Dementia in China: epidemiology, clinical management, and research advances

Jia, Longfei; Quan, Meina; Fu, Yue; Zhao, Tan; Li, Yan; Wei, Cuibai; Tang, Yi; Qin, Qi; Wang, Fen; Qiao, Yuchen; Shi, Shengnan; Wang, Yanjiang; Du, Yifeng; Zhang, Jiewen; Zhang, Junjian; Luo, Benyan; Qu, Qing; Zhou, Chunkui; Gauthier, Serge; Jia, Jianping

doi:10.1016/s1474-4422(19)30290-x

Cited by 539 publications

(438 citation statements)

References 70 publications

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“…Alzheimer's disease is the cause of 60-70% of cases of dementia, the population of which is estimated to be 40-50 million worldwide, more than doubled from 1990 to 2016 [1]. Without disease-modifying treatment, Alzheimer's disease has become an increasing challenge to healthcare systems and economy in China [2] and internationally. Several recent clinical trials of Alzheimer's disease targeting the amyloid hypothesis especially by lowering amyloid-beta (Aβ) have failed, which led us to think about other therapeutic targets for Alzheimer's disease [3].…”

Section: Introductionmentioning

confidence: 99%

Effects of gene mutation and disease progression on representative neural circuits in familial Alzheimer’s disease

et al. 2020

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Background: Although structural and functional changes of the striatum and hippocampus are present in familial Alzheimer's disease, little is known about the effects of specific gene mutation or disease progression on their related neural circuits. This study was to evaluate the effects of known pathogenic gene mutation and disease progression on the striatum-and hippocampus-related neural circuits, including frontostriatal and hippocampusposterior cingulate cortex (PCC) pathways. Methods: A total of 102 healthy mutation non-carriers, 40 presymptomatic mutation carriers (PMC), and 30 symptomatic mutation carriers (SMC) of amyloid precursor protein (APP), presenilin 1 (PS1), or presenilin 2 gene, with T1 structural MRI, diffusion tensor imaging, and resting-state functional MRI were included. Representative neural circuits and their key nodes were obtained, including bilateral caudate-rostral middle frontal gyrus (rMFG), putamen-rMFG, and hippocampus-PCC. Volumes, diffusion indices, and functional connectivity of circuits were compared between groups and correlated with neuropsychological and clinical measures. Results: In PMC, APP gene mutation carriers showed impaired diffusion indices of caudate-rMFG and putamen-rMFG circuits; PS1 gene mutation carriers showed increased fiber numbers of putamen-rMFG circuit. SMC showed increased diffusivity of the left hippocampus-PCC circuit and volume reduction of all regions as compared with PMC. Imaging measures especially axial diffusivity of the representative circuits were correlated with neuropsychological measures. Conclusions: APP and PS1 gene mutations affect frontostriatal circuits in a different manner in familial Alzheimer's disease; disease progression primarily affects the structure of hippocampus-PCC circuit. The structural connectivity of both frontostriatal and hippocampus-PCC circuits is associated with general cognitive function. Such findings may provide further information about the imaging biomarkers for early identification and prognosis of familial Alzheimer's disease, and pave the way for early diagnosis, gene-or circuit-targeted treatment, and even prevention.

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Section: Introductionmentioning

confidence: 99%

Effects of gene mutation and disease progression on representative neural circuits in familial Alzheimer’s disease

et al. 2020

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“…Dementia have been a common public health burden, which threatens 47 million people worldwide, and this number is expected to increase to 131 million by 2050 [54]. China has the largest number of patients who suffer from dementia that imposes a huge challenge for health care system that has been facing the burden of aging of population [55]. Identification of persons at high risk of dementia and early diagnosis of cognitive impairment, as well as clinical management and care, are still urgently required in China.…”

Section: Viewpoints Research Theme 4: Health Transitions In Chinamentioning

confidence: 99%

Evaluation of the relationship between cognitive impairment and suboptimal health status in a northern Chinese population: a cross-sectional study

Ding¹,

Zhao²,

Wang³

et al. 2020

Journal of Global Health

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“…The worldwide costs that are associated with Alzheimer's dementia accounted for 1.09% of the global gross domestic product, whereas such costs accounted for 1.47% in China, indicating that the burden of dementia is even higher in China compared with the world average [24]. Thus, effective measures are needed to facilitate dementia prevention and reduce disease burden that is caused by dementia in China [25].…”

Section: Introductionmentioning

confidence: 99%

“…However, insufficient awareness and knowledge of the potential of dementia prevention among the Chinese public has been a substantial obstacle [25]. Some studies evaluated the Chinese population's overall understanding of dementia, suggesting that the recognition of dementia needs to be improved [26,27].…”

Section: Introductionmentioning

confidence: 99%

Public awareness and knowledge of factors associated with dementia in China

Zheng

Shi

Gong

et al. 2020

Preprint

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Background Dementia is a global public health priority. Many modifiable factors have been shown to influence the development of dementia, but these factors are not adequately known by the general public. This study assessed public awareness of the factors that are associated with dementia among the general population in China. Methods A cross-sectional study was conducted from May to October 2019 using an Internet-based questionnaire. We collected basic sociodemographic characteristics and investigated participants’ knowledge of risk and protective factors that are associated with dementia. The primary outcome measures were the proportions of participants who identified each option as a risk or protective factor. Logistic regression analysis was performed to compare levels of the knowledge of factors that are associated with dementia across populations with different demographic characteristics. Results Data from a total of 3,338 respondents were analyzed. The percentages of participants who accurately identified dementia risk factors were the following: 84.24% for negative affect, 65.07% for alcohol use, 56.68% for smoking, 48.74% for hypertension, and 42.66% for diabetes. The percentages of participants who accurately identified dementia protective factors were the following: 90.00% for exercise, 84.69% for social activity, 80.92% for intelligence games, 74.45% for reading, and 6.14% for antihypertensive or hypolipidemic drugs. The majority of Chinese people correctly recognized the role of lifestyle factors in the development of dementia but not medical factors. Levels of knowledge of the factors that are associated with dementia were significantly distinct across populations with different characteristics. The following sociodemographic characteristics were associated with more comprehensive knowledge of dementia risk and protective factors: women, young age, high education levels, white-collar jobs, and contact with individuals with dementia. Conclusions Public awareness and knowledge of risk and protective factors for dementia in China are still insufficient. More efforts are needed to publicize information about dementia to reduce risk and prevent dementia.

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Dementia in China: epidemiology, clinical management, and research advances

Cited by 539 publications

References 70 publications

Effects of gene mutation and disease progression on representative neural circuits in familial Alzheimer’s disease

Effects of gene mutation and disease progression on representative neural circuits in familial Alzheimer’s disease

Evaluation of the relationship between cognitive impairment and suboptimal health status in a northern Chinese population: a cross-sectional study

Public awareness and knowledge of factors associated with dementia in China

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