When insomnia and obstructive sleep apnea (OSA) coexist, it is referred to as comorbid insomnia and obstructive sleep apnea (COMISA). The prevalence of COMISA in the general population ranges from 0.6% to 19.3%. It is primarily characterized by difficulty falling asleep, frequent nighttime awakenings, early morning awakening, poor sleep quality, snoring or apnea during sleep, unrefreshing or nonrestorative sleep, excessive daytime sleepiness, fatigue, attention impairment, memory impairment, emotional disorders, and impaired quality of life. COMISA can lead to adverse outcomes in multiple systems and increase all-cause mortality. Therefore, it is significant to establish a guidline for the diagnosis, differential diagnosis, and standardized treatment of COMISA. The guideline was organized by the Chinese Academy Society of Sleep Medicine, Chinese Medical Doctor Association and Sleep Medicine Group, China Neurologist Association. It was formed by reviewing domestic and international COMISA diagnosis and treatment practices, through literature evidence review, and after extensive discussion. The guideline summarized the epidemiology, etiology and risk factors, pathophysiological mechanisms, clinical manifestations, assessment methods, diagnosis, differential diagnosis, and treatment studies of COMISA, providing a basis for decision-making in the diagnosis and treatment of COMISA for clinician.

Respiratory problems in chronic obstructive pulmonary disease (COPD) patients are prone to poor sleep quality, anxiety and depression, but they are often ignored by medical staff and patients themselves. Understanding the sleep quality, anxiety and depression symptoms of patients with COPD and their influencing factors can help to improve the quality of life of patients, however, there are few relevant studies.

To investigate the sleep quality, anxiety and depression of patients with COPD and explore the influencing factors.

Convenience sampling was used to recruit COPD patients who visited the Department Respiratory Diseases and Critical Care Medicine of seven hospitals in Anhui Province from August to November 2022. Demographic characteristics, dyspnea grade, airflow restriction severity, risk of malnutrition, physical activity level, vaccination, and acute exacerbations in the last 1 year were collected. The Pittsburgh Sleep Quality Index (PSQI) and the Hospital Anxiety and Depression Scale (HADS) were used to evaluate the sleep quality and anxiety and depression symptoms of COPD patients, and the influencing factors were analyzed by multivariate Logistic regression.

A total of 248 patients with COPD were investigated, among which the incidence of poor sleep quality was 60.9% (151/248), only 8.9% (22/248) of the patients thought they had good sleep quality, and more than half of the patients actually had insufficient sleep time (54.4%) or low sleep efficiency (60.1%). 29.4% (73/248) of COPD patients had at least one of the symptoms of anxiety or depression, of which 35 had anxiety symptoms, 61 had depression symptoms, and 23 had both anxiety and depression symptoms. Multivariate Logistic regression analysis showed that older ages (OR=1.052, 95%CI=1.018-1.086) and risk of malnutrition (OR=3.393, 95%CI=1.855-6.206) were risk factors for poor sleep quality in COPD patients. Regular physical activity was a protective factor for poor sleep quality in COPD patients (OR=0.450, 95%CI=0.242-0.834) (P<0.05). Acute exacerbations ≥2 times (OR=2.220, 95%CI=1.093-4.510) and malnutrition risk (OR=1.961, 95%CI=1.044-3.683) were risk factors for anxiety and depression symptoms in COPD patients (P<0.04). In COPD patients, PSQI score was positively correlated with HADS-A (r_s=0.413) and HADS-D score (r_s=0.430), and there was a positive correlation between HADS-A score and HADS-D score (r_s=0.719, P<0.05) .

The incidence of poor sleep quality, anxiety and depression symptoms was high in COPD patients, and age, malnutrition risk, regular physical activity and number of acute exacerbations in the past year are important influencing factors. Medical staff, family members and patients themselves should improve the awareness of sleep quality, anxiety and depression, and actively carry out screening and intervention work for key patients to improve the sleep quality and mental health of patients.

Artificial intelligence (AI) psychological interventions offer advantages such as real-time delivery, personalization, low stigma, and no geographical limitations, enabling more accurate assessment and intervention for mental health issues, thus addressing the shortcomings of traditional mental health services. While AI has been applied to address various mental health conditions, its practical effectiveness still lacks effective integration. Taking depression and anxiety disorders as an example, this paper reviews the efficacy of AI interventions, including robots, virtual reality, games, and applications. The findings show that these interventions can significantly alleviate depression or anxiety symptoms and improve mental health. However, challenges remain, including data privacy and security concerns, ethical and legal issues, technological limitations, long-term adherence, and cultural adaptability. With technological advancements, AI psychological interventions are expected to expand their application scenarios, integrate multidisciplinary approaches, and foster global collaboration for data sharing and ethical oversight, thereby advancing the intelligent development of mental health services.

To provide researchers with a comprehensive understanding of the Psychology and Behavior Investigation of Chinese Residents (PBICR), this paper introduces its background and features from four aspects. In terms of design concepts, PBICR focuses on many aspects of mental health and health behaviours in the Chinese population, takes full account of timeliness and efficiency, adheres to the original intention of data openness and data sharing, builds a high-quality database with a large-sample, multi-centre, repetitive, nationwide cross-sectional design, and promotes data mining and exchange and cooperation; in terms of survey implementation, PBICR adopts a combination of population size-proportional, multistage sampling and quota sampling, and obtains data through face-to-face field surveys with strict quality control to ensure the representativeness and reliability of the samples; in terms of output, PBICR's research content is rich and updated in line with international hotspots, which can satisfy the demand for research on diversified variables and data, and the results of its past research have a higher influence in many fields such as public health, management, communication, and psychology; Looking ahead, PBICR will gradually complete the construction of databases from the general database to sub-databases, pay attention to special populations and a wide range of regions around the world, add tracking surveys and biomedical data research perspectives, and have great research potential to drive research on the mental and behavioural health of Chinese residents through the overall layout of the multi-dimensional.

In the current rehabilitation environment, emotional issues and cognitive dysfunctions in stroke patients are often overshadowed by physical, speech, and swallowing difficulties, leading to their underestimation in clinical rehabilitation. This oversight can result in adverse outcomes, impacting the overall success of rehabilitation. Currently, clinical treatments primarily rely on pharmacotherapy to alleviate symptoms, which has limited effectiveness and can cause a range of adverse reactions.

To observe the efficacy of precision exercise prescriptions on anxiety, depression, and cognitive functions in stroke patients and to preliminarily analyze the underlying mechanisms of action.

A total of 84 stroke patients hospitalized in the Rehabilitation Department of Changzhou Dean Hospital from January 2022 to March 2023 were selected. They were randomly divided into a control group (42 patients) and an experimental group (42 patients). The control group received standard rehabilitation treatment, while the experimental group received precision exercise prescriptions based on cardiopulmonary exercise testing (CPET) results in addition to standard rehabilitation, over 12 weeks. The Self-rating Anxiety Scale (SAS), Self-rating Depression Scale (SDS), Mini-mental State Examination (MMSE) scores, and Homocysteine (Hcy) levels were compared before and after rehabilitation training in both groups. A Pearson correlation analysis was conducted between pre-rehabilitation Hcy levels and SAS, SDS, MMSE scores.

All 42 patients in the experimental group completed the CPET and the 12-week precision exercise prescription rehabilitation without any adverse events. Before rehabilitation training, there were no statistically significant differences in SAS, SDS, MMSE scores, and Hcy levels between the two groups (P>0.05). After rehabilitation training, the scores of SAS, SDS, and Hcy levels in the experimental group were significantly lower compared to pre-treatment values (P<0.05), and which were significantly lower than those of the control group (P<0.05). The MMSE score in experimental groups increased significantly after interventions compared to pre-treatment value (P<0.05), and it was significantly higher than that of the control group (P<0.05). There were no significant differences in SAS, SDS, MMSE scores, and Hcy levels before and after rehabilitation training in the control group (P>0.05). Pearson correlation analysis revealed a positive correlation between Hcy levels and SAS, SDS scores (r-values of 0.420 and 0.507, respectively, P<0.05) and no correlation with MMSE scores (r=0.079, P=0.473) .

Our findings suggest that precision exercise prescriptions significantly improve anxiety, depression, and cognitive functions in stroke patients, suggesting their potential as a novel therapeutic approach in clinical applications. Hcy may be one of the mechanisms through which precision exercise prescriptions improve anxiety and depression in stroke patients. Further research is needed to determine whether Hcy is related to the improvement of cognitive functions through this prescription.

Middle-aged and elderly ischemic stroke patients suffer from multiple co-morbid chronic diseases, and this co-morbidity status has a great impact on the patients' healthy living standard. Currently, there are few studies on the current status of ischemic stroke co-morbidities and the analysis of co-morbidity patterns.

To understand the current status of ischemic stroke co-morbidities in middle-aged and elderly people in Henan Province, and explore the association between ischemic stroke co-morbidities, so as to provide a reference basis for the management of ischemic stroke co-morbidities, as well as the preventive and control measures.

Ischemic stroke patients over 45 years of age attending Henan Provincial People's Hospital from January 2021 to December 2022 were selected for the study, with their chronic disease prevalence counted, the status of ischemic stroke co-morbidities was compared by different demographic characteristics, and the co-morbidity patterns of ischemic stroke in the middle-aged and elderly population were investigated using cluster analysis.

A total of 1 685 middle-aged and elderly ischemic stroke patients were enrolled in this study, of whom 90.0% (1 516/1 685) had at least 1 co-morbid chronic disease; 13.6% (230/1 685) had 2 co-morbid chronic diseases, 26.9% (454/1 685) had 3 co-morbid chronic diseases, and 49.4% (832/1 685) had 4 or more co-morbid chronic diseases. The chronic diseases with high prevalence were hypertension in 1 047 cases (62.1%) and dyslipidemia in 755 cases (44.8%). Among ischemic stroke patients, the prevalence of co-morbidities was higher in females compared with males (χ²=14.516, P<0.05) ; the prevalence of co-morbidities tended to increase with age (χ²_trend=148.889, P<0.001) ; and the prevalence of co-morbidities tended to decrease with higher education (χ²_trend=30.890, P<0.001). Cluster analysis showed four patterns of co-morbidity, which were cardiovascular-metabolic patterns (hypertension, dyslipidemia, heart attack, and diabetes mellitus), patterns characterized by hepato-pulmonary-gastrointestinal-urinary disorders (chronic lung disease, renal disease, hepatic disease, gastrointestinal disorders, and urinary disorders), psychiatric-degenerative patterns (neurological or psychiatric problems, arthritis or rheumatism, disorders related to memory), and cancer.

The prevalence of co-morbidities of ischemic stroke in middle-aged and elderly people in Henan province is high, and their co-morbidity patterns include cardiovascular-metabolic patterns, patterns characterized by hepato-pulmonary-gastrointestinal-urinary disorders, psychiatric-degenerative patterns, and cancers, among which cardiovascular-metabolic patterns are more associated with ischemic stroke, and the screening and prevention of which should be better controlled.

Test anxiety disorder is a group of symptoms related to stress caused by tests, exams, evaluations, and others. It is among the severe psychological problems in exams. Long-term test anxiety is likely to cause tension, fear, irritability, depression, and other negative emotions, and it disturbs working memory, attention, and other cognitive abilities and even leads to suicidal ideation. In order to standardize the clinical diagnosis and treatment of test anxiety disorder, under the organization of the Test Anxiety Disorder Collaboration of the Chinese Society of Psychosomatic Medicine, this expert consensus was formulated by 13 experts in the field of psychiatry and psychology. We collaborate and announce the expert consensus based on current research and clinical experience. We hope the consensus can provide clinicians with scientific and comprehensive guidance on test anxiety disorder, including epidemiology, etiology, clinical manifestations, evaluation, and treatment.

There are a large number of middle-aged and elderly patients with chronic diseases. However, there is currently limited research on the depression status and influencing factors of middle-aged and elderly patients with chronic diseases nationwide.

By exploring the depression status and influencing factors of middle-aged and elderly patients with chronic diseases in China, to provide a reference for improving their mental health status.

According to the fifth round of national survey data conducted by the China Health and Retirement Longitudinal Study (CHARLS) in 2020, a total of 12 551 middle-aged and elderly patients with chronic diseases were selected as the study objects. The depression status of the study objects was measured using the Center for Epidemiologic Studies Depression Scale (CES-D), and the main factors affecting the depression status of middle-aged and elderly patients with chronic diseases were analyzed using the chi-square test and multivariate Logistic regression.

Among middle-aged and elderly patients with chronic diseases, the proportion of those with depressive symptoms was 40.7% (5 111/12 551). The results of multivariate Logistic regression analysis showed that: gender (male: OR=0.613, 95%CI=0.553-0.680), age (65-<75 years old: OR=0.862, 95%CI=0.769-0.965; ≥75 years old: OR=0.604, 95%CI=0.510-0.716), presence of spouse/partner living together or not (have OR=0.730, 95%CI=0.648-0.822), places of residence (rural: OR=1.515, 95%CI=1.387-1.654), educational levels (junior high school: OR=0.727, 95%CI=0.657-0.805; senior high school and above: OR=0.561, 95%CI=0.488-0.646), social status (1 item: OR=0.870, 95%CI=0.793-0.956; ≥ 2 items: OR=0.866, 95%CI=0.779-0.963), satisfaction with child relationships (satisfaction: OR=0.266, 95%CI=0.218-0.324), smoking (OR=1.131, 95%CI=1.014-1.263), alcohol consumption (OR=0.873, 95%CI=0.795-0.959), nighttime sleep duration (6-<8 h: OR=0.539, 95%CI=0.493-0.590; ≥8 h: OR=0.443, 95%CI=0.396-0.495), BADL (damaged: OR=1.875, 95%CI=1.692-2.077), IADL (damaged: OR=2.251, 95%CI=2.030-2.496), number of chronic diseases (2 types: OR=1.202, 95%CI=1.076-1.342; 3 types: OR=1.452, 95%CI=1.289-1.636; ≥ 4 types: OR=1.954, 95%CI=1.749-2.183) were the influencing factors of depression symptoms in middle-aged and elderly patients with chronic diseases (P<0.05) .

The incidence of depressive symptoms in middle-aged and elderly patients with chronic diseases is 40.7%, and the situation is not optimistic. Their depression is influenced by various factors. Healthcare institutions and policymakers should pay attention to their mental health and take targeted measures from personal, family, community, and other aspects to improve.

Poor sleep quality in older adults is closely associated with a range of adverse health outcomes. Strengthening sleep health and rehabilitation management within existing primary healthcare for older adults can help prevent or slow the onset and progression of many chronic diseases, thereby saving substantial medical resources. However, a comprehensive sleep-rehabilitation management system has yet to be established at the primary healthcare level. To address this gap, the Community Rehabilitation Working Committee of Chinese Rehabilitation Medical Association, has developed the Chinese Expert Consensus on Sleep Health and Rehabilitation Management for Community-dwelling Older Adults (2025 Edition), in collaboration with experts from multiple domestic institutions. Grounded in evidence-based research on sleep rehabilitation and informed by multidisciplinary clinical experience, the consensus considers the current availability of community-level rehabilitation resources and future trends in primary healthcare. It offers consensus-based recommendations on age-related changes in sleep physiology, goals and requirements for sleep management, rehabilitation screening and assessment, management content, and procedural workflows. The publication of this consensus is expected to play a pivotal role in guiding primary healthcare institutions to implement standardized and evidence-based management of sleep rehabilitation in older adults.

In the context of an aging society, the number of elderly Alzheimer's disease and related dementia (ADRD) patients in China has been increasing year by year, placing a heavy caregiving burden on their primary family caregivers and garnering extensive attention both domestically and internationally.

This study aims to analyze the burden of ADRD among Chinese elderly individuals, explore the influence of age, period, and cohort factors on its incidence and prevalence, and predict its incidence post-2021, providing a basis for the development of preventive and curative measures by relevant authorities.

Using ADRD data from the Global Burden of Disease Study 2021 (GBD 2021), we extracted the crude incidence rate, crude prevalence rate, crude mortality rate, and crude DALY rate of ADRD among Chinese elderly individuals from 1992 to 2021. After age standardization, we analyzed trends using the Joinpoint regression model and calculated the annual percentage change (APC) and average annual percentage change (AAPC). Age-period-cohort models were used to analyze the effects of age, period, and cohort factors on the incidence and prevalence of ADRD, while Bayesian age-period-cohort models were employed to predict incidence rates from 2022 to 2030.

The age-standardized incidence and prevalence of ADRD among China's elderly population from 1992 to 2021 showed an overall increasing trend (incidence: AAPC=0.57%, 95%CI=0.41%-0.72%; prevalence: AAPC=0.64%, 95%CI=0.60%-0.68%). The growth rate of standardized incidence was higher in men than in women (AAPC: 0.63% vs. 0.60%), while the growth in standardized prevalence was higher in women than in men (AAPC: 0.68% vs. 0.66%). The standardized mortality rate decreased across three intervals (1992-2019: APC of -0.11%, -0.41%, and -0.08%) but increased from 2019 to 2021 (APC=1.96%, 95%CI=0.78%-3.15%). The effects of age, period, and cohort factors on ADRD incidence and prevalence were significant. Specifically, the risk of incidence and prevalence increased with age in both men and women over 60 years old, with individuals aged 95 years and older having 13.24 and 13.53 times higher risk of incidence in men and women, respectively, compared to the 60-64 age group. The corresponding prevalence risks were 13.55 and 16.05 times higher. Over time, the risk increased, peaking during 2017-2021. In contrast, cohort effects revealed a progressive decrease in risk with later birth cohorts. By 2030, the standardized incidence rate is projected to increase by approximately 43.62% in women (from 1 267.77 to 1 820.80 per 100 000) and by 36.52% in men (from 920.22 to 1 256.30 per 100 000). Additionally, the number of ADRD cases among men and women was expected to rise significantly, with increases of 89.74% and 105.06%, respectively, between 2021 and 2030.

The increasing burden of ADRD in China's elderly population highlights the need for effective measures, particularly to protect elderly women.

As a common affective mental disorder, depressive disorder has currently become the second health burden worldwide, however, its pathogenesis remains to be further elucidated. The clinical treatment of depressive disorder primarily relies on western medicine. However, there is great clinical need for effective and rapid-onset antidepressants for the unsatisfactory effect, obvious treatment time-lag, and intolerable adverse reactions of current drug treatment. Ferroptosis is a novel form of cell death discovered in recent years, which has been found to be involved in the pathogenesis of numerous neurological disorders, including depressive disorder. Currently, some studies have shifted the focus of antidepressant treatment towards targeted inhibition of ferroptosis, and achieved positive outcomes. The present paper provides a comprehensive review of the involvement of ferroptosis in depressive disorder pathogenesis and its potential therapeutic implications, drawing on clinical and preclinical evidence that elucidates the underlying mechanisms linking depressive disorder with ferroptotic processes.

Anorexia nervosa (AN) is a type of eating disorders characterized by self-starvation, significant loss of body mass, and malnutrition. AN has the highest mortality rate among all psychiatric disorders, leading to severe psychopathologic symptoms and life-threatening medical complications. However, AN cannot be recognized and diagnosed early in China, resulting in a prolonged course of the disease. Therefore, under the organization of the Eating Disorders Coordination Group of the Psychosomatic Medicine Society of the Chinese Medical Association, together with the Eating Disorders Research Collaboration Group of the Psychiatric Medicine Society of the Chinese Medical Association, this expert consensus was formulated by 16 medical experts based on evidence-based medical evidence, domestic and international guidelines and expert consensus, expert experience, etc., in order to improve the recognition, diagnosis and treatment of AN among domestic professionals.

Insomnia not only decreases the quality of life and working efficiency, but also relates to other deceases. Suitable exercises may be useful to improve sleep quality. However, comparative studies on the effects of different types of exercise on sleep outcomes are currently lacked.

To compare the effects of different exercise types on sleep in insomnia patients and to provide insights for developing exercise prescriptions to improve sleep in this population.

Randomized controlled trials (RCT) investigating the effects of different types of exercises on the sleep of people with insomnia were retrieved from the PubMed, Web of Science, EBSCO, Scopus, China National Knowledge Infrastructure (CNKI), and Wanfang Data Knowledge Service Platform from database inception to December 2023. The quality of the literatures was assessed using the Jadad scale. A network meta-analysis was performed using the random-effects model of the frequency framework in Stata 17.0 software, and publication bias was observed using a funnel plot.

A total of 36 articles representing 2 706 participants were included in this study. Exercise interventions were categorized into five types, including the aerobic exercise (AE), resistance training (RT), mind-body exercise (ME), prolonged time of exercise (PTE), and AE combined with RT (AE+RT). The results of the network meta-analysis showed that there was a significant difference in the total score of the subjective evaluation tools between AE group and blank control group (SMD=2.20, 95%CI=0.35-4.05, P<0.05). The maximum surface under the cumulative ranking curve (SUCRA) of the total score of the subjective evaluation tools was detected in AE group (82.2%), followed by ME (71.1%), AE+RT (54.2%), RT (38.9%), controlled trial (CT) (29.2%) and PTE groups (24.4%). There was a significant difference in sleep latency (SL) between PTE group versus AE+RT group (SMD=-14.66, 95%CI=-28.60 to -0.72), between AE+RT group versus RT group (SMD=21.32, 95%CI=6.24-36.40), and between AE+RT group versus AE group (SMD=11.19, 95%CI=1.56-20.81) (all P<0.05). The maximum SUCRA of SL was detected in AE+RT group (96.7%), followed by CT (77.1%), ME (49.5%), AE (42.6%), PTE (27.9%) and RT groups (6.1%). There was a significant difference in sleep efficacy (SE) between AE group versus CT group (SMD=4.59, 95%CI=1.59-7.58, P<0.05). The maximum SUCRA of SE was detected in the AE group (83.1%), followed by AE+RT (59.9%), RT (50.7%), ME (46.9%), PTE (35.5%) and CT groups (23.9%). There was a significant difference in wake time after sleep onset (WASO) between PTE group versus RT group (SMD=23.39, 95%CI=14.67-32.02), between PTE group versus AE group (SMD=14.86, 95%CI=4.64-36.40), between PTE group versus CT group (SMD=12.11, 95%CI=7.62-16.59), between RT group versus ME group (SMD=-27.61, 95%CI=-40.49 to -14.73), between RT group versus CT group (SMD=-11.28, 95%CI=-20.86 to -1.70), between ME group versus AE group (SMD=19.08, 95%CI=5.18-32.98), and between ME group versus CT group (SMD=16.33, 95%CI=7.26-25.40) (all P<0.05). The maximum SUCRA of WASO was detected in the RT group (94.7%), followed by CT (80.2%), AE (41.8%), ME (31.5%) and PTE groups (1.7%). There was a significant difference in the total sleep time (TST) between RT group versus AE group (SMD=-20.84, 95%CI=-38.46 to -3.23), between AE group versus CT group (SMD=12.02, 95%CI=2.96-21.08) (all P<0.05). The maximum SUCRA of TST was detected in the AE group (87.2%), followed by AE+CT (71.6%), PTE (53.8%), ME (40.6%), CT (35.9%) and RT groups (10.8%). There was no significant difference in the sleep quality (SQ) among groups (P>0.05). The maximum SUCRA of SQ was detected in the AE group (84.2%), followed by AE+CT (75.5%), ME (24.9%) and CT groups (15.4%). Publication bias analysis of the total score of subjective evaluation tools, SL, SE, WASO, TST, and SQ revealed some asymmetry in all six outcome indicators, indicating a certain risk of publication bias.

Given the favorable effects of AE on multiple sleep parameters, we recommend insomnia patients engage in moderate-intensity AE, such as jogging or brisk walking, three times a week for approximately 30 minutes. Additionally, options include moderate-intensity RT or AE+RT four to five times a week. When engaging in the above exercises, attention should be paid to the choice of time period, and exercise within 3 hours before bedtime should be avoided as much as possible.

Cognitive impairment is one of the serious risk factors affecting the quality of life in the elderly. Some studies have found an association between frailty and cognitive function, but research on mediating and moderating effects between the two is relatively scarce.

To explore the influence of frailty on cognitive function, and to investigate the mediating role of activities of daily living and depressive symptoms between frailty and cognitive function. Additionally, the moderating effect of social participation will be analysed.

Using data from the 2018 China Longitudinal Healthy Longevity Survey (CLHLS), 8 173 individuals aged 65 and older were selected to obtain relevant information on frailty, cognitive function, activities of daily living, depressive symptoms, social participation, and demographic data among the elderly. The differences in cognitive function among elderly individuals with different characteristics were analyzed. Pearson correlation analysis was employed to investigate the interrelationships between the variables. Stratified regression was utilised to examine the impact of frailty on cognitive function. The Process macro programme was used to test the chain mediating role of activities of daily living and depressive symptoms between frailty and cognitive function, and the moderating effect of social participation within it.

Of the 8 173 participants, 1 769 (21.6%) had cognitive impairment and all variables were correlated. Stratified regression analyses showed frailty negatively predicts cognitive function (B=-2.862, P<0.001). The results of the chain-mediated effects analysis showed that the activities of daily living (B=-1.713, 95%CI=-1.944 to -1.498) and depressive symptoms (B=-0.435, 95%CI=-0.531 to -0.345) mediated the link between cognitive function and frailty to some extent. The interaction term between frailty and social participation (B=1.140, 95%CI=0.822 to 1.457) as well as the interaction term between depression and social participation (B=0.113, 95%CI=0.015 to 0.211) both significantly and positively predicted cognitive function, while the interaction term between activities of daily living and social participation was negatively correlated with cognitive function (B=-0.413, 95%CI=-0.560 to -0.266) .

Social participation moderated the direct and indirect effects of activities of daily living and depressive symptoms on the relationship between frailty and cognitive function. The findings indicate that interventions targeting older people's mental health and enhancing the quality of social relationships may facilitate the dissolution of the correlation between frailty and cognitive impairment.

Obstructive sleep apnea (OSA) is prevalent in the elderly population due to the weakened neuromuscular function of the upper airway and unstable respiratory regulation in the elderly. OSA is a risk factor for a variety of common chronic diseases, and affects cognitive function and multi-system organ function in the elderly. Therefore, it is essential to provide effective therapeutic interventions for OSA in the elderly. The Sleep Medicine Branch of the Chinese Geriatrics Society, as the initiator, organized domestic experts in related fields to repeatedly discuss the operation process, requirements, specific ways and methods of noninvasive positive pressure ventilation (NPPV) treatment for elderly OSA patients with reference to domestic and international clinical studies, and finally made this expert consensus, which is aimed at standardizing the treatment of NPPV in elderly OSA patients in China to provide a reference.

Understanding the condition and influencing factors of cognitive impairment in maintenance hemodialysis (MHD) patients could signficantly enhance their quality of life while alleviating the burden on their families and society.

TO investigate the status of cognitive impairment in MHD patients and explore the possible influencing factors.

Using convenience sampling, we selected MHD patients from three hemodialysis centers (including the Department of Nephrology at the First Affiliated Hospital of Shihezi University, the Department of Nephrology at Shihezi People's Hospital, and the Langshen Hemodialysis Center) in Shihezi City between April 2023 and April 2024. We collected data on demographic characteristics, cognitive impairment levels, sleep quality, independent living abilities, serum levels of α-Klotho, β-Klotho, FGF-23, and other common laboratory indicators. Cognitive function was assessed with the Montreal Cognitive Assessment (MoCA), sleep quality was evaluated with the Athens Insomnia Scale (AIS-8), and independent living ability was assessed using the Functional Activities Questionnaire (FAQ). Serum levels of α-Klotho, β-Klotho, and FGF-23 were measured by the ELISA method. Univariate and multivariate Logistic regression analyses were performed to identify influencing factors, which were validated for their predictive value on cognitive impairment using the receiver operating characteristic (ROC) curve. A nomogram was subsequently plotted.

A total of 276 MHD patients were surveyed, revealing a cognitive impairment incidence rate of 76.4% (211/276). Among these, 145 patients had mild cognitive impairment and 66 patients had moderate cognitive impairment. Nearly half of the patients exhibited suspected insomnia (21.4%) or confirmed insomnia (25.4%). Among the patients studied, 14.9% (41 out of 276) lacked the ability to live independently. The multivariate Logistic regression analysis indicated that age (OR=1.038, 95%CI=1.004-1.072) and sleep disorders (OR=1.179, 95%CI=1.051-1.322) were risk factors for cognitive impairment in MHD patients (P<0.05). High serum α-Klotho levels (OR=0.996, 95%CI=0.994-0.998), high serum β-Klotho levels (OR=0.750, 95%CI=0.661-0.852), and higher years of education (OR=0.800, 95%CI=0.699-0.915) were protective factors (P<0.05). The area under the ROC curve (AUC) showed that age (AUC=0.732, 95%CI=0.667-0.797), sleep disorder (AUC=0.710, 95%CI=0.638-0.783), α-Klotho (AUC=0.774, 95%CI=0.709-0.839), β-Klotho (AUC=0.741, 95%CI=0.663-0.819) and years of education (AUC=0.718, 95%CI=0.647-0.789) had predictive value for cognitive impairment in MHD patients. The combination of age, sleep disorder, serum α-Klotho, serum β-Klotho and years of education (P=-0.004×α-Klotho-0.287×β-Klotho+0.370×age-0.223×years of education +0.165×AIS-8 score+6.658) predicted the occurrence of MHD. The AUC of cognitive impairment was 0.894 (95%CI=0.851-0.937, P<0.001), the sensitivity was 82.9%, and the specificity was 78.5%.

The prevalence of cognitive impairment among MHD patients is substantially high, estimated at approximately 76%. Age, sleep disorders, years of education, and levels of α-Klotho and β-Klotho are important influencing factors. Medical staff and patients' families should raise awareness of cognitive impairment, actively screen and intervene in key patients to improve their quality of life and reduce the burden on their families and society.

Whether considering the cumulative effect of sustained C-reactive protein (CRP) and distinguishing different aspects of depressive symptoms may be the reasons for the inconsistent conclusions of previous studies on the association between CRP and depressive symptoms among middle-aged and older adults. The relationship between cumulative effects of CRP elevations and different aspects of depressive symptoms in middle-aged and older adults in China is not well understood.

This study aims to examine the relationship between cumulative episodes of CRP elevations over two successive determinations and depressive symptoms, as well as somatic and non-somatic retardation, among Chinese middle-aged and older adults.

This study used public data from the 2011-2018 Chinese Health and Retirement Longitudinal Study (CHARLS) and included 3 868 subjects. They were categorized based on the frequency of CRP elevations over two consecutive measurements: "elevated on zero occasion" (n=2 918), "elevated on one occasion" (n=763), and "elevated on two occasions" (n=187). Depressive symptoms were assessed using the Center for Epidemiological Studies Depression Scale (CESD-10) in 2011, 2015, and 2018, capturing both somatic and non-somatic dimensions. Multiple linear was used to explore the associations between cumulative episodes of CRP elevations over two successive determinations with depressive symptom scores in 2018, as well as the scores of somatic and non-somatic components separately. Multivariate Logistic regression was used to investigate the effects of cumulative episodes of CRP elevations on the risk of depressive symptoms in 2018.

The results of multiple linear regression analysis showed that after adjusting for all covariates, elevated on two occasions compared with elevated on zero occasion, which was an influential factor for the total score of depressive symptoms (β=1.22, P<0.05), the score of somatic depressive symptoms (β=0.51, P<0.05) and the score of non-somatic symptoms (β=0.71, P<0.05). Logistic regression analysis showed that after adjusting for all covariates, elevated on two occasions were associated with a higher risk of depressive symptoms than elevated on zero occasion (OR=1.64, 95%CI=1.18-2.29) .

Among Chinese middle-aged and older adults, there is a positive association between cumulative effects of CRP elevations and depressive symptoms, encompassing both somatic and non-somatic retardation. Addressing chronic inflammation and treating chronic inflammatory diseases promptly may help mitigate depression risk.

Cognitive impairment poses a major health challenge in China's aging society, profoundly affecting patients' quality of life and increasing the care burden. Currently, home-based rehabilitation for cognitive impairment in China faces several issues, including low detection rates, fragmented intervention measures, and an inadequate family support system. To establish a home-based rehabilitation framework suited to China's context, the Community Rehabilitation Working Committee of Chinese Rehabilitation Medicine Association organized a multidisciplinary expert panel to develop the Chinese Expert Consensus on the Management of Home-based Rehabilitation for Cognitive Impairment (2026 Edition), based on a systematic review of domestic and international evidence. This consensus retrieved relevant guidelines and high-quality studies from both Chinese and international databases and developed recommendations following evidence-based medicine principles. It focused on key issues such as early screening, non-pharmacological interventions, home environment adaptation, and caregiver support and training. The document aimed to provide scientific and practical guidance for community healthcare workers and caregivers, enhance family rehabilitation capacity, delay disease progression, and improve the quality of life for both patients and caregivers.

With the rapid progression of aging in China, the challenge of multimorbidity has become a significant concern for both public health and clinical practice. Nocturnal sleep status, including sleep duration and quality, is crucial for regulating body metabolism and physiological functions in the elderly. However, current research on the relationship between nocturnal sleep status and multimorbidity was limited to specific regions or the middle-aged population. The association between nocturnal sleep status and prevalence of multimorbidity among community-dwelling older adults remains ambiguous.

To investigate the association between nocturnal sleep status and prevalence of multimorbidity among community-dwelling older adults.

In April 2023, a total of 11 917 community-dwelling older adults from the Chinese Longitudinal Healthy Longevity and Happy Family Study (CLHLS-HF, wave 2018) were selected as the participants. Multivariate Logistic regression was used to explore the association of sleep duration and sleep quality with the prevalence of multimorbidity, represented by odds ratios (OR) and 95% confidence intervals (95%CI). Additionally, restrictive cubic splines (RCS) based on Logistic regression analysis were utilized to analyze the dose-response relationship between sleep duration and prevalence of multimorbidity.

Of the 11 917 community-dwelling older adults, with an average age of (84.4±11.4) years ranged from 65.0 to 117.0 years, 6 477 were females (54.35%) and 5 440 were males (45.65%). Multivariate Logistic regression results after adjusting for covariates such as gender, age, region, and years of education, indicated that compared to those with 6-8 h of nocturnal sleep duration, older adults with shorter sleep duration (<6 h) had a higher prevalence of multimorbidity (OR=1.51, 95%CI=1.36-1.67, P<0.05) ; compared to those with good sleep quality, individuals with fair sleep quality (OR=1.34, 95%CI=1.22-1.46, P<0.05) and poor sleep quality (OR=2.14, 95%CI=1.91-2.40, P<0.05) were associated with higher prevalence of multimorbidity. RCS plots revealed a "U" -shaped nonlinear association between sleep duration and prevalence of multimorbidity, with an optimal sleep duration of approximately 7 hours.

Community-dwelling older adults with sleep durations less than 6 hours, fair or poor sleep quality, are associated with an increased prevalence of multimorbidity. The optimal sleep duration for community-dwelling older adults is approximately 7 hours. Normal sleep duration and good sleep quality are important for the prevention of multimorbidity.

Diabetes and depression are global public health issues. There is a significant correlation between diabetes and depression. Therefore, monitoring and intervening in diabetes, depression, and their comorbidity among middle-aged and elderly people is crucial.

To explores the prevalence of diabetes and depression, as well as their comorbidity, among the elderly population, and the impact of sleep, exercise, and social activities on these conditions.

Based on the 2018 China Health and Retirement Longitudinal Study, 11 177 participants who met the research criteria were included as subjects. A multifactorial Logistic regression analysis model was employed to investigate the association between sleep, exercise, and social activities with the comorbidity of diabetes and depression. Subsequently, the product of nap duration and nighttime sleep duration was incorporated into the regression model for interaction analysis.

A total of 11 177 subjects were included in the study, with a prevalence of diabetes of 13.95% (1 559/11 177), a prevalence of depressive status of 24.85% (2 777/11 177), and a comorbidity prevalence of both diabetes and depressive status of 14.64% (1 636/11 177). The results of the multinomial Logistic regression analysis indicated that a nighttime sleep duration of 7 to 9 hours (OR=0.337, 95%CI=0.296-0.384), a nighttime sleep duration greater than 9 hours (OR=0.509, 95%CI=0.374-0.692), and a nap duration greater than 90 minutes (OR=0.792, 95%CI=0.666-0.941) were all protective factors for the comorbidity of diabetes and depressive status. High levels of social interaction were also found to reduce the risk of comorbidity (OR=0.778, 95%CI=0.686-0.882, P<0.05). The interaction analysis results showed that maintaining a nighttime sleep duration of 7 to 9 hours, regardless of nap duration, was effective in preventing the comorbidity of diabetes and depressive status (P<0.001). If the nighttime sleep duration is less than 7 hours, a nap duration of 60 to 90 minutes can also reduce the risk of comorbidity (OR=0.740, 95%CI=0.577-0.950, P<0.05). In the case of a nighttime sleep duration greater than 9 hours, not taking a nap (OR=0.270, 95%CI=0.125-0.581) or maintaining a nap duration of 60 to 90 minutes (OR=0.165, 95%CI=0.040-0.674) can also reduce the risk of comorbidity.

The comorbidity prevalence of diabetes and depressive status among middle-aged and elderly people in China is relatively high (14.64%). Nighttime sleep duration of more than 7 hours, nap duration of more than 90 minutes, and a high level of social interaction can all effectively reduce the risk of comorbidity of diabetes and depressive status. Moderate levels of physical activity can reduce the risks of diabetes and depressive status respectively. Napping serves as a compensatory mechanism, helping to make up for insufficient nighttime sleep. If nighttime sleep is less than 7 hours, controlling the nap duration to 60 to 90 minutes can also reduce the risk of comorbidity of diabetes and depressive status.

Conventional methods for identifying traditional Chinese medicine (TCM) herbals mainly rely on subjective experiences, making it difficult to meet the needs for accurate classification and identification.

This study aims to develop an artificial intelligence model and a desktop application capable of automatically recognizing 163 types of TCM herbals based on convolutional neural networks (CNN) .

From January 2020 to June 2024, data from two datasets of 163 TCM herbals were collected for training, validation, and testing of the deep learning model. The performance of the CNN model was evaluated for the accuracy, sensitivity, specificity, precision, area under the receiver operating characteristic (ROC) curve (AUC), and F1 score. After model training, an application was developed using PyQt5 technology for convenient clinical use.

A total of 276 767 images were included in this study. Five models, including EfficientNetB0, ResNet50, MobileNetV3, VGG19, and ResNet18, were developed. After comparing their performance, the EfficientNetB0 model achieved the highest accuracy (99.0%) and AUC (0.994 2) in the validation dataset, and it was selected as the optimal model. In the test dataset, the EfficientNetB0 model achieved an accuracy of 99.0%, sensitivity of 99.0%, specificity of 100.0%, and an AUC of 1.0 across all categories, demonstrating an excellent performance.

The deep learning model developed based on CNN can quickly and accurately recognize 163 types of TCM herbals with high sensitivity and recognition capability, thus providing a robust support for physicians to accurately identify TCM herbals.

The elderly population in our country is large and growing rapidly, and depression is a common emotional disorder and mental health problem among the elderly population. The mental health of the female elderly population is increasingly becoming a focus of social concern.

To explore the influencing factors of depression symptoms in the female elderly population from a multi-level and comprehensive perspective of health ecology, and provide theoretical basis for identifying and intervening in depression symptoms in the elderly female population in China.

In January 2024, we extracted for the 2020 survey data from the China Health and Retirement Longitudinal Survey (CHARLS), and a group of female elderly adults aged 60 years and above were selected for the study (n=4 594). Based on the health ecology model, the influencing factors were divided into five levels: personal characteristics layer, behavioural characteristics layer, interpersonal network layer, living and working conditions layer, and policy environment layer. The χ² test and binary Logistic regression model were used to explore the influencing factors of depression symptoms and to establish a health ecology model of depression symptoms in the Chinese female elderly population.

The detection rate of depression symptoms in the Chinese female elderly population was 48.06% (2 208/4 595). Logistic regression analysis showed that age of ≥80 years (OR=0.601, 95%CI=0.449-0.804), sleep duration of≥6 h (OR=0.561, 95%CI=0.493-0.639), satisfaction with life (OR=0.256, 95%CI=0.199-0.330), better self-rated physical health (OR=0.459, 95%CI=0.395-0.533), urban household registration (OR=0.717, 95%CI=0.603-0.853), satisfaction with children (OR=0.666, 95%CI=0.472-0.940), education level of junior high school and above (OR=0.712, 95%CI=0.582-0.871), family income >50 000 yuan (OR=0.822, 95%CI=0.704-0.959) and the per capita GDP of the city is 50 000 to 100 000 yuan (OR=0.841, 95%CI=0.730-0.970) were the protective factors for the development of depression symptoms in the Chinese female elderly population (P<0.05). Having become disabled (OR=1.786, 95%CI=1.556-2.050), suffering from chronic diseases (OR=1.159, 95%CI=1.014-1.324), central region (OR=1.298, 95%CI=1.107-1.522) and western region (OR=1.407, 95%CI=1.183-1.675) were the risk factors for depression symptoms in the Chinese female elderly population (P<0.05) .

The detection rate of depression symptoms in the Chinese female elderly population is relatively high, and there are many influencing factors, including: age in the personal characteristics layer; sleep time, satisfaction with life, self-related of physical health, disability, and chronic disease in the behavioral characteristics layer; household registration type, satisfaction with children, and geographical distribution in the interpersonal network layer; education and family income in the living and working conditions layer; the per capita GDP of the city in the policy environment layer. Effective intervention measures should be taken at all layers, targeting key populations, in order to reduce the incidence of depression symptoms among the Chinese elderly women.

Sleep health is a novel concept, a multidimensional sleep-wakefulness pattern that adapts to individual, social, and environmental demands to promote physical and mental well-being. Current research has found that sleep health is not only associated with physiological health issues such as diabetes, overweight/obesity, and cardiovascular risks but also has significant impacts on mental health issues such as anxiety and depression. Previous sleep-related studies have primarily focused on identifying and treating sleep disorders and problems, with less attention to the positive attributes of sleep health. This review summarizes studies on sleep health, including its definition, measurement tools, and correlations with health outcomes, aiming to foster a more comprehensive understanding of sleep health and provide a reference for research on sleep health among Chinese residents.

The accelerated aging of China's population has contributed to the increasing prominence of chronic disease comorbidities, significantly increasing the medical burden and threatening patients' physical and mental health. Elderly patients with chronic disease comorbidities are more likely to have psychological problems such as anxiety and depression due to multiple comorbidities, and their symptom detection rate is significantly higher than that of the healthy or single chronic disease population. Although the pathogenesis is unclear, demographic (age, gender, education), socioeconomic (household income, place of residence), social support, health status, and lifestyle factors are strongly associated with mental health, and elucidation of these factors is essential for the development of precise intervention strategies. Existing interventions are classified as both pharmacological and non-pharmacological. Although medications provide symptomatic relief, the risk of polypharmacy limits how they're used. Non-pharmacological interventions show unique advantages through diversified means: group psychological intervention strengthens the social support network, cognitive behavioral therapy corrects negative cognition, exercise therapy improves both physical and psychological health, music/nostalgia/narrative therapy regulates emotional states, Internet+ technology breaks through time and space constraints to increase accessibility of interventions, traditional Chinese medicine therapy realizes physical and mental co-treatment, and health education and co-psychological care enhance self-management ability through knowledge and empowerment. These interventions have been shown to be effective in improving the mental health of comorbid patients. This article reviews national and international studies focusing on the epidemiology, influencing factors, and intervention strategies of elderly multimorbid patients to provide a basis for mental health promotion. In the future, it is necessary to deepen research on the mechanism of multidisease interaction, establish a personalized intervention system based on risk assessment, and verify the effect of intervention through multicenter long-term follow-up, in order to achieve the goal of healthy aging.

As a neurodegenerative disease, Alzheimer's disease (AD) has a high incidence rate and rapid development, which seriously affects the quality of life of patients. In recent years, research on music therapy intervention in AD has gradually increased, lacking effective systematic evaluation and analysis.

A meta-analysis was conducted on the intervention effects of music in the treatment of cognition, emotion, living ability and sleep disorders in AD patients.

Randomized controlled trials (RCT) on the intervention effect of music therapy methods on Alzheimer's patients were searched by computer in CNKI, Wanfang Data, VIP, Medline, Elsevier Science Direct, PubMed, and Embase from inception to February 2023, and the data was analyzed using RevMan 5.3 software.

The study included 15 RCTs with a total of 1 077 patients. The results of Meta-analysis showed that the intervention effects of music therapy on cognitive function (MD=4.35, 95%CI=1.64 to 7.05, Z=3.15, P=0.002), negative emotion (SMD=-0.71, 95%CI=-1.26 to -0.15, Z=2.51, P=0.01), life ability (SMD=-0.91, 95%CI=-1.55 to -0.27, Z=2.77, P=0.006) in the music therapy group was better than that of control group. There was no significant difference in sleep disorder intervention between the two groups (MD=-1.04, 95%CI=-3.10 to 1.02, Z=0.99, P=0.32). Subgroup analysis showed that the music therapy groups with treatment period was <12 weeks (P=0.01), treatment duration <45 min/time (P=0.02), treatment frequency ≥3 times/week (P<0.001), individual implementation method (P<0.001), individual + group implementation method (P=0.002), receiving music therapy as the intervention method (P<0.001) had better intervention effect on cognitive function than the control group; the music therapy groups with treatment period ≥12 weeks (P=0.004), treatment frequency <3 times/week (P=0.01), implementation method of individual+group (P=0.02), intervention measure of receiving music therapy (P=0.002), intervention measure of active music therapy (P=0.002), had better intervention effect on negative emotions than the control group.

Music therapy can improve the cognitive function, mental state, and daily self activity of AD patients. However, due to the low quality of case studies included, more large-scale and high-quality evidence-based studies are still needed to verify.

Depression is a common psychiatric disorder with limited treatment options. Deep transcranial magnetic stimulation (dTMS), as a new non-invasive neuromodulation technique, has been utilized in the treatment of major depressive disorder (MDD), but there is less evidence from clinical studies.

To explore the clinical efficacy of dTMS combined with escitalopram oxalate (Esc) in the treatment of depression, and provide further reliable data reference for dTMS in the treatment of depression patients.

A total of 73 patients with depression who attended Department of Psychiatry, Affiliated Hospital of Guizhou Medical University from December 2021 to January 2023 were selected as the study subjects and divided into the control group (n=35) and combined treatment group (n=38) according to the random number table. Patients in the control group were given Esc ( 10 mg per day in the first week and 20 mg per day from the second week for 2 consecutive weeks). The combined treatment group received the treatment of dTMS (left DLPFC as the stimulation target, 18 Hz, 120%MT, 1 980 times per day for 2 weeks, 10 times in total) based on the same treatment for the control group. The depressive symptoms and cognitive improvement of patients in the two groups were evaluated before and after the two weeks of treatments by Hamilton depression scale (HAMD), Beck Scale for Suicide Ideation (BSS), Montreal Cognitive Assessment Scale (MoCA) and the mean oxygenated hemoglobin (oxy-Hb) concentration in the prefrontal cortex measured by functional near-infrared spectroscopy (fNIRS) based on the verbal fluency text (VFT) task.

The actual completion of the trial was 30 cases in the control group and 31 cases in the combined treatment group. After treatment, the HAMD and BSS scores of the combined treatment group were lower than those of the control group, and the MoCA score was higher than that of the control group (P<0.05). After treatment, the HAMD and BSS scores of patients in the two groups were lower than those before treatment, and the MoCA score was higher than that before treatment (P<0.05). There was no significant activation of the prefrontal cortex after treatment in both groups. The improvement of depression symptoms and cognitive function in the combined treatment group was better than that in the control group.

The combination of dTMS and Esc can improve the depressive symptoms and cognitive function better than Esc treatment alone in depression patients.

Alzheimer's disease (AD) is a common neurodegenerative disease in the elderly population. It's typical clinical manifestation is progressive memory impairment. Ferroptosis, rising as a new research direction on AD biological mechanism in recent years, mainly studies on iron-dependent programmed cell death. A large amount of evidence has shown that AD is closely related to ferroptosis in the brain. However, the exact mechanism of the role ferroptosis has played in AD is still unclear. One of the most popular research results indicates that AD might be induced by iron metabolism disorders, lipid peroxidation, and amino acid metabolism, thereby affecting the deposition of iron ions in the brain. So far, some effective chemical components of traditional Chinese herbs as cures of AD have been studied in depth, such as rhodiola rosea, polygala root, ginkgo biloba, poria cocos, etc. These traditional Chinese herbs have shown remarkable effects in the treatment of AD by means of targeting ferroptosis. In this context, this review systematically elaborates on the metabolism of iron in the brain, the characteristics of ferroptosis, and focuses on the metabolic regulation mechanism of ferroptosis. Meanwhile, this review also discusses the connection between ferroptosis and AD. Furthermore, it lists the effective compositions in traditional Chinese herbs that can improve AD by inhibiting ferroptosis, so as to provide reference information for the development and research of ferroptosis inhibitors in the future.

Homocysteine (Hcy) levels are strongly associated with vascular health problems like stroke, and early identification and screening for hyperhomocysteinemia (HHcy) is crucial for stroke prevention. However, lack of systematic epidemiological data on the relationship between Hcy and stroke in Hebei Province, China, and insufficient comprehensive studies on HHcy and other risk factors limit the development of effective prevention and control strategies.

To investigate the correlation between Hcy and stroke in people aged 40 years and over in Hebei Province, thus providing scientific basis for the development of accurate stroke prevention and control strategies.

On the basis of the China National Stroke Screening Survey from January 2018 to December 2020, 92 942 permanent residents aged 40 and above were sampled from 49 monitoring sites in 9 cities of Hebei Province by multi-stage cluster sampling method. The correlation between Hcy and stroke was investigated by unconditional Logistic regression analysis, and stratified analysis was performed based on age and sex. At the same time, the combined effects of Hcy and other factors on stroke were further studied.

The prevalence of stroke among people aged 40 years and above in Hebei Province was 4.51% (4 196/92 942) , and the prevalence of high Hcy was 36.25% (33 692/92 942) . The prevalence of stroke in people with high Hcy levels was significantly higher than that in people with normal Hcy levels (P<0.05) . Stratified by Hcy quartiles, the prevalence of stroke tended to increase as Hcy levels gradually increased (χ² _trend=367.310, P<0.05) . The results of stratification analysis showed that in two age groups (40-59 years old and ≥60 years old) , the prevalence of stroke was significantly higher in people with high Hcy levels than in people with normal Hcy levels (P<0.05) . With the incremental increase of Hcy levels from Q1 to Q4, the prevalence of stroke in people with 40-59 and ≥60 years old showed an incremental trend (the trend χ² values were 109.213, and 75.653, respectively, P<0.05) . The prevalence of stroke was significantly higher in both males and females with high Hcy levels than normal Hcy levels (P<0.05) , and the prevalence of stroke in both males and females showed an increasing trend as the Hcy level increased from Q1 to Q4 (the trend χ² values were 197.115, and 117.406, respectively, P<0.05) . There was a positive additive interaction but no multiplicative interaction between high Hcy and hypertension (RERI=0.41, AP=0.08, SI=1.12, P<0.05) , and a negative additive (RERI=-0.30, AP=-0.25, SI=0.41, P<0.05) and negative multiplicative (OR=0.77, 95%CI=0.64-0.92, P<0.05) interactions. No interaction was found with diabetes or alcohol consumption.

The prevalence of high Hcy exceeded 36% in people over 40 years of age in Hebei province, and the prevalence of stroke increased with higher Hcy levels, especially across age and gender. The risk of stroke was increased when high Hcy coexisted with hypertension, whereas there was a negative interaction between high Hcy and smoking, with an antagonistic effect when the two exposure factors coexisted that altogether reduced the risk of stroke. However, it should be emphasized that the reduced risk does not mean that the harms of these two factors alone can be ignored, and that high Hcy and smoking are still important risk factors for stroke. Therefore, people at high risk of stroke should have their Hcy levels monitored regularly, and should take targeted measures to control their blood pressure, improve healthy lifestyles, and take folic acid and B vitamins supplements to reduce the overall risk of stroke.

Post-stroke patients are often left with different degrees of functional impairment, and in the process of returning from the medical institution to the community and home, it is necessary for medical institutions at all levels to cooperate and interact, so as to form a good full-cycle rehabilitation closed loop. At present, the application of full-cycle stroke rehabilitation is progressing, but some resistance still exists. This articel is based on the concept of full-cycle rehabilitation for stroke, combined with the current situation of the development of community-based rehabilitation, we also think about the development of the full-cycle rehabilitation and community-based rehabilitation link for stroke. The article emphasizes the importance of "community-based inflection-point rehabilitation" and the need to establish standards of community-based rehabilitation. Moreover, the article also mentions the need to emphasize the full-cycle stage of rehabilitation for stroke patients, explore the development strategy of community-based rehabilitation, and effectively improve the quality of life in community and family.

With the rapid development of economy and the change of fertility concept in modern population, the number of advanced maternal age is increasing year by year. Compared with appropriate maternal age, advanced maternal age is more likely to suffer from depressive symptoms due to personal, family, work, and other reasons.

To systematically evaluate the detection rate of postpartum depression in advanced maternal age (≥35 years at delivery) in China to provide relevant evidence for early prevention and intervention.

CNKI, Wanfang, VIP, CBM, PubMed, Cochrane Library, Embase, and Web of Science were searched for articles on the detection rate of postpartum depression in advanced maternal age in China by combining subject terms and free terms from inception to July 2023. The process of literature screening, data extraction and quality assessment were carried out by two researchers independently. Stata 16.0 software was used for data analysis.

A total of 21 studies were included, with a total sample size of 5 163. The results of Meta-analysis showed that the overall detection rate of postpartum depression in advanced maternal age in China was 20.0% (95%CI=17.4%-22.6%). The subgroup analysis revealed that the detection rate of postpartum depression was 19.5% (95%CI=13.8%-25.3%) in women < 40 years old, 40.3% (95%CI=11.4%-69.3%) in women ≥ 40 years old, 19.7% (95%CI=11.7%-27.7%) in women with high school education level or higher, 30.7% (95%CI=19.1%-42.3%) in women with high school education level or lower, 21.1% (95%CI=14.4%-27.9%) in primipara, 16.2% (95%CI=12.9%-19.6%) in multipara, 16.4% (95%CI=12.2%-20.6%) in natural childbirth, 27.8% (95%CI=20.9%-34.8%) in cesarean section, 20.7% (95%CI=15.6%-25.8%) in women with male newborn and 27.3% (95%CI=20.5%-34.0%) in women with female newborn; there were 38.7% (95%CI=22.6%-54.8%) women with pregnancy complications, 11.7% (95%CI=7.6%-15.8%) women without pregnancy complications, 29.5% (95%CI=17.9%-41.1%) women with adverse pregnancy and childbirth history, 27.7% (95%CI=16.6%-38.8%) women without adverse pregnancy and childbirth history, 18.0% (95%CI=16.5%-19.4%) published the year before 2020, 19.5% (95%CI=18.0%-21.0%) published the year after 2020, 20.4% (95%CI=18.2%-22.6%) in the north and 18.2% (95%CI=17.0%-19.4%) in the south, 20.0% (95%CI=18.5%-21.5%) in the Edinburgh Postnatal Depression Scale (EPDS) score ≥ 13 and 16.9% (95%CI=15.2%-18.5%) in the EPDS score ≥ 10. The Egger's test (t=1.76, P=0.095) and the Begg's test (Z=1.48, P=0.147) indicated no significant publication bias.

The detection rate of postpartum depression is higher for advanced maternal age in China, including women ≥ 40 years old, with high school education level or lower, primipara, cesarean section, female newborn, pregnancy complications and adverse pregnancy and childbirth history, publish year after 2020, areas of the north, EPDS score ≥ 13, attention should be paid to the psychological status of advanced maternal age, and corresponding prevention and intervention measures should be formulated.

Population aging in China is deepening, and the widowed rate of the elderly is also on the rise. Widower is one of the most stressful events in the human life course, and its impact also affects the mental health and economic level of widower. In many studies on the impact of widower on the mental health of the elderly at home and abroad, the proxy variables used are traditional indicators, such as subjective well-being, loneliness, depression level, and some studies do not consider the endogeneity between widowhood and health status.

To evaluate the impact of widowhood on the mental health of older adults in China, and provide a basis and reference for formulating the mental health intervention program for older adults in China.

Using the 2018 China Health and Retirement Longitudinal Study (CHARLS) as the data source, 4 694 older adults aged 60 years and above were selected as study subjects and divided into the widowed group (n=644) and non-widowed group (n=4 050) . The mental frailty index was used as a perspective for evaluating the mental health status of older adults. Using propensity score matching (PSM) model, the propensity score was calculated by using Logit regression analysis, the robustness was tested by using standard deviation variation, common support bar graph and nuclear density distribution, the impact of widowhood on the physical and mental health of older adults was analyzed by using K-nearest neighbor matching, radius matching and kernel matching, and the heterogeneity was tested based on gender, household type and age.

Compared to the non-widowed group, the mental health of older adults in the widowed group was impaired (P<0.05) . Logit regression model results showed that female (OR=2.274, 95%CI=1.917-2.698) , age (OR=0.975, 95%CI=0.972-0.978) , secondary education level (OR=0.618, 95%CI=0.505-0.756) and monthly family consumption (OR=1.000, 95%CI=1.000-1.000) were correlated with widowhood (P<0.05) . The robustness test results after matching were better. The results of PSM showed that widowhood significantly increased the mental frailty index level (ATT ranged from 0.054 to 0.055, P<0.05) . The results of heterogeneity test showed that there were significant differences between urban and rural areas and among different age groups in the impact of widowhood on the mental frailty index of older adults, but there was no significant difference between male and female in the impact of widowhood on the mental frailty index of older adults. Among them, the impact of widowhood on the older adults in rural areas was more significant (ATT ranged from 0.072 to 0.075, P<0.05) , but the impact on older adults in urban areas was not significant; the impact on older adults in the low age group and high age group was more significant (ATT ranged from 0.061 to 0.081, P<0.05; 0.067-0.078, P<0.05) , but the impact on older adults in the middle age group was not significant.

Widowhood has a negative impact on the mental health of the older adults. The impact varies among different older adults. The widowed older adults in rural areas, just entering old age and in their later years need attention and psychosocial support.

Postpartum depression may occur not only in the mother but also in spouses, which affects their quality of life, increases the social and family economic burden, and is not conducive to the growth and development of the child. Therefore, it is important to identify the factors that influence its occurrence at an early stage.

To clarify the incidence of postpartum depression in Chinese maternal spouses through meta-analysis.

A computerized search was performed for cohort studies, case-control studies, and cross-sectional studies on the incidence of postpartum depression in Chinese maternal spouses in the databases of CNKI, Wanfang Data, VIP, CBM, PubMed, Web of Science, CINAHL, Embase, and Cochrane Library, with the time of search being from the establishment of the databases to March 2024. The search was conducted from the time of database construction to 2024-03-19. Two researchers independently screened the literature, and the included studies were subjected to data extraction, literature quality assessment, and meta-analysis by Stata 14.0 software.

39 papers were finally included, with a total sample size of 12 162 cases. Meta-analysis results showed that the prevalence of postpartum depression among maternal spouses in China was 14% (95%CI=12%-17%). The results of subgroup analysis showed that the incidence of postpartum depression in spouses was 17% (95%CI=13%-22%) within 1 month postpartum and 13% (95%CI=10%-15%) within 1 month-1 year postpartum; the incidence was 17% (95%CI=11%-23%) in inland areas and 13% (95%CI=11%-16%) in coastal regions; the measurement tool EPDS showed an incidence of 13% (95%CI=11%-16%) for spouses in studies using the EPDS and 18% (95%CI=10%-29%) for other study instruments; the incidence of postpartum depression was 15% (95%CI=11%-21%) for spouses of primiparous women and 14% (95%CI=11%-18%) for spouses of multiparous mothers. For the year of publication, the incidence was 16% (95%CI=10%-22%) for studies published from 2007 to 2016 and 14% (95%CI=12%-16%) for studies published from 2017 to 2023. Sensitivity analyses were performed by excluding literature one by one, and the combined effect sizes did not change significantly, suggesting that the meta-merged results were relatively robust. The distribution of each study point on both sides of the funnel plot was symmetrical, and the results of Egger's test showed t=1.79, P=0.082, suggesting that there was no significant publication bias.

The incidence of postpartum depression in Chinese maternal spouses is high, with an overall incidence of 14%, of which the incidence is as high as 17% within 1 month postpartum. Early screening and prevention should be emphasized.

With the further aging of the population, the incidence of cognitive impairment is increasing, and there is a lack of effective treatments. The construction of an accurate risk prediction model can be used to help community healthcare workers to identify, warn and intervene with potential patients at an early stage, and to reduce the pressure on social healthcare.

This study aims to construct a prediction model for the risk of cognitive impairment in older adults in the community, analyse the influencing factors of cognitive impairment in older adults, and provide empirical references for the development of targeted interventions.

In April 2024, elderly people aged ≥60 years were selected from the China Health and Retirement Longitudinal Survey (CHARLS) 2020 database (n=7 334) , and their socio-demographic characteristics and data on their health status and behaviours, activities of daily living (ADL) , depression, and cognitive abilities were collected. They were randomly divided into a training set (n=5 133) and a validation set (n=2 201) in a ratio of 7∶3. The best predictor variables were screened using LASSO regression ten-fold cross-validation, the factors influencing cognitive impairment in older adults were analysed using Logistic regression, and nomagram were constructed, and the performance of the predicion model was assessed using the area under the curve of the subject work characteristics (ROC) curves and the analysis of the calibration curves.

The detection rate of cognitive impairment in older adults was 14.48% (1 062/7 334) . LASSO regression screened nine potential predictor variables, which were age, type of residence, marital status, gender, education, exercise, society, activity of daily living, and depression. The results of multifactorial Logistic regression analysis showed that age [OR (95%CI) =1.238 (1.109-1.504) for 70-79 years old and OR (95%CI) =2.231 (1.546-3.222) for ≥80 years old using 60-69 years old as a reference] , type of residence [OR (95%CI) =2.144 (1.617-2.842) for rural using urban as a reference] , marital status [OR (95%CI) =0.691 (0.562-0.851) for no spouse, using spousal as a reference] , education [OR (95%CI) =0.209 (0.173-0.254) for primary school and below, using illiteracy as a reference, and for junior high school OR (95%CI) =0.059 (0.038-0.090) , OR (95%CI) for high school/vocational high school=0.043 (0.021-0.089) , and OR (95%CI) for college and above=0.038 (0.005-0.280) ] , and society [with no society as a reference, and OR (95%CI) with society=0.746 (0.624-0.892) ] , ability to perform ADL [OR (95%CI) =1.529 (1.171-1.997) with no impairment as a reference and OR (95%CI) =1.580 (1.319-1.891) with impairment] , and depression [OR (95%CI) =1.580 (1.319-1.891) with no depression as a reference and OR (95%CI) =1.580 (1.319-1.891) with depression] were the influencing factors of cognitive impairment (P<0.05) . Based on the seven predictor variables screened by multifactor Logistic regression analysis, a prediction model was established. The areas under the ROC curves of the prediction model in the training and validation sets were 0.821 (95%CI=0.805-0.836) and 0.839 (95%CI=0.817-0.861) , respectively; the Hosmer-Lemeshow test χ²=5.022 (P=0.755) and χ²=3.963 (P=0.860) ; calibration curves showed significant agreement between predicted and actual values.

In this study, a prediction model for the risk of cognitive impairment in community-dwelling older adults containing a total of seven indicators, including age, residence, and so on, was established, and the prediction model had good accuracy and differentiation, which can be used to identify the risk of developing cognitive impairment in older adults.

As China enters a moderately aging society, the mental health problems of the elderly are increasing year by year, and lifestyle habits are closely related to the mental health of the elderly.

Exploring the relationship between nap time, nighttime sleep, and depressive symptoms among elderly people in China, and determining recommended sleep time based on lifestyle habits, providing scientific basis for early prevention and control of depression in the elderly.

Based on the publicly released fifth round (2020) of the China Health and Retirement Longitudinal Study (CHARLS) on November 16, 2023, 8 233 eligible individuals were included as research subjects. The Depression Rating Scale (CSE-D10) was used to assess depressive symptoms in elderly individuals, with nap duration divided into 5 levels: no nap, <30 min, 30-59 min, 60-89 min, ≥90 min. Nighttime sleep was divided into 5 levels: ≥8 h, 7-<8 h, 6-<7 h, 5-<6 h, <5 h. Multivariate Logistic regression analysis was used to explore the factors that affect the occurrence of depression symptoms in elderly people. Random forest model was used to analyze the importance of nap duration and nighttime sleep in the occurrence of depression symptoms in elderly people. Restrictive cubic spline curves were used to further explore the dose-response relationship between nap duration, nighttime sleep duration, and the risk of depression symptoms.

During the 2020 survey period, the incidence of depressive symptoms among elderly people in China was 24.84% (2 045/8 233) . The results of multivariate Logistic regression analysis showed that a nap duration of 30-59 minutes was a protective factor for depression symptoms in the elderly (OR=0.814, 95%CI=0.673-0.985, P=0.034) , and a nighttime sleep duration of less than 5 hours was a risk factor for depression symptoms in the elderly (OR=1.705, 95%CI=1.435-2.027, P<0.001) . Women, unmarried/separated/divorced/widowed, disabled, physically painful, physically active, self-rated health status decreased, life satisfaction decreased, stroke, and Parkinson's disease increased the risk of depression symptoms in the elderly (P<0.05) . The random forest model showed that the duration of nap time and nighttime sleep time had a significant impact on depressive symptoms. There was a non-linear relationship between the duration of nap time and the occurrence of depressive symptoms (P_nonlinear<0.05) . The risk of depression in elderly people continued to decrease with increasing time after nap time of 30 minutes, with the lowest level being about 50 minutes. The risk of depression symptoms increased after nap time exceeded 75 minutes. The risk of depression in elderly people decreased continuously with time after 6 hours of sleep at night, with a minimum level of about 7 hours. The risk of depression increased after more than 9 hours of sleep (P_overall<0.05) .

The incidence of depression (24.84%) is higher in the elderly population in China, and there is a J-shaped relationship between the duration of nap time and nighttime sleep and depression. It is recommended that elderly people nap for 30-75 minutes every day, and moderate nap time can effectively reduce the risk of depression symptoms in the elderly. At the same time, sleeping for 6-9 hours at night can reduce the risk of depression symptoms, which has certain significance for early prevention and control of depression in the elderly population.

With the aging and life expectancy increasing in China, sleep disorders in the elderly (≥80 years old) have received widespread attention. As one of the common problems, sleep disorders seriously affect the quality of life and physical and mental health among the elderly, and can also aggravate or induce multiple diseases.

To conduct a scoping review of studies on sleep disorders in community dwelling older adults over 80 years and provide guidance for the early diagnosis and treatment of sleep disorders in community dwelling older adults in China.

PubMed, Embase, CINAHL, Web of Science, Cochrane Library, OpenGrey, SinoMed, CNKI, Wanfang Data, and VIP databases were searched for literature on sleep disorders in community dwelling older adults from inception to March 15, 2023. Literature was independently screened by 2 investigators and basic characteristics of the literature were extracted (authors, time of publication, country, type of study, sample size, assessment tool or modality, prevalence, findings) .

A total of 10 486 papers were searched, and 21 papers were finally included, of which 14 were in English and 7 were in Chinese, 16 were cross-sectional studies, 2 were quasi-experiment studies and 3 were longitudinal studies. The results of the analysis indicated that sleep disorders were more prevalent with serious adverse effects in the community dwelling older adults aged over 80 years (the prevalence rate ranged from 10.0% to 60.3%), which were assessed by nine tools or modalities, including three structured scales with the more commonly used scale being Pittsburgh Sleep Quality Index (PSQI). The influencing factors of sleep disorders were divided into three categories of social demographic factors, physical health and disease-related factors, psychological and behavioral characteristic factors. Interventions such as music therapy, therapy combined with interaction mode groups were found to be effective in improving sleep disorders. However, few prevention and intervention studies were conducted.

The high prevalence of sleep disorders among older people in the community is high with serious effects, there is insufficient knowledge about sleep disorders among community dwelling older adults and fewer types of assessment tools lacking specificity in China. The influencing factors of sleep disorders among older people are complex and diverse, with a lack of research on prevention and intervention.

Post-stroke fatigue (PSF) has a significant impact on patients' prognostic recovery and is an independent risk factor for stroke recurrence and post-stroke death. Therefore, understanding the current epidemiological status of PSF is of great significant in promoting stroke prevention and treatment in China.

To systematically evaluate the current situation and development trend of PSF in China, in order to provide a reference basis for the relevant departments to formulate targeted stroke prevention and treatment strategies.

PubMed, Web of Science, Embase, CNKI, Wanfang Data, VIP, and CBM were searched by computer to collect cross-sectional studies on the prevalence of PSF in China from inception to 2023-05-20. Meta-analysis was performed using Stata 16.0 software after 2 investigators independently screened the literature, extracted information and evaluated the risk of bias of the included studies.

A total of 57 cross-sectional studies involving 19 provinces/autonomous regions/municipalities directly under the central government and special administrative regions of China, with a total sample size of 13 621 individuals, including 5 764 individuals with PSF. Meta-analysis showed that the prevalence of PSF in China was 43.5% (95%CI=40.0%-47.0%). The results of subgroup analysis showed that the prevalence was 38.4% (95%CI=34.3%-42.5%) for men and 45.2% (95%CI=40.7%-49.7%) for women by gender grouping; the prevalence was 40.0% (95%CI=32.3%-48.0%) for those under 60 years of age, 67.9% (95%CI=54.2%-80.1%) for those aged 60-75 years by age grouping and 71.9% (95%CI=48.9%-90.5%) for those aged 75 years and above; the prevalence was 40.0% (95%CI=35.0%-45.2%) in North China, 41.0% (95%CI=29.5%-53.0%) in Northeast China, 49.5% (95%CI=43.1%-55.8%) in East China, 40.3% (95%CI=34.9%-45.8%) in Central China, 40.0% (95%CI=28.4%-52.2%) in South China, 59.3% (95%CI=54.0%-65.0%) in Southwest China, and 46.2% (95%CI=38.3%-54.2%) in Northwest China by regional grouping; the prevalence was 56.3% (95%CI=42.8%-69.4%) for hemorrhagic stroke and 40.0% (95%CI=36.7%-43.4%) for ischemic stroke by stroke nature grouping; the prevalence was 41.4% (95%CI=37.0%-45.8%) for acute phase and 46.4% (95%CI=40.8%-52.1%) for recovery phase by stroke duration grouping; the prevalence was 56.0% (95%CI=43.7%-67.9%) for elementary school and below, 46.7% (95%CI=39.6%-53.8%) for junior high school, 46.8% (95%CI=40.3%-53.4%) for senior high school, and 43.6% (95%CI=35.7%-51.6%) for college and above by education level grouping; the prevalence was 45.8% (95%CI=40.8%-50.9%) for those with a spouse and 53.6% (95%CI=47.4%-59.8%) for those without a spouse by marital status; the prevalence was 45.0% (95%CI=33.2%-57.0%) for those who were employed and 53.8% (95%CI=40.1%-67.2%) for those who were unemployed or retired by work status grouping; the prevalence was 41.8% (95%CI=38.3%-45.3%) for those who applied the Fatigue Severity Scale (FSS), 65.8% (95%CI=57.1%-74.0%) for those who applied the Check List Individual Strength (CIS), 50.5% (95%CI=44.6%-56.5%) for those who applied the Chinese version of the Neurological Fatigue Index for Stroke (NFI-stroke), 52.7% (95%CI=43.1%-62.1%) for those who applied the Chinese version of the Fatigue Assessment Scale (C-FAS), and 48.9% (95%CI=43.6%-54.2%) for those who applied the Mental Fatigue Self-Rating Scale (MFS). Additionally, in terms of age distribution, the prevalence of PSF in China increased gradually with age (χ²_trend=87.081, r=0.209, P<0.01) ; in terms of cultural background, the trend of correlation between the prevalence of PSF in China and education level was not statistically significant (χ²_trend=0.333, P=0.564) ; and in terms of spatial distribution, the prevalence of PSF (40.0%-59.3%) varied significantly among the seven regions of the country (χ²=122.615, P<0.01), and the prevalence of PSF (23.3%-74.2%) also varied significantly among 19 provincial-level administrative regions in China (χ²=504.294, P<0.01) ; from the perspective of the publication time, the prevalence of PSF in China fluctuated in 32.4% to 53.9% from January 2013 to May 2023 (χ²_trend=48.011, P<0.01) .

The results of this study have shown a high overall prevalence of PSF in China, with significant differences among regions and provinces. The highest prevalence was found in Southwest China and Guizhou Province, whereas the lowest prevalence was observed in North China, South China, and Tianjin City. Additionally, PSF was found to be more prevalent among certain groups, including females, advanced age, no spouse, low education level, unemployed or retired work status, recovery phase of stroke, and hemorrhagic stroke.

Stroke is an acute cerebrovascular disease in which blood fails to flow into the brain, resulting in damage to brain tissue, with high rates of disability, death, and recurrence, and most of the related studies in Ningxia region are clinical analyses of strokes, which lack trend analysis of stroke hospitalization in Ningxia in recent years.

To analyze the disease prevalence characteristics and distribution of stroke hospitalized patients in Ningxia, and provide a basis for the development of comprehensive prevention and treatment measures for stroke.

The case home page data of 55 hospitals of traditional Chinese medicine (TCM) and western medicine in Ningxia region were collected, and the data discharged from 2013 to 2019 with a primary diagnosis of stroke [International Classification of Diseases (ICD) -10 coded as I60-I63] were screened and analyzed. SPSS 24.0 software was applied to analyze the differences in gender and age using the chi-square test, and a geographic information system (GIS) was applied to analyze the distribution of stroke hospitalization rate data across Ningxia from 2013 to 2019 using global spatial auto correlation analysis.

A total of 190 634 stroke patients were finally included. The hospitalization rate of stroke in Ningxia region showed an increasing trend year by year from 2013 to 2019 (hospitalization rates of 24.302/10 000, 30.045/10 000, 34.949/10 000, 39.397/10 000, 44.049/10 000, 47.617/10 000, and 52.944/10 000, respectively, χ²_trend=5.982, P=0.014) , and the hospitalization rates were higher during the cold season of each year, with a significant peak in March and a slight decline thereafter. Among the stroke inpatients in Ningxia from 2013 to 2019, there were 167 194 cases of ischemic stroke and 23 440 cases of hemorrhagic stroke; there was significant difference between ischemic stroke and hemorrhagic stroke patients in gender and age (χ²=473.533, 7 518.543, P<0.05) ; and the proportion of male, ≥60 years old hospitalized patients in ischemic stroke and hemorrhagic stroke exceeded 50% from the data. The results of global auto correlation analysis showed spatial aggregation of stroke hospitalization rates in 2013, 2018 and 2019 (P<0.05) . The spatial distribution map showed that the hospitalized stroke patients in Ningxia were mainly concentrated in north-central Ningxia.

From 2013 to 2019, the hospitalization rate of stroke patients in Ningxia showed increasing and varying degrees of aggregation, and the areas with higher hospitalization rates were concentrated in north-central Ningxia.

The body roundness index (BRI) is an emerging anthropometric indicator that has been increasingly associated with various cardiometabolic conditions, including hypertension and diabetes. However, its association with obstructive sleep apnea (OSA) and its potential as a predictive tool remain poorly understood.

This study aimed to investigate the association between BRI and OSA risk and to evaluate its predictive performance for OSA in adults.

A cross-sectional analysis was conducted among 638 outpatients suspected of OSA at Shenzhen University Affiliated South China Hospital between January 2024 and March 2025. All participants underwent overnight polysomnography, and OSA was defined as an apnea-hypopnea index (AHI) ≥ 5 events per hour. Anthropometric measurements—including height, weight, waist circumference, and neck circumference were collected to calculate BRI, BMI, a body shape index (ABSI), and weight-adjusted waist index (WWI). Multivariable Logistic regression models were used to assess the association between BRI and OSA after adjusting for potential confounders. Receiver operating characteristic (ROC) curves were constructed to compare the diagnostic accuracy of each index, with subgroup analyses performed by sex.

Of the 638 participants, 552 (86.5%) were diagnosed with OSA. The multivariable Logistic regression revealed a significant dose-response relationship between BRI and OSA risk (P_trend<0.001). After adjusting for confounding factors, the risk of OSA in the highest quartile group of BRI (Q4: >5.744) was 6.955 times (95%CI=2.960-16.344) that of the lowest group (Q1: ≤3.931). The ROC analysis demonstrated that BRI achieved an area under the curve (AUC) of 0.740 (95%CI=0.682-0.799) for OSA detection, with an optimal cut-off value of 4.199 yielding 73.4% sensitivity and 68.6% specificity. In comparison, the AUC for ABSI, WWI, and BMI were 0.633, 0.676, and 0.717, respectively. DeLong test results confirmed that BRI's AUC was greater than those of ABSI and WWI (P<0.05). In men, the AUC of BRI in diagnosing OSA was 0.774. In women, the AUC of BRI in diagnosing OSA was 0.654.

BRI serves as a significant influencing factor for the prevalence of OSA among Chinese adults, demonstrating good predictive efficacy. Consequently, BRI can be utilized as an economical and effective tool for the early screening of OSA.

Cognitive impairment is also known as cognitive disorders. With the rapid aging of the population, the number of people affected by cognitive disorders and the Alzheimer's disease is on the rise. The stigma associated with cognitive disorder is widely recognized in the international community, but related research in this field remains limited. This paper found that definition and measurement of stigma of cognitive disorders need to be standardized, there is a lack of research on economically underdeveloped areas and evidence to establish causal inference; and there is ample room for improvement in both the quantity and quality of intervention studies. The research on stigma of cognitive disorders provides an unique opportunity to break the binary subject perspective in the traditional field of stigma research. At the same time, the discussion on the mechanism of cognitive disorder stigma formation can also deepen the academic discussion on labeling theory and attribution theory.