• ISSN 2096-5516 CN 10-1536/R
  • Sponsored: China Association for Alzheimer’s Disease

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  • Xianbo ZHOU, Zhong PEI
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    Alzheimer’s disease is a huge societal issue and places a serious economic burden on the ever-aging society. Although tremendous progresses have been made in the early detection, diagnosis and treatment which bring new options and hope for patients and their families, transformative early detection, diagnosis and treatment are still being developed. Here we report the current state of AD early detection, diagnosis and drug development where promising progress are made and hopefully revolutionary therapies will be developed soon to solve this global issues with the help of timely detection, early diagnosis and precision neurology through targeting immunoneurology/multi-mechanisms and cocktail medicine.

  • Mengxun LUO, Zhihong LU, Yelin CHEN
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    Alzheimer's Disease (AD) is a devastating neurodegenerative condition that warrants attention from all individuals, given its widespread prevalence and profound societal burden. As the population of elderly individuals continues to rise, the incidence of AD is steadily increasing. Conventional pharmacotherapeutic interventions offer only transient amelioration of certain AD symptoms, failing to halt the inexorable progression of the disease. Over the past two decades, extensive efforts have been made to develop anti-AD drugs with disease modifying potentials but all of which have been failed. Consequently, AD has long been perceived as an incurable affliction. However, lecanemab, a monoclonal antibody that targets aggregated amyloid-beta (Aβ), has demonstrated efficacy in slowing the progression of AD in a rigorously conducted randomized, double-blind, multi-center phase 3 clinical trial. This landmark advancement signifies AD as a modifiable condition, with aberrant Aβ aggregation serving as a pivotal etiological factor. This breakthrough holds epochal significance for both theoretical understanding and therapeutic modalities, heralding a transformative epoch in humanity's pursuit to conquer AD. In this review, we endeavor to summarize the cutting-edge advancements in AD research, with the aim of augmenting societal awareness and comprehension of this disease.

  • Lu LIN, Xin MA, Gang WANG, Hongzheng WANG, Zhiqun WANG, Zhiwen WANG, Xiaoming WANG, Huifang WANG, Feiqi ZHU, Liyan QIAO, Zhaorui LIU, Zhigang QI, Bin TANG, Kuncheng LI, Zhaohui LI, Shifu XIAO, Jintai YU, Xianbo ZHOU, Hexin ZHAO, Mangsuo ZHAO, Hongbin ZHAO, Yun GU, Hong GUO, Ling GUO, Qihao GUO, Liping FU, Min LEI, Weigang PAN, Yong XU, Jun WANG, China association for Alzheimer's disease
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    Alzheimer's disease (AD) is a severe neurodegenerative disorder with complex etiology, currently lacking effective treatment options. China is among the countries with the largest and fastest-growing elderly population globally, also identified as a high-risk nation for AD. Consequently, early prevention of AD emerges as one of the most crucial endeavors in the fieldof healthcare today. Building upon domestic and international research, we have formulated a Chinese-specific AD early prevention guideline, integrating evidence-based literature, intervention studies, case analyses, experiential insights, and expert consultations, and showcasing the advantages of traditional Chinese medicine, martial arts, health preservation practices, and community organization. This guideline addresses distinctive features of preventive measures and encompasses strategies at the individual, family, and society levels, advocating for proactive lifestyles, social engagement, cognitive training, physical exercise, tobacco cessation and moderate alcohol consumption, nutritional balance, adequate sleep, management of blood pressure, glucose and lipid levels, weight, and other chronic conditions, along with incorporating traditional Chinese medicine (TCM) into primary prevention efforts against AD. This guideline serves as a reference for individuals, families and communities engaged in AD prevention initiatives.

  • Qun XU, J. Wesson Ashford, PIU CHAN, Shubin CHEN, Jeffrey Cummings, J. Gu Ben, Qihao GUO, Ying HAN, Yingxue HUA, Hua JIN, Nagaendran Kandiah, Haiyan LI, Xiaolei LIU, Xin LIU, Peilin LU, Zhong PEI, Xiaogeng SHI, Kai SUN, Bin TANG, Goerge Vradenburg, Huifang WAGN, Jun WANG, Xiaoming WANG, Yanrui WANG, Yanmei WANG, Yulin WANG, Wenfeng WENG, Meizhe XIN, Yulan ZHANG, Hexin ZHAO, Xianbo ZHOU, Hongzheng WANG
    PDF (419) HTML (1919)

    Dementia/cognitive impairment in elderly persons is often caused by more than one common age-related brain diseases. Alzheimer’s disease (AD) is the most common neurodegenerative disease that leads to or contributes to dementia/cognitive impairment. It is the only one of the 10 top deadliest diseases globally that has no curative nor long lasting effective symptom treatments. AD places tremendous burdens on individuals, their families, and the economies of essentially all societies. Early and timely detection and intervention has been increasingly considered to be the best strategy to combat AD. Over the last 3 decades, numerous studies have suggested approaches to reducing the risk of dementia, and up to 40% of dementia cases could be prevented or delayed by addressing risk factors, which are outlined in the 2020 Lancet report on dementia prevention. However, the current global healthcare system is not equipped sufficiently to detect AD early or in a timely fashion. For example, a recent study found that less than 10% of mild cognitive impairment (MCI) is diagnosed in primary care setting. Recently, with the full approval of the anti-Amyloid beta (Aβ) antibody drug lecanemab and donanemab for early AD and the publications of ~20-year follow-up studies establishing that modification of risk factors could markedly reduce AD-dementia incidence and increase life span, there is rapidly growing interest in early AD recognition. The Chinese Association of Alzheimer’s Disease (CAAD) recognizes the importance of early and timely detection of AD in an at-home setting and has assembled a global panel of association professionals, clinicians and researchers who are expert in different areas of AD to reach the consensus reported here with the following goals: 1) to provide individuals, family, community, associations and organizations with expert guidance, 2) on the digital tools and available resources for the screen of cognitive impairment/dementia at home and describe a work flow for the next steps for those at risk or suspected of AD, 3) discuss current available or future resources for AD biomarker as at-home screen, and 4) to establish a framework for future improvement and worldwide application if results warrantee such a direction. The experts reviewed the current available evidence, tools, resources and considered the significance of screening for AD at home and the consensus recommendations are reported here.

  • Ruoxi DING, Zhaorui LIU
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    With the acceleration of population aging in China, the prevalence of dementia in China is rapidly increasing and has become an important public health issue. Considering the limitations of pharmacological treatment in terms of efficacy in improving symptoms and functions of patients with dementia, non-pharmacological treatment has become one of the important elements in the research of dementia and cognitive disorders. In this paper, we will sort out the development of non-pharmacological treatments from four aspects: exercise rehabilitation, psychological intervention, physical therapy, and cognitive function training, and discuss the characteristics and the effects of these treatments, in order to provide references for research and clinical practice related to the prevention and early intervention of dementia.

  • HUANG Yuyuan, YU Jintai
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    Alzheimer’s disease (AD), the most common type of dementia, is becoming a major challenge in global health and social care. Nowadays, significant breakthroughs have been made in the diagnosis, prevention, and treatment of AD over the past decade. In this review, we summarize and analyze the latest advancements in the field of AD, including prevention, diagnostic biomarkers, and disease-modifying therapies targeting β-amyloid. We propose a three-tiered, comprehensive, and scientific control system for Alzheimer’s disease, providing new perspectives for further understanding and curing the disease.

  • Yong XU, Jun WANG, Hongzheng WANG, Yanjiang WANG, Zhaorui LIU, Jintai YU, Zhi ZHOU, Dantao PENG, Baijun GU, Kuncheng LI, Qinghua HOU, Xin MA, Xiaoming WANG, Zhiwen WANG, Huifang WANG, Bin TANG
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    According to the National Bureau of Statistics of China in 2023, the population aged > 60 in China is about 280 million, accounting for approximately 19.84% of the total population. Among them, the population aged > 65 is about 210 million, accounting for approximately 14.86% of the total population. China has rapidly entered a deep aging society. The aging population has also brought about a rapid increase in age-related disabilities and diseases, bringing a heavy burden to society and families. Among them, Alzheimer's disease (AD) is the most common type of dementia in the elderly and one of the most common causes of loss of daily living abilities in the elderly. There are currently about 9.83 million AD patients in China, with a severe disease burden, which brings heavy medical, care, and economic burdens to families and society. It has become one of the most expensive, deadly, and burdensome diseases in current healthcare, seriously affecting public health and sustainable social development in China. However, the diagnostic and treatment rates of AD in China are still relatively low. Therefore, strengthening the prevention and treatment of AD, preventing and slowing down the occurrence and development of AD are urgent public health issues.
    This report is aimed at the most concerned issues of people and government agency, such as: What is the current basic data on Alzheimer's disease in China? Why is the awareness rate relatively increased but the patient's desire to seek medical treatment relatively low? Are there any effective measures to address this?
    This report summarizes the latest data available in various related fields, analyzes the current situation, problems, and trends of AD epidemiology, disease burden, diagnosis and treatment, risk factors, rehabilitation care, and disease screening in China, and proposes China's Alzheimer's disease prevention and control strategies, especially emphasized the importance of development of validated tools for screening and early diagnosis, the innovation of new drugs, and building and cultivating a nationwide network of localized social mutual assistance and support.
    This report is to aid medical professionals, AD patients, family members and caregivers, government policy makers, elderly care institutions, etc. as they consider performances to provide better support for patients, to propose the formulation of relevant health policies, and to further raise public awareness of AD, to alleviate the overall burden of AD disease, and promote the realization of healthy aging in China.

  • Hou Qinghua
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  • XIAO Jinwen, REN Rujing, WANG Gang
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    With the development of researches on anti-amyloid-β(Aβ) monoclonal antibodies(mAbs) and the deeper understanding of disease-modifying therapies, related clinical trials and studies on anti-Aβ mAbs for treating Alzheimer's disease recently have made great progress. Due to successive FDA approval of Aducanumab and Lecanemab (BAN2401), these drugs have been used in clinic. On December 11 2022, Aducanumab was first applied to the treatment of mild Alzheimer's disease for clinical use by the author's team in Lecheng medical pioneer area in Boao Hainan, which officially initiating the anti-Aβ mAbs therapy for Alzheimer's disease in China. This review systematically summarizes the research progress and clinical practice of anti-Aβ mAbs for the treatment of Alzheimer's disease.

  • ZHU Yuan, YU Xiaoping, WANG Gang
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    To cope with the heavy economic and care burden on families and society due to the growing number of elderly people with Alzheimer's disease in China, we will provide relevant professionals with targeted norms and guiding documents. We developed this expert consensus which based on the references of domestic and foreign clinical guidelines, systematic reviews and original research, at the same time, we combined with the practice and experience of domestic clinical and nursing experts in related fields. The consensus include four aspects, the personnel requirements and facilities for dementia patients living at home, the specific content of care for dementia patients, the health resources and policy support of social care and transitional care from home to institution. The consensus will provide guidance and practical support for standardizing the home care of elderly patients with dementia based on community support.

  • Xinyi QIAN, Ling YUE, Shifu XIAO
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    Alzheimer's Disease (AD) is a common neurodegenerative disease, but the exact pathogenesis is still under investigation. Therefore, it is difficult to early identify and make the appropriate intervention. Easily available, economical, and effective biomarkers are urgently needed to improve clinical diagnosis and treatment. In recent years, the development of blood-based biomarkers in AD has developed vigorously, and it may be able to completely change the status of the diagnosis and treatment of AD in the near future. Here we presents an overview of the latest advances in the blood-based biomarkers of AD and its potential clinical implementation.

  • Dongjing SONG, Bin LIU, Ying ZHONG, Jianjun WANG, Cuicui LIU
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    Objective: To evaluate the clinical efficacy and safety of Sodium oligomannate combined with donepezil hydrochloride tablets in the treatment of Dementia. Methods: 60 patients with Dementia were randomly divided into control group and combined treatment group, with 30 cases in each group. The patients in the control group were given donepezil hydrochloride 10 mg once a day, and the patients in the combined treatment group were given donepezil hydrochloride 10 mg once a day and Sodium oligomannate twice a day (450 mg / time). Both groups were treated for 12 months. MMSE and ADL were used to evaluate the cognitive function and ADL of the two groups. The levels of nutritional and immune indexes were evaluated according to the changes of adiponectin, reptin and serum amyloid A (SAA). The safety of the two treatments was evaluated by observing the adverse reactions of the two groups. Results: After 12 months of treatment, the cognitive function and activities of daily living of the two groups were improved in varying degrees, the MMSE score of the the combined treatment group (20.01 ± 4.40 )was significantly higher than that before treatment (16.30 ± 3.18) and the control group (17.86 ± 3.08) (all P < 0.05); The ADL score in the combined treatment group (62.20 ± 10.04) was significantly higher than that before treatment (52.13 ± 7.28) and that in the control group (58.08 ± 8.98) (all P < 0.05); The serum adiponectin (20.32 ± 5.43) in the combined treatment group was significantly higher than that before treatment (12.30 ± 3.26), and also significantly higher than that in the control group (13.21 ± 5.12) (all P < 0.05); The levels of reptin and SAA were significantly lower than those before treatment and those in the control group (all P < 0.05). After treatment, there were no obvious abnormalities in ECG, hematuria routine, liver and kidney function, dizziness, fatigue, drowsiness, gastrointestinal and other adverse reactions in the two groups. Conclusion: Compared with donepezil hydrochloride tablets, Sodium oligomannate combined with donepezil hydrochloride tablets had better clinical efficacy, and safety was satisfactory in the treatment of Dementia.

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  • XIAO Shufang, LI Jiamin, LIU Yidan, LI Xiaofeng
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    Objective: To evaluate the efficacy and safety of transcranial direct current stimulation in the treatment of mild cognitive impairment and mild to moderate Alzheimer's disease. Methods: These articles published in Pubmed, Embase, Cochrane Central Register of Controlled Trials, Chinese Biomedical Database, CNKI, Wanfang, VIP and other Chinese and English databases before March 8, 2022 were searched, with a supplementary search of unpublished clinical trials on Clinicaltrails.gov. The primary outcome is the change of score in the main cognitive function scale before and after the intervention, and the secondary outcome was the occurrence of adverse reactions. Review Manager 5.2 software was used to summarize and analyze the extracted data, and Cochrane bias risk assessment tool was used to evaluate the quality of the included literature. Results: Twenty-three studies were included, of which 18 studies (20 data groups) were included in quantitative analysis, with a total of 953 people. Comprehensive all included study indicates the anode transcranial direct current stimulation to improve cognitive function (SMD = 0.75, 95% CI = [0.42, 1.08], P < 0.00001); Subgroup analysis suggested that was effective in both mild cognitive impairment(SMD=0.20, 95%CI= [0.02, 0.37], P=0.03) and mild to moderate Alzheimer's disease (SMD=0.79, 95%CI=[0.53, 1.04], P < 0.00001). The optimized parameters of transcranial direct current stimulation were unilateral/bilateral frontotemporal parietal lobe, 0.06mA/cm2 current density, and ≤20 times of stimulation has been proved to have cognitive benefits. Conclusion: Transcranial direct current stimulation is safe and effective for the treatment of cognitive impairment in mild cognitive impairment and mild to moderate Alzheimer's disease. According to current research data, the recommended stimulation site is unilateral/bilateral frontotemporal parietal lobe, and 0.06mA/cm2 current density is used in a short-term treatment. More high-quality studies are needed to explore the benefits of higher current densities and prolonged treatment cycles.

  • LI Kuncheng, LI Qianqian
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    The Alzheimer's disease neuroimaging Initiative (ADNI) aims to study brain imaging and biomarkers that provide information for Alzheimer's disease treatment trials. Through the continuous stages of ADNI-1, ADNI-go, ADNI-2 and ADNI-3, the phenotypic analysis of amyloid and tau and the improvement of neuroimaging methods have successfully realized the standardized analysis and measurement of data, and the unrestricted public sharing of data around the world. This paper reviews ADNI research as follows.

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  • GUO Ling, GUAN Xue, LI Qingyan, HU Jianying, ZHANG Hongjiang
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    Alzheimer's disease (AD) is a common neurodegenerative disease with a variety of pathological changes. Oxidative stress plays an important role in the pathogenesis and development of AD. Based on the multifactorial characteristics in the onset mechanisms of AD, it requires that multi-type or multi-effect agents are with neuroprotective actions to AD be studied and dig out. Natural drugs may be better than sythetics because of their multi-pathway, multi-target and multi-effect characteristics. Transgenic animals models of AD have a variety of pathophysiological characteristics of AD. To target the prevention or treatment of AD, they are good for researchers to investigate and evaluate the effecacy of the natural drugs on the oxidative-stress responses in AD. This paper is going to review the previous studies on the effects of the oxidative-stress responses of the natural drugs on transgenic mice of AD. It can provide the theoretical basis and practical evidence to further studies in the future.

  • ZHOU Xianbo
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    Alzheimer's disease (AD) has become the only disease in the top 10 deadliest diseases that has no cure or effective therapies. Early detection and intervention of mild cognitive impairment (MCI), one cause of which is AD has been increasingly recognized as the best strategy to combat AD at present. Therefore reliable, accessible and affordable tools to detect MCI early are urgently in need. An international working group called the Global Advisory Group on Future MCI Care Pathways had extensively discussed and put forth consensus for rationale and means to detect MCI early both at home and in clinical settings which were published earlier in 2020. Here, a brief summary of the consensus and recommendations to adapt the consensus to China were presented.

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  • ZHONG Chunjiu
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    Alzheimer's disease (AD) is a complex disease with multiple pathophysiological features, including neurodegeneration, β-amyloid (Aβ) deposition, Tau hyperphosphorylation, neuroinflammation, glucose metabolism dysfunction, and so forth. To date, there are no effective drugs or methods to stop or delay the progression of the disease. A variety of theoretical hypotheses, including Aβ cascade hypothesis as a dominant mainstream hypothesis, try to elucidate AD pathogenesis. However, AD pathogenesis remains unclear and the development of new drugs against AD encounters serious setback. The thought and method based on ''Reductionism'' philosophy have achieved great success in guiding the research of simple diseases with single or a few pathophysiological characteristics. Nevertheless, it is difficult to guide to the studies of age-related complex diseases with multiple pathophysiological features, such as AD, using the thought and method of ''Reductionism'' philosophy. Neurodegenerative alteration characterized by progressive loss of synapses/neurons and brain atrophy is the only direct basis for the occurrence, progression, and clinical manifestations of AD. The future researches should be devoted to clarify the mechanism of AD neurodegenerative change and its relationship with other multiple pathophysiological characteristics. Only in this way can we truly understand AD pathogenesis and find effective drugs or methods for the disease prevention and treatment.

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  • Yingquan WANG, Jinghong LIANG, Ruixia JIA, Yong XU
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    Objective: To determine the prevalence of Alzheimer disease(AD)in the past thirty years and provide estimates about elderly (aged 60 and over) people with AD in China from 2015 to 2050. Method: Retrieve the Chinese and English data base. Screening published epidemiology surveys of dementia from 1990-2018. Meta-analysis was used to calculate their pooled prevalence. The age-moving method was used to estimate the population aged 60 and over in 2020, 2030, 2040 and 2050 based on the data of the sampling survey of 1% of the population in 2015 released by the National bureau of statistics. Pooled prevalence from 2015 to 2017 was used as the basis to estimate the number of elderly people with dementia in the future. Results: The pooled prevalence of AD from 1985 to 2018 was 3.9% (95%CI: 3.4-4.4). 6.6% (95%CI: 4.7-8.6) as the prevalence rate from 2015 to 2018 among them. In 2020, 2030 and 2040, the number of people with AD will be 14.50 million, 20.75 million and 26.87 million. There will be 30.03 million people with AD in 2050. 6.14 million, 9.07 million, 14.82 million as the number of AD patients in different age groups. The number of people with AD will be 2.35 times than that of 2015. Conclusion: The number of AD in China will increase dramatically in the next 30 years without preventive measures.

  • BU Xianle, WANG Yanjiang
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    Alzheimer’s disease (AD) is the most common type of dementia and has become animportant disease affecting the health of the elderly. In 1907, Alois Alzheimer, a German psychiatrist and pathologist, reported the first case of AD. In 1910, a German psychiatrist and pathologist Emil Kraepelin proposed that AD was an independent disease and named it after Alzheimer, which began the exploration of AD. AD has become the focus of research in neuroscience area, and more and more researches are engaged in the exploration of AD. In order to adapt to this need, we translatedthe English version of the first AD case report into Chinese, and introduced the discovery process and pathological features of this disease, which helps to understand the history of AD. Finally, we discussed the significance and enlightenment of the case.

  • 2018年,国内第一部关于阿尔茨海默病研究的学术期刊《阿尔茨海默病及相关病》杂志正式创刊了,这是一件令人激动的事情! 该杂志由全国性的阿尔茨海默病防治协会主办,面向国内外从事阿尔茨海默病研究、临床医疗、康复护理的专家学者,以及阿尔茨海默病及相关病的患者、照护者、志愿者等各界人士,为广大科研人员和临床医护人员发表科研成果、进行多层级学术交流、及时了解国内外学术发展前沿和更新相关学科知识提供了一个重要学术平台.该杂志的创办,将为推动我国相关领域疾病的临床诊治和基础研究等方面的发展起到积极作用.