Objective:To investigate the prevalence and mortality of dementia and assess the impact of geriatric syndromes (GS) on the risk for dementia and death in elderly population in Beijing.Methods:A cross-sectional survey was conducted in the elderly population aged ≥65 years and selected by a multi-stage sampling in Beijing during 2013-2015. Cognitive function was screened using the Chinese Revised Version of the Mini-Mental State Examination (MMSE). Then, neurological examination and psychiatric assessment were performed for those with the MMSE score lower than the cut-off value. The information about GS prevalence was also collected. The study also collected death records for all individuals from baseline until December 31, 2019. Based on the age and gender distribution from Beijing data of the 2010 Six th National Population Census, the dementia prevalence in the study population was directly standardized. Logistic regression analysis was used to evaluate the association of different forms of dementia with GS, and Cox proportional hazards regression model was used to estimate the hazard ratio ( HR) and 95% CI of death. Results:During 2013-2015, a total of 2 935 individuals completed dementia assessments, of which 167 were diagnosed with dementia. The standardized prevalence of dementia was 5.9% (95% CI: 5.0%-17.4%). The individuals with Alzheimer's disease (AD) and vascular dementia (VaD) accounted for 58.7% and 28.1% of total individuals with dementia, respectively. Aging, lower education level, urinary incontinence, and fall were risk factors for AD, while disability of activity of daily life dependence, hypertension, and stroke were found to be risk factors for VaD. After a median follow-up of 5.44 person-years, 399 deaths were recorded. The 5-year mortality risk was 2.87 (95% CI: 1.92-4.17) times and 4.93 (95% CI: 3.23-7.53) times higher for the elderly individuals with AD and VaD, respectively, compared to non-demented individuals. After adjusting for demographic, GS, and cardiovascular risk factors, the mortality risk in the elderly individuals with AD showed no significant difference compared with non-demented individuals ( HR=1.32, 95% CI: 0.89-1.97), while the mortality risk in those with VaD was 2.46 (95% CI: 1.49-4.05) times higher than that in non-demented individuals. Conclusions:The prevalence of dementia in Beijing increased significantly in the context of population aging, especially the prevalence of AD. The presence of GS increased the risks for AD and VaD, as well as the risk for death. Close attention needs to be paid to GS management in dementia prevention in elderly population.

The uniqueness of the location of large general hospitals in urban areas determines that the contradiction between space constraints and medical expansion has become a problem of management bottleneck.The situation that expert visits are too concentrated on a certain working day morning has been significantly improved by carrying out peak load shifting in the visiting arrangements and visiting units of large general hospitals through the Total Quality Management theory and continuous improvement of work mode,greatly alleviating public transportation congestion around the hospital.Through the internal construction of the quality of outpatient clinics,it can effectively improve the patients'sense of access to health care.

The uniqueness of the location of large general hospitals in urban areas determines that the contradiction between space constraints and medical expansion has become a problem of management bottleneck.The situation that expert visits are too concentrated on a certain working day morning has been significantly improved by carrying out peak load shifting in the visiting arrangements and visiting units of large general hospitals through the Total Quality Management theory and continuous improvement of work mode,greatly alleviating public transportation congestion around the hospital.Through the internal construction of the quality of outpatient clinics,it can effectively improve the patients'sense of access to health care.

The uniqueness of the location of large general hospitals in urban areas determines that the contradiction between space constraints and medical expansion has become a problem of management bottleneck.The situation that expert visits are too concentrated on a certain working day morning has been significantly improved by carrying out peak load shifting in the visiting arrangements and visiting units of large general hospitals through the Total Quality Management theory and continuous improvement of work mode,greatly alleviating public transportation congestion around the hospital.Through the internal construction of the quality of outpatient clinics,it can effectively improve the patients'sense of access to health care.

The uniqueness of the location of large general hospitals in urban areas determines that the contradiction between space constraints and medical expansion has become a problem of management bottleneck.The situation that expert visits are too concentrated on a certain working day morning has been significantly improved by carrying out peak load shifting in the visiting arrangements and visiting units of large general hospitals through the Total Quality Management theory and continuous improvement of work mode,greatly alleviating public transportation congestion around the hospital.Through the internal construction of the quality of outpatient clinics,it can effectively improve the patients'sense of access to health care.

The uniqueness of the location of large general hospitals in urban areas determines that the contradiction between space constraints and medical expansion has become a problem of management bottleneck.The situation that expert visits are too concentrated on a certain working day morning has been significantly improved by carrying out peak load shifting in the visiting arrangements and visiting units of large general hospitals through the Total Quality Management theory and continuous improvement of work mode,greatly alleviating public transportation congestion around the hospital.Through the internal construction of the quality of outpatient clinics,it can effectively improve the patients'sense of access to health care.

The uniqueness of the location of large general hospitals in urban areas determines that the contradiction between space constraints and medical expansion has become a problem of management bottleneck.The situation that expert visits are too concentrated on a certain working day morning has been significantly improved by carrying out peak load shifting in the visiting arrangements and visiting units of large general hospitals through the Total Quality Management theory and continuous improvement of work mode,greatly alleviating public transportation congestion around the hospital.Through the internal construction of the quality of outpatient clinics,it can effectively improve the patients'sense of access to health care.

The uniqueness of the location of large general hospitals in urban areas determines that the contradiction between space constraints and medical expansion has become a problem of management bottleneck.The situation that expert visits are too concentrated on a certain working day morning has been significantly improved by carrying out peak load shifting in the visiting arrangements and visiting units of large general hospitals through the Total Quality Management theory and continuous improvement of work mode,greatly alleviating public transportation congestion around the hospital.Through the internal construction of the quality of outpatient clinics,it can effectively improve the patients'sense of access to health care.

The uniqueness of the location of large general hospitals in urban areas determines that the contradiction between space constraints and medical expansion has become a problem of management bottleneck.The situation that expert visits are too concentrated on a certain working day morning has been significantly improved by carrying out peak load shifting in the visiting arrangements and visiting units of large general hospitals through the Total Quality Management theory and continuous improvement of work mode,greatly alleviating public transportation congestion around the hospital.Through the internal construction of the quality of outpatient clinics,it can effectively improve the patients'sense of access to health care.

Objective To analyze the disease burden and change trend of breast cancer mortality among Chinese women from 2013 to 2021.Methods The indicators of breast cancer-related mortality (MR),age-standardized mortality rate (ASMR),deaths,and urban-rural deaths in the Chinese Cause of Death Surveil-lance Dataset from 2013 to 2021 were collected and collated,and the trend changes of MR,ASMR,and years lost in life of premature death (YLL) were analyzed,annual percentage change (APC) was used for trend a-nalysis,and Fisher substitution test was used to compare APC in different regions.Results From 2013 to 2021,a total of 88112 cases of breast cancer died,with an average annual MR of 7.56/100000 and an ASMR of 6.34/100000.From 2013 to 2021,the MR rate of breast cancer (APC=2.12%,t=5.414,P<0.001),MR in rural areas (APC=2.84%,t=7.581,P<0.001),and YLL in rural areas (APC=1.61%,t=3.588,P=0.009) showed an upward trend in China.MR at 40-<45 years old showed a downward trend (APC=-2.76%,t=-4.689,P=0.002),and at 70-<75 years old (APC=1.41%,t=2.494,P=0.041),75-<80 years old (APC=3.05%,t=3.690,P=0.008),and 80-<85 years old (APC=1.82%,t=2.909,P=0.023).There was a statistically significant difference in APC between MR and ASMR in urban and rural areas (P<0.001).There was no significant difference in the trend of other indicators (P>0.05).Conclusion From 2013 to 2021,the disease burden of breast cancer mortality in Chinese women showed an upward trend,and the comprehensive prevention and treatment of breast cancer should be strengthened to reduce the risk of breast cancer death.