Objective:To investigate the neuroimaging relationship between tau protein deposition and brain atrophy, and assess their relationships with cognitive decline in Alzheimer′s disease (AD) patients.Methods:From April 2017 to October 2019, 26 AD patients (12 males, 14 females, age (70.7±12.2) years) and 19 cognitively normal controls (CN; 9 males, 10 females, age (65.6±8.1) years) in Chinese PLA General Hospital were retrospectively enrolled. All subjects received (S)-6-[(3- 18F-fluoro-2-hydroxy)propoxy]-2-(4-methylaminophenyl)quinoline ( 18F-THK5317) PET/MR and the standardized uptake value ratio (SUVR) and gray matter volume (GMV) were measured. General linear model (GLM) was used to evaluate the differences of SUVR and GMV between two groups. Pearson correlation analysis was used to assess the relationships between SUVR and GMV, and relationships of SUVR and GMV with Mini-Mental State Examination (MMSE) scores in AD patients. Results:Compared with CN, the AD patients showed significantly increased 18F-THK5317 retention in lateral temporal, frontal, posterior cingulated/precuneus and occipital cortex with significant differences of SUVR between two groups (2.18±0.54 vs 1.78±0.09, 2.13±0.50 vs 1.82±0.06, 2.03±0.45 vs 1.69±0.08, 2.18±0.57 vs 1.76±0.10, t values: 2.58-6.57, all P<0.001). The AD patients also showed decreased GMV in medial temporal, posterior cingulated/precuneus and orbitofrontal cortex ( t values: 3.67-8.85, all P<0.001). In AD patients, SUVR was negatively associated with GMV in bilateral lateral temporal cortex, pre-frontal cortex and orbital frontal cortex ( r values: from -0.52 to -0.43, all P<0.05). Both SUVR ( r=-0.599, P=0.001) and GMV ( r=0.443, P=0.023) were significantly correlated with MMSE scores in AD patients. Conclusion:AD patients have neocortical 18F-THK5317 abnormal uptake and GMV reduction, which are significantly correlated with cognitive decline.

For lack of cognitive screening standard system and controversy over the value of imaging for cerebrovascular diseases in China, the research group of Alzheimer′s Disease Chinese (ADC) studied the knowledge of neuropsychology, neuroimaging and clinical neurology, systematically reviewed the diagnostic techniques such as memory, language, visuospatial, executive, function, and magnetic resonance imaging (MRI) of cerebrovascular diseases, and their optimal threshold and diagnostic value for vascular dementia. Via a consensus meeting, the diagnostic guidelines and practical screening process are combined to construct a framework in Chinese population, which is based on the objective evidence of medical history and clinical evaluation. The diagnosis of vascular dementia is supported by imaging evidence of cerebrovascular diseases and differentiates from other causes of dementia or comorbidities. This consensus is applicable to medical units in China, and is of great significance for early detection, early diagnosis and early treatment of vascular dementia.

Criteria for diagnosis of Alzheimer's disease (AD) is not available in China.The international criteria is not a proper choice due to issues such as translation and lead to low diagnostic rate and high rate of missed diagnosis.The research group of Alzheimer's Disease Chinese (ADC) reviewed knowledge and techniques in neuropsychology,neuroimaging,molecular biology,and clinical neurology,and systematically studied the detection techniques such as memory,language,visuospatial,executive function,and medial temporal lobe visual scores on MRI,and their optimal threshold and diagnostic value for the diagnosis of AD.Through a systematic review and consensus meeting,a diagnostic framework for screeningAD in the Chinese population was established.Among these methods,an operational standard for clinical pathology models increased the diagnostic sensitivity by 15％.The sensitivity and specificity of screening memory impairment increased by 18.1％ and 11.6％,respectively.The sensitivity of screening medialtemporal lobe atrophy increased by 24.5％ and missed diagnosis was decreased by 34.5％.An operational standard for clinical biology models,incorporating the latest molecular imaging and molecular biology techniques,has enabled the early diagnosis of AD in China.The framework combines a principled diagnostic guideline with an operational screening protocol,which is applicable to all clinical settings and of great significance for the early detection,early diagnosis and early treatment of AD.

There are no standard diagnostic criteria for Alzheimer′s disease (AD) in China. The copied international criteria has led to a high rate of missed diagnosis due to issues such as translation and cultural discrepancy. Under the principles of semantic equivalence, content equivalence and performance equivalence, the research group of Alzheimer′s Disease Chinese (ADC) adopted several effective methods, such as two-way translation, content conversion, performance evaluation, etc. to systematically study the cognitive, behavioral, functional, and general assessment techniques in dementia screening and diagnosis, as well as their screening thresholds and diagnostic values. We also established a dementia screening and assessment framework in clinical practice through systematic reviews and group consensus. It has improved the early diagnosis rate of dementia in China, been accepted by home and abroad academic institutions, which is of great significance for early diagnosis and treatment of dementia.

Objective To study the sensitivity and specificity of combined AD8 and MMSE in detecting cognitive impairment in servicemen undergoing physical examination.Methods Cognitive impairment in 1723 servicemen undergoing physical examination in our hospital was assesed according to their AD8 and MMSE scores.Results The AD8 score was ≥2 in 326 (18.9％) out of the 1723 servicemen who underwent AD8 examination and in 84 (52.2％) out of the 161 servicemen who complained of cognitive impairment detected by MMSE.The MMSE was abnormal in 78 (48.4％) out of the 161 servicemen who complained of cognitive impairment.Of the 66 servicemen (41.0％) who were diagnosed with dementia,46 (69.7％) were diagnosed according to their AD8 score and 55 (83.3％) were diagnosed according to their MMSE score.ROC curve analysis showed that the specificity (91.6％) of combined AD8 and MMSE was significantly higher than that (60.0％) of simple AD8.Covariance analysis revealed that the score of trail making test-A was significantly higher while that of MMSE,delay recall,executive function,working memory and word fluency was significantly lower in servicemen with abnormal AD8 and MMSE than in those with normal AD8 and MMSE (P＜0.01).Conclusion Combined AD8 and MMSE can improve its specificity and reliability in detecting dementia in servicemen undergoing physical examination and can thus be popularized in grass-root medical and healthcare institutions.

Objective To investigate the health status,functional ability,mental psychology,health care and other longevity-related characteristics of individuals aged ≥ 100 years as well as risk factors in Hainan province,China.Methods China Hainan Centenarian Cohort Study (CHCCS) is a community-based,prospective cohort study to establish multi-dimensional database consisting of questionnaire findings,anthropometric parameters and biological specimens as well as imaging features.With the household registration information provided by the Department of Civil Affairs of Hainan province,a baseline survey was conducted in centenarians in 18 counties in Hainan with the oldest old in 5 counties as controls between 2014 and 2017.The survey included face to face interview,physical examination and biological specimen collection.After the baseline survey,the participants of CHCCS were followed up at an interval of 2 years to collect the information about their living status,disease status or major death causes.Results According to the information provided by the Department of Civil Affairs of Hainan province in 2014,the survey found that 1 473 centenarians were still living.By December 2016,1 002 of them had agreed to be surveyed.The average age of 722 centenarians with complete information in the baseline survey was (102.7± 2.7) years,the majority of them were females (83.0％),widows (88.8％),in Han ethnic group (84.5％),lived with family members (87.8％),illiterates (89.7％) and farmers (81.0％).Conclusion CHCCS has provided longevity-related information of the large longevity population and collected the valuable and rare biological specimens with great urgency to establish an interdisciplinary platform and base for longevity,senility and healthy aging research.

ObjectiveTo investigate the neuropsychological characteristics of primary hypothyroidism.MethodSixty patients with primary hypothyroidism were enrolled and 60 euthyroid subjects with age-,gender-,and education-matched served as control.Neuropsychological parameters were determined in all the participants.ResultThe word list learning,figure recall,picture recall,verbal fluency,digit span,and trail making A and B in subclinical hypothyroid patients were impaired as compared with the control (6.0± 1.6 vs 7.6± 1.1,7.3± 1.4 vs 8.6±1.1,9.1±1.9 vs 10.0±0.1,6.7±1.4 vs 9.1±1.2,11.4±2.5 vs 13.3±1.5,11.3±2.2 vs 12.8±1.5,8.0±1.8 vs 9.2±0.8,5.0±1.6 vs 6.7±1.6,12.5±3.8 vs 15.7±2.0,61.1±32.5 vs 41.9±10.6,82.0±40.2 vs 43.2±14.5,all P＜0.05 ).Neuropsychological dysfunctions in all 11 tests were found among moderate and severe hypothyroid patients(26.2±5.0 vs 29.4±4.7,6.3±1.5 vs 6.8±1.4,8.9±2.2 vs 9.9±0.2,28.7±9.7 vs 37.0±6.0,6.4±1.1 vs 9.4±1.3,8.5±1.0 vs 9.4±0.6,11.9±3.0 vs12.9±1.7,8.1±1.8 vs 9.5±1.1,5.1±1.7 vs 6.6±1.5,11.4±2.9 vs 15.1±2.4,55.1±12.2 vs 41.0±11.6,all P＜0.05).ConclusionThe severity of cognitive impairment is accompanied with the decrease of thyroid function,it suggests that the cognitive function must depend on the normal levels of thyroid hormones.

Objective To investigate the prevalence of cognitive and motor disorders as well as emotional and sleep abnormality in the veterans from military communities in Beijing. Methods The participants underwent a comprehensive in-person evaluation including detailed neuropsychological testing,Hospital Anxiety and Depression Scale and special questionnaires for movement and sleep disorders. Results The overall prevalence of cognitive impairment, extrapyramidal diseases was 32.7%, 8.8% . The prevalence of mild cognitive impairment, dementia, Parkinson disease, essential tremor, anxiety and depression was 26.2% , 6.5% , 2.0% , 6.1 % , 1.4% and 4.1% respectively. Prevalence of all kinds of sleep disorders ranged from 10. 3% to 53. 9%. The prevalence of cognitive impairment had no significant difference of sex, but were correlated to age and education, the correlation coefficient was 0. 326 and -0.221 ( P<0.01) . Conclusion Veterans from military communities had higher prevalence of cognitive impairment, extrapyramidal diseases and sleep disorders and lower that of anxiety and depression relatively.

Objective To study the related factors of leukoaraiosis (LA). Methods 480 elderly patients examined with cranial CT or MRI were investigated retrospectively. A single-factor and multi-Logistic regression analysis were performed. A rank correlation analysis was performed between the severity of LA and age as well as the course of hypertension. Results The prevalence of LA was 35%. The age (t=3.243，P=0.0013) and the incidence of hypertension (χ2=9.8941，P=0.0017) were higher in LA group than in non-LA group, the incidence of diabetic were lower (χ2=4.4193，P=0.0355). The age (OR=1.06，95%CI：1.027～1.103，P=0.0006), hypertension (OR=1.15，95% CI：1.065～1.236，P=0.0003), and diabetes (OR=0.85，95% CI：0.726～0.994，P=0.0421) were correlated with LA. Neither age (r=0.1553，χ2=4.9701，P=0.5477) nor the course of hypertension (r=-0.0758，χ2=1.9076，P=0.7527） were correlated with the severity of LA. Conclusion The age and hypertension was independent risk factors for LA, but the severity of LA was not correlated with age or course of hypertension.