Methods: Questionnaires of the physical examination population in Youyi Road Community Health Service Centre for Baoshan District, Shanghai from April to December 2020 were collected. A total of 3937 subjects were included. The association between PA and cognitive function, the association between TyG and its combined obesity indicators and cognitive function were analyzed using generalized linear regression models, and gender stratified analysis was conducted. The mediating effects of TyG and its combined obesity indicators in the relationship between PA and cognitive function were evaluated using the mediation models. Results: After full adjustment, there was a significant association between PA and cognitive function (β=0.337, P < 0.05), and the trend of the analysis results in men was consistent with that of the total population (β=0.374, P < 0.05). There was no significant association between TyG and the mini-mental state examination (MMSE) score in the total population. Compared with TyG-body mass index (TyG-BMI) and TyG-waist circumference (TyG-WC), the association between TyG-waist-to-height ratio (TyG-WHtR) and MMSE score was significantly enhanced (β=-0.588, P < 0.001), and the results of the gender subgroup analysis were consistent with those of the total population. TyG-BMI, TyG-WC and TyG-WHtR all played significant mediating roles between PA and cognitive function, among which the mediating effect of TyG-WHtR was the strongest (9.81%, P < 0.05). Conclusion: There is a significant association between PA, TyG and its combination with obesity indicators and cognitive function. TyG-BMI, TyG-WC and TyG-WHtR all played significant mediating roles between PA and cognitive function, and TyG-WHtR plays the strongest mediating role in the association. The TyG-obesity combined indexes provide basis for formulating cognitive function protection strategies for individuals with metabolic abnormalities..

Objective: To evaluate the clinical efficacy and safety of the Bushen Tiaozhou Formula in the intervention of postmenopausal women with mild cognitive impairment (MCI) of kidney deficiency type. Methods: A randomized controlled trial was designed. Eighty postmenopausal women with kidney deficiency type MCI were divided into an experimental group and a control group using a random number table, with 40 cases in each group. The experimental group received oral administration of the Bushen Tiaozhou Formula granules (Jiangyin Tianjiang Pharmaceutical Co., Ltd.), one dose daily, dissolved in warm water and taken twice daily, in addition to basic health guidance (including diet, exercise, and cognitive training recommendations). The control group received only the same basic health guidance. The treatment course was 12 weeks for both groups. The primary efficacy measures were the Montreal Cognitive Assessment (MoCA) and the cognitive subscale of the Alzheimer's Disease Assessment Scale (ADAS-cog) before and after treatment. The Clinical Global Impression of Change (CGIC), Traditional Chinese Medicine (TCM) syndrome score, and Activities of Daily Living (ADL) scale were used as secondary efficacy measures to evaluate the improvement in cognitive function, clinical symptoms, and quality of life. Adverse events were recorded. Results: Seventy-seven cases completed the study (38 in the experimental group, 39 in the control group). After treatment, the MoCA scores in the experimental group significantly increased, and the ADAS-cog scores significantly decreased (both P<0.01), with the improvement being significantly superior to that in the control group (both P<0.01). The overall improvement rate based on CGIC in the experimental group was 81.58%. The total TCM syndrome score significantly decreased (P<0.01), and the ADL score also improved significantly (P<0.01), with all these indicators showing significantly better results than in the control group (all P<0.05). The comprehensive efficacy evaluation based on the change rate of MoCA scores showed a total effective rate of 81.58% in the experimental group, significantly higher than 23.08% in the control group (P<0.01). During the study, only two cases in the experimental group experienced mild gastrointestinal discomfort, which resolved spontaneously, indicating good safety. Conclusions: The Bushen Tiaozhou Formula can effectively improve cognitive function, alleviate kidney deficiency-related clinical symptoms, and enhance daily living ability in postmenopausal women with kidney deficiency type MCI, with good safety. It provides an effective option for early TCM intervention in cognitive impairment among postmenopausal women.

Gait abnormalities have long been regarded as exclusion criteria for Alzheimer’s disease (AD). However, with advances in modern gait-analysis research, this traditional view is being overturned. Modern gait analysis, which integrates wearable sensors, computer vision, and artificial-intelligence algorithms, now generates gait parameters that already support the early, accurate, and dynamic detection of abnormal gait patterns.This paper reviews the mechanisms underlying gait disturbances in AD, integrating them with the cerebral pathological evolution characteristic of the disorder. We provide a comprehensive overview of progress in gait-analysis research in AD, with particular emphasis on studies linking digitized gait parameters to biological diagnostic markers (BDMs)，aiming to evaluate the application values of gait-related digital diagnostic markers (DDMs) for the early identification of AD.

Objective: To observe the effects of Xiao-Xu-Ming Decoction (XXMD) on the expression of nuclear receptor coactivator 4 (NCOA4) and ferritin heavy chain (FTH1) in glutamate (Glu)-induced neurotoxic injury in mouse hippocampal neuronal cells (HT22), and to explore the mechanism of traditional Chinese medicine in treating Alzheimer's disease (AD). Methods: HT22 cells in the logarithmic growth phase were divided into a control group, a Glu model group, and low- and high-dose XXMD groups. An in vitro AD cell model was established by inducing HT22 cell damage with 20 mmol/L Glu. The cells in the XXMD groups were treated with different concentrations (500 and 1 000 μg/mL) of XXMD. The effects of XXMD on the proliferation and survival rate were detected using the methyl thiazolyl tetrazolium (MTT) assay. Autophagy flux was assessed using mRFP-GFP-LC3 adenovirus transfection. The associations between NCOA4/LC3 and NCOA4/FTH1 expression were examined by immunofluorescence double staining. The protein expression levels of LC3BⅡ/Ⅰ, NCOA4, and FTH1 were measured using Western blot analysis. Results: XXMD alleviated Glu-induced damage to HT22 cells in a dose-dependent (P < 0.01). Compared with the control group, the Glu group showed increased autophagy flux, elevated protein expression of NCOA4 and LC3BⅡ/Ⅰ (P < 0.01), and decreased protein expression of FTH1 (P < 0.01). Compared with the Glu group, the low- and high-dose XXMD groups exhibited reduced autophagy flux, decreased protein expression of NCOA4 and LC3BⅡ/Ⅰ (P < 0.01), and upregulated FTH1 protein expression (P < 0.01). Conclusions: XXMD significantly improves the survival rate of Glu-induced HT22 cells and inhibits abnormal autophagy flux. The mechanism may involve the downregulation of NCOA4 protein expression and upregulation of FTH1 protein expression.

Objective: To explore the effect of regulation intervention on anxiety and cognitive function of Alzheimer's patients. Methods: A total of 93 patients with Alzheimer's disease admitted to the Department of geriatrics and geriatric psychiatry in our hospital from January 2024 to December 2024 were selected and randomly divided into the control group (46 cases) and the observation group (47 cases). Both groups received brain health screening, the control group received conventional drug therapy combined with basic nursing intervention, and the observation group received acupoint regulation intervention on the basis of the control group. The effect was evaluated by self rating Anxiety Scale score, Mini Mental State Examination (MMSE) score, activity of daily living scale (ADL) score and clinical efficacy. Results: After 12 weeks of intervention, the self rating Anxiety Scale score of the observation group was lower than that of the control group, and the MMSE score of the observation group was higher than that of the control group (t=6.182, 3.798, P=0.000, 0.000); After 24 weeks of intervention, the improvement of each index in the observation group was better than that in the control group (P<0.05); The curative effect of the observation group was higher than that of the control group (P<0.05). Conclusion: Brain health screening combined with acupoint regulation intervention can gradually improve the anxiety of patients with Alzheimer's disease, and continuously improve cognitive function and activities of daily living. The overall curative effect is good, which is worthy of clinical application.

Objective: To explore the association between sedentary behavior (SB) contexts, characteristics, and cognitive function in older adults. Methods: A face-to-face survey was conducted among 1,485 elderly individuals aged 60-80 years undergoing health check-ups at the Xinchang Community Health Service Center in Pudong New Area, Shanghai. The survey included an SB questionnaire (covering 9 common SB contexts and 2 SB characteristics), MemTrax assessment (measuring the percentage of correct responses [MTx-%C], mean response time [MTx-RT], and a composite index [MTx-Cp, where MTx-Cp = MTx-%C / MTx-RT × 100]), and health examination data. Linear regression analysis was used to examine the association between SB and cognitive function. Stratified analysis was used to explore whether the impact of sedentary behavior (SB) on cognitive function differed by sex. Results: A total of 1,441 participants were included, of whom 630 (43.72%) were male, 454 (31.51%) had primary school education, and 673 (46.70%) had junior high school education. The average daily sedentary time was （6.59 ± 2.78 ）hours. The primary SB context was screen time (2.97 ± 1.55 hours). Participation rates in hobbies (21.10%), reading (5.20%), and listening to the radio (6.94%) were low. Cognitive function was positively correlated with screen time, meals (male), transportation, and hobbies (female) (all P < 0.05), negatively correlated with "thinking/idleness" (male) and socializing (all P < 0.05), but showed no significant association with reading or listening to the radio. The frequency of SB bouts was positively correlated with MTx-%C, but the longest continuous sedentary time had no significant effect. Conclusions: The sedentary time among older adults in Shanghai is higher than the national average, with screen time being the predominant SB context. The effects of different sedentary behavior contexts on cognitive function varied and demonstrated significant sex-specific patterns. Consequently, the future public health strategies should not be limited to advocating for "reducing sedentary time," but should also promote a paradigm shift toward "optimizing sedentary behavior." Furthermore, the influence of sex differences should be fully considered in the design of intervention measures.

Dysregulated metabolism of triglyceride-rich lipoproteins (TRLs) and remnants constitutes a shared risk factor for both cardiovascular disease (CVD) and Alzheimer's disease (AD), with close pathological interconnections between the two conditions. This review synthesizes current evidence on the common mechanisms through which TRLs and their remnants contribute to both CVD and AD, primarily involving the promotion of atherosclerosis, induction of systemic and neuroinflammation, and exacerbation of insulin resistance. By integrating clinical and genetic findings, it highlights the potential bridging role of TRLs between cardiovascular risk and cognitive decline. Furthermore, the review summarizes advances and limitations of current management strategies including lifestyle interventions, conventional pharmacotherapy, and emerging treatments within the framework of cardiocerebral comorbidity. It proposes a patient-centered, multidisciplinary integrated care pathway aimed at optimizing the management of these co-occurring conditions. Future research should focus on novel targets within TRLs metabolism to develop more effective interventions and improve outcomes in this high-risk population.

Objective: To assessment of the incidence and risk factors of cognitive decline in maintenance hemodialysis (MHD) patients. Methods: A total of 89 MHD patients and 30 Non-dialysis individuals with matched age and sex in the same community were enrolled. The cognitive functions of MHD patients and Non-dialysis individuals were evaluated by mini-mental State Examination (MMSE). The values below 27 indicative of cognitive impairment, which was corrected by the educational background. The clinical data, previous medical history, biochemical indicators of malnutrition, bone mineral metabolism and inflammation were evaluated. Logistic regression analysis was performed to find out the risk factors of cognitive decline in MHD patients. Results: Out of 89 enrolled MHD patients, 43.8% were classified with cognitive impairment, significantly higher than that in the healthy individuals group (13.3%, P=0.003). In the cognitive impairment group, age and MCV were significantly higher than that of the normal cognitive group, and the HDL was significantly lower than that of the normal cognitive group (P<0.05). Further analysis found that the scores in all fields of the cognitive impairment group were significantly lower than those with normal cognitive function, especially in attention, computational power and language ability (P<0.05). The results of logistic regression analysis showed that age(β=-0.110, P=0.008), MCV(β=-0.168, P=0.022) and HDL(β=3.071, P=0.038) were the independent risk factors affecting cognitive impairment in MHD patients. Conclusion: The incidence of cognitive impairment in MHD patients was significantly higher than that in matched healthy individuals in the same community. Age, MCV and HDL were independent risk factors for cognitive impairment in MHD patients.

我国人口老龄化加剧，认知障碍老年人数量持续增长，给家庭与社会带来沉重负担。本研究聚焦我国人口老龄化加剧背景下认知障碍老年人服务体系建设的国家需求。通过文献分析、实地调研与专家访谈，系统梳理了服务体系现状，精准识别了筛查覆盖率低、城乡与区域资源配置不均、专业人才短缺、政策衔接不畅及经济负担重等核心问题。为应对挑战，本研究提出构建具有中国特色的“预防-筛查-诊断-治疗-康复-长期照护”全链条服务体系，强调以社区和家庭为核心，发挥政府、市场与社会多元主体协同作用。具体对策包括：完善分层筛查网络、优化整合式照护服务供给、强化科技赋能与康复支持、健全多层次政策与经济保障机制、加快专业人才培养。本研究旨在为民政部门提供兼具创新性与可操作性的政策建议，推动服务体系系统化、精细化发展，助力健康老龄化国家战略的深入实施。