1.Chinese expert consensus on community-based three-level comprehensive prevention and treatment of Alzheimer's disease(2025 edition)
Ying WANG ; Liang SUN ; Gang WANG ; Chunbo LI ; Houguang ZHOU ; Yifeng DU ; Yunpeng CAO ; Kai WANG ; Jiewen ZHANG ; Yao YAO ; Shangfeng TANG ; Yurong JING ; Qihua XU ; Xizhe PENG ; Yu HU ; Haimei QI
Chinese Journal of Geriatrics 2025;44(3):227-237
Alzheimer's disease(AD), a neurodegenerative disorder associated with aging, is the most prevalent form of dementia.As the aging population continues to expand, AD presents significant health and caregiving challenges for families and society, making it a pressing international public health concern.In recent years, numerous countries have implemented dementia prevention and treatment strategies that emphasize community-based comprehensive approaches.Currently, the community-based AD prevention and treatment model in China is still in the exploratory phase, with community efforts lacking organization.In alignment with China's action plan for advancing dementia prevention and treatment, and to achieve the strategic objective of "healthy aging, " this consensus is based on the principle of three-level prevention and is tailored to the characteristics of AD disease progression.It aims to develop a comprehensive prevention and treatment strategy for AD that is suitable for communities in China, providing technical guidance and support to establish a scientific basis for formulating community AD prevention and treatment models.
2.The opportunities and challenges on prevention and control of Alzheimer′s disease
Heng ZHANG ; Chengxuan QIU ; Yifeng DU
Chinese Journal of Neurology 2025;58(1):10-16
Alzheimer′s disease (AD) is a major public health challenge with no curative treatment at present and has become the fifth leading cause of death for urban and rural residents in China. Although diagnostic technology has made significant progress in recent years, precise identification of AD still faces certain limitations and challenges due to its heterogeneity and complex pathogenesis. It is possible to shift the paradigm and focus on the key "window" of the early stage of AD dementia to achieve breakthroughs. This article is based on MIND-CHINA (randomized controlled Multimodal INterventions to delay Dementia and disability in rural China) to discuss the etiology, prediction, risk-factors assessment, diagnosis, and intervention research of AD, in order to develop AD prediction and prevention strategies that are in line with China′s national conditions, and make a multi-perspective analysis of the current limitations and challenges on AD diagnosis and prevention to promote the future of precision medicine for AD.
3.Application of quantitative electroencephalogram in the early diagnosis of Alzheimer′s disease
Yixing WANG ; Yan WANG ; Lin SONG ; Yifeng DU
Chinese Journal of Neurology 2025;58(4):440-444
Alzheimer′s disease (AD) is the most common reason of dementia in the elderly, which brings a heavy burden to families and society. Due to its high prevalence, hidden onset, and poor effect of late treatment, it is urgent to improve the level of early diagnosis of AD, and slow or reverse the progression of the disease through early detection and intervention. Quantitative electroencephalogram (qEEG) can directly reflect the real-time discharge of brain neurons, and has a unique advantage in the early diagnosis of AD due to its characteristics of non-invasive, cheap, convenient and high time resolution. The ideas and methods of early diagnosis and differential diagnosis of AD by multi-angle qEEG spectrum analysis, synchronization and complexity analysis are steadily developing. It is expected to be one of the neurophysiological biomarkers for early screening and diagnosis of AD. The present paper reviews the typical qEEG characteristics of AD and its early stages, summarizes and compares the application and potential of commonly used qEEG techniques in the early diagnosis of AD.
4.Association between circadian syndrome, metabolic syndrome and mild cognitive impairment in older adults
Jie LU ; Rui LIU ; Shi TANG ; Tingting HOU ; Lin CONG ; Yongxiang WANG ; Yifeng DU
Chinese Journal of Behavioral Medicine and Brain Science 2025;34(3):208-214
Objective:To explore the association between circadian syndrome (CircS), metabolic syndrome (MetS) and mild cognitive impairment (MCI) in elderly rural adults in China.Methods:From March to September 2018, totally 5 765 participants aged 60 years or older from 52 villages in Yanlou Town, Yanggu County, Shandong Province were selected. The data included demographic, underlying disease and neuropsychological data were collected by questionaire survey. Having ≥3 of the following components was defined as MetS: elevated waist circumference, high triglycerides, low high-density lipoprotein cholesterol, elevated blood pressure and elevated fasting glucose. Having ≥4 of the following components was defined as CircS: short sleep (<6 h/d), depression and five other components which were used to define MetS, with elevated waist circumference as a mandatory item. MCI was diagnosed according to Petersen's criteria and further classified into amnestic MCI (aMCI) and non-amnestic MCI (naMCI) based on whether the memory domains impaired.Data were analyzed using multivariable Logistic regression and general linear regression models by R statistical software.Results:In the total sample ( n=4 898), 1 280 participants were diagnosed with MCI, of which 1 075 were aMCI and 205 were naMCI.Compared to the normal group, CircS alone was significantly associated with increased risks of MCI ( B=0.695, P=0.039) and aMCI ( B=0.782, P=0.024), as well as lower verbal fluency scores ( B=-0.244, P=0.045). No significant associations were found between MetS alone or both MetS and CircS and cognitive impairment( P>0.05). At the component level, short sleep and depression were associated with increased risks of MCI ( B=0.167, P=0.025; B=0.605, P<0.001) and aMCI ( B=0.185, P=0.020; B=0.600, P<0.001). Conclusion:Individuals with CircS are at a higher risk of cognitive impairment, CircS is more strongly associated with cognitive impairment than MetS, with short sleep duration and depressive symptoms potentially playing key roles.
5.Association between circadian syndrome, metabolic syndrome and mild cognitive impairment in older adults
Jie LU ; Rui LIU ; Shi TANG ; Tingting HOU ; Lin CONG ; Yongxiang WANG ; Yifeng DU
Chinese Journal of Behavioral Medicine and Brain Science 2025;34(3):208-214
Objective:To explore the association between circadian syndrome (CircS), metabolic syndrome (MetS) and mild cognitive impairment (MCI) in elderly rural adults in China.Methods:From March to September 2018, totally 5 765 participants aged 60 years or older from 52 villages in Yanlou Town, Yanggu County, Shandong Province were selected. The data included demographic, underlying disease and neuropsychological data were collected by questionaire survey. Having ≥3 of the following components was defined as MetS: elevated waist circumference, high triglycerides, low high-density lipoprotein cholesterol, elevated blood pressure and elevated fasting glucose. Having ≥4 of the following components was defined as CircS: short sleep (<6 h/d), depression and five other components which were used to define MetS, with elevated waist circumference as a mandatory item. MCI was diagnosed according to Petersen's criteria and further classified into amnestic MCI (aMCI) and non-amnestic MCI (naMCI) based on whether the memory domains impaired.Data were analyzed using multivariable Logistic regression and general linear regression models by R statistical software.Results:In the total sample ( n=4 898), 1 280 participants were diagnosed with MCI, of which 1 075 were aMCI and 205 were naMCI.Compared to the normal group, CircS alone was significantly associated with increased risks of MCI ( B=0.695, P=0.039) and aMCI ( B=0.782, P=0.024), as well as lower verbal fluency scores ( B=-0.244, P=0.045). No significant associations were found between MetS alone or both MetS and CircS and cognitive impairment( P>0.05). At the component level, short sleep and depression were associated with increased risks of MCI ( B=0.167, P=0.025; B=0.605, P<0.001) and aMCI ( B=0.185, P=0.020; B=0.600, P<0.001). Conclusion:Individuals with CircS are at a higher risk of cognitive impairment, CircS is more strongly associated with cognitive impairment than MetS, with short sleep duration and depressive symptoms potentially playing key roles.
6.Chinese expert consensus on community-based three-level comprehensive prevention and treatment of Alzheimer's disease(2025 edition)
Ying WANG ; Liang SUN ; Gang WANG ; Chunbo LI ; Houguang ZHOU ; Yifeng DU ; Yunpeng CAO ; Kai WANG ; Jiewen ZHANG ; Yao YAO ; Shangfeng TANG ; Yurong JING ; Qihua XU ; Xizhe PENG ; Yu HU ; Haimei QI
Chinese Journal of Geriatrics 2025;44(3):227-237
Alzheimer's disease(AD), a neurodegenerative disorder associated with aging, is the most prevalent form of dementia.As the aging population continues to expand, AD presents significant health and caregiving challenges for families and society, making it a pressing international public health concern.In recent years, numerous countries have implemented dementia prevention and treatment strategies that emphasize community-based comprehensive approaches.Currently, the community-based AD prevention and treatment model in China is still in the exploratory phase, with community efforts lacking organization.In alignment with China's action plan for advancing dementia prevention and treatment, and to achieve the strategic objective of "healthy aging, " this consensus is based on the principle of three-level prevention and is tailored to the characteristics of AD disease progression.It aims to develop a comprehensive prevention and treatment strategy for AD that is suitable for communities in China, providing technical guidance and support to establish a scientific basis for formulating community AD prevention and treatment models.
7.The opportunities and challenges on prevention and control of Alzheimer′s disease
Heng ZHANG ; Chengxuan QIU ; Yifeng DU
Chinese Journal of Neurology 2025;58(1):10-16
Alzheimer′s disease (AD) is a major public health challenge with no curative treatment at present and has become the fifth leading cause of death for urban and rural residents in China. Although diagnostic technology has made significant progress in recent years, precise identification of AD still faces certain limitations and challenges due to its heterogeneity and complex pathogenesis. It is possible to shift the paradigm and focus on the key "window" of the early stage of AD dementia to achieve breakthroughs. This article is based on MIND-CHINA (randomized controlled Multimodal INterventions to delay Dementia and disability in rural China) to discuss the etiology, prediction, risk-factors assessment, diagnosis, and intervention research of AD, in order to develop AD prediction and prevention strategies that are in line with China′s national conditions, and make a multi-perspective analysis of the current limitations and challenges on AD diagnosis and prevention to promote the future of precision medicine for AD.
8.Application of quantitative electroencephalogram in the early diagnosis of Alzheimer′s disease
Yixing WANG ; Yan WANG ; Lin SONG ; Yifeng DU
Chinese Journal of Neurology 2025;58(4):440-444
Alzheimer′s disease (AD) is the most common reason of dementia in the elderly, which brings a heavy burden to families and society. Due to its high prevalence, hidden onset, and poor effect of late treatment, it is urgent to improve the level of early diagnosis of AD, and slow or reverse the progression of the disease through early detection and intervention. Quantitative electroencephalogram (qEEG) can directly reflect the real-time discharge of brain neurons, and has a unique advantage in the early diagnosis of AD due to its characteristics of non-invasive, cheap, convenient and high time resolution. The ideas and methods of early diagnosis and differential diagnosis of AD by multi-angle qEEG spectrum analysis, synchronization and complexity analysis are steadily developing. It is expected to be one of the neurophysiological biomarkers for early screening and diagnosis of AD. The present paper reviews the typical qEEG characteristics of AD and its early stages, summarizes and compares the application and potential of commonly used qEEG techniques in the early diagnosis of AD.
9.A retrospective analysis comparing mandibular fibula reconstruction by transoral versus submandibular approach
Fan XU ; Dongqing MIAO ; Yuli WANG ; Yifeng BIAN ; Na XIAO ; Yifei DU ; Xu DING
STOMATOLOGY 2025;45(5):355-359,366
Objective To compare the clinical and functional differences between transoral and submandibular approach in mandibu-lar segmental resection and reconstruction with free fibula flaps(FFFs).Methods Patients who underwent mandibular segmental re-section and FFFs reconstruction in the Department of Oral and Maxillofacial Surgery of the Affiliated Stomatological Hospital of Nanjing Medical University from January 2015 to March 2023 were retrospectively analyzed.All cases were divided into transoral approach and submandibular approach groups.Clinical characteristics of the patients were recorded including age,gender,follow-up time,pathologi-cal diagnosis,body mass index(BMI),American Society of Anesthesiologists(ASA)classification,James Brown classification of mandibular defect and number of fibular segments.The perioperative indexes,such as average operation time,average bleeding vol-ume,average blood transfusion volume,average drainage volume,average hospitalization time and postoperative complications such as malocclusion,fistula,infection,flap failure,and restriction of mouth opening were compared between the two groups.The University of Washington Quality of Life Questionnaire was used to investigate the appearance,function of swallow and speech more than 6-month postoperatively.Results The average intraoperative bleeding and postoperative drainage were significantly lower in the transoral ap-proach group than in the submandibular approach group(P=0.013 9,P=0.001 9).The appearance score was significantly higher in the transoral approach group than in the submandibular approach group(83.52±12.37)vs.(67.19±13.64)(P<0.000 1).The differ-ences between the two groups in other variables were not statistically significant.Conclusion Cases of transoral approach had signifi-cantly better aesthetic outcomes compared with those of submandibular approach.
10.A retrospective analysis comparing mandibular fibula reconstruction by transoral versus submandibular approach
Fan XU ; Dongqing MIAO ; Yuli WANG ; Yifeng BIAN ; Na XIAO ; Yifei DU ; Xu DING
STOMATOLOGY 2025;45(5):355-359,366
Objective To compare the clinical and functional differences between transoral and submandibular approach in mandibu-lar segmental resection and reconstruction with free fibula flaps(FFFs).Methods Patients who underwent mandibular segmental re-section and FFFs reconstruction in the Department of Oral and Maxillofacial Surgery of the Affiliated Stomatological Hospital of Nanjing Medical University from January 2015 to March 2023 were retrospectively analyzed.All cases were divided into transoral approach and submandibular approach groups.Clinical characteristics of the patients were recorded including age,gender,follow-up time,pathologi-cal diagnosis,body mass index(BMI),American Society of Anesthesiologists(ASA)classification,James Brown classification of mandibular defect and number of fibular segments.The perioperative indexes,such as average operation time,average bleeding vol-ume,average blood transfusion volume,average drainage volume,average hospitalization time and postoperative complications such as malocclusion,fistula,infection,flap failure,and restriction of mouth opening were compared between the two groups.The University of Washington Quality of Life Questionnaire was used to investigate the appearance,function of swallow and speech more than 6-month postoperatively.Results The average intraoperative bleeding and postoperative drainage were significantly lower in the transoral ap-proach group than in the submandibular approach group(P=0.013 9,P=0.001 9).The appearance score was significantly higher in the transoral approach group than in the submandibular approach group(83.52±12.37)vs.(67.19±13.64)(P<0.000 1).The differ-ences between the two groups in other variables were not statistically significant.Conclusion Cases of transoral approach had signifi-cantly better aesthetic outcomes compared with those of submandibular approach.

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