With the rising prevalence of dementia and the relative shortage of professional medical resources, dementia-related health services should be increasingly provided by primary care institutions. Currently, China lacks community-based guidelines for dementia management, and post-diagnosis care lacks standardized guidance.

This study aims to evaluate domestic and international guidelines on post-diagnosis management of dementia using the Appraisal of Guidelines for Research & Evaluation InstrumentⅡ(AGREEⅡ), to analyze and summarize their recommendations, and to provide a reference for clinical practice.

A systematic search was conducted across major Chinese and English databases, including PubMed, Medline, Elsevier, CNKI, Wanfang Data and Yiigle, as well as websites such as Google Scholar, the Guidelines International Network (GIN), the National Institute for Health and Care Excellence (NICE), the New Zealand Guidelines Group (NZGG), the CMA Infobase, and the Scottish Intercollegiate Guidelines Network (SIGN), to identify guidelines related to community-based post-diagnosis management of dementia published in the past decade. The search was conducted up to October 2024. The AGREE Ⅱ instrument was used for quality assessment, and recommendations from guidelines graded as A and B were analyzed and summarized.

Eighteen guidelines were included in the study, comprising three from China, five from the United Kingdom, two from the United States, two from Canada, two from Europe, and one each from Japan, Australia, Malaysia, and India. According to the AGREE Ⅱ evaluation, only two guidelines were rated as Grade A, 10 as Grade B, and the remaining six as Grade C. The intraclass correlation coefficient (ICC) values between two researchers were all >0.75 (P<0.001). In terms of AGREE Ⅱ domain scores, Chinese guidelines scored lower than international guidelines in the "Scope and Purpose" domain (P<0.05). Recommendations from the 12 Grade A and B guidelines were synthesized and categorized into six themes: general principles, regular assessment, pharmacological management, non-pharmacological management, comorbidity management, and caregiver support.

The methodological quality of existing guidelines on post-diagnosis management of dementia requires improvement, and some recommendations lack applicability to the local context. Chinese scholars should strictly adhere to the scientific and normative principles of guideline development and promptly establish a localized post-diagnosis management guideline of dementia to better guide clinical practice.

People with dementia typically require ongoing care and comprehensive management following diagnosis. However, current long-term management strategies exhibit significant shortcomings, and the importance of family caregivers in their long-term care is often overlooked.

This study aims to develop a post-diagnostic management program tailored to the community context in Beijing, encompassing both patients with dementia and their family caregivers.

The research team constructed a draft of the management program using literature analysis and stakeholder interviews, and conducted an expert meeting in June 2025 to validate the draft. A total of 10 experts were invited to attend the meeting, and their basic information and authority levels were collected via the meeting invitation letter. Within three days after the meeting, the modified management program was sent back to the experts for verification, and they were asked to rate the importance of each item.

The expert authority coefficient was 0.86. The mean importance scores for all items ranged from 4.3 to 5.0, with coefficients of variation ranging from 0 to 0.22. The Kendall's coefficient of concordance for the importance scores of all items were 0.140 (P<0.05). The final program comprises five domains: follow-up assessment, medication management, non-pharmacological interventions, management of coexisting health problems, and caregiver support, as well as the corresponding division of responsibilities, and the corresponding management process has been formulated.

The program is scientifically sound, reliable, comprehensive, and considers practical implementation within primary care settings. It provides a feasible and evidence-informed framework for care of people with dementia and their caregivers in Beijing.

The number of persons living with Alzheimer's disease (AD) will increase dramatically in China. Community physicians play an increasingly critical role in its early screening and management. However, the structure and applicability of the Alzheimer's Disease Knowledge Scale (ADKS) within this population remain unclear.

To explore the factor structure of ADKS in Chinese community physicians.

A cross-sectional online survey was conducted from December 1, 2021, to January 7, 2022, using convenience sampling. Demographic information and ADKS scores were collected from participating community physicians. Exploratory factor analysis (EFA) using principal component analysis with varimax rotation was performed to identify the underlying factor structure. Confirmatory factor analysis (CFA) was subsequently carried out in R 4.3.0 with the Lavaan package to evaluate model fit, and the final model was visualized using semPlot.

A total of 5 313 persons viewed at the online survey, with 1 288 community physicians completing the questionnaire. Among the 1 288 participants, 389 (30.2%) were male and 899 (69.8%) were female, with an average age of (38.5±9.2) years. A total of 419 (32.5%) participants held below-bachelor qualifications, while 869 (67.5%) had a bachelor's degree or higher. EFA extracted eight factors with eigenvalues of 2.58, 1.73, 3.22, 1.11, 1.43, 1.37, 1.64, and 1.35, collectively explaining 48.13% of the total variance. These factors were labeled as knowledge about disease causes, symptoms, patient experience, comorbidity, differential diagnosis, treatment and rehabilitation, care needs, and life impact. CFA indicated acceptable model fit (GFI=0.929, χ²/df=3.71, RMSEA =0.046). All items showed factor loadings above 0.3, and moderate correlations were observed among the eight factors.

The ADKS demonstrated a clear and clinically interpretable 8-factor structure when applied to community physicians. This model comprehensively covers key domains of AD knowledge from a clinical practice perspective, supporting the use of the scale as a reliable instrument for systematically assessing AD-related knowledge in community physicians.

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.

Alzheimer's disease and related cognitive disorders are characterized by an insidious onset and long disease course, making early identification a critical strategy for reducing disease burden. The 10th edition of the Guidelines for Preventive Activities in General Practice issued by the Royal Australian College of General Practitioners (RACGP) adopts a strong primary care orientation and emphasizes opportunistic case-finding among high-risk populations, integrating evidence-based principles on screening, selection of cognitive assessment tools, and multidimensional management of modifiable risk factors. Drawing on the 2024 Lancet Commission on Dementia Prevention, Intervention and Care, World Health Organization evidence, and the life-course management framework, this paper systematically interprets the key recommendations of the RACGP guideline from a general practice perspective, with a focus on risk identification, exclusion of reversible causes, stratified use of screening instruments, and longitudinal management. The analysis suggests that commonly used tools such as the MoCA, GPCOG, RUDAS and AD8 demonstrate complementary strengths across different community populations and clinical contexts, supporting their integration into opportunistic screening pathways in primary care. In addition, interventions targeting physical activity, metabolic control, hearing impairment, sleep disorders and medication optimization constitute a feasible life-course prevention package. In the Chinese primary care context, early identification of cognitive impairment remains constrained by insufficient linkage between screening and referral, limited workforce training and resource integration, and low public awareness. This paper proposes embedding cognitive screening into family doctor contract services and chronic disease management programmes, and leveraging integrated care networks to establish a closed-loop pathway encompassing screening, assessment, referral, intervention and follow-up, thereby advancing earlier prevention and strengthening the role of primary care in dementia risk reduction.

Community screening and diagnosis of mild cognitive impairment (MCI) in the community are of great value in the prevention of dementia. Currently, there is still no consensus on the management of community screening and diagnosis in the MCI population. This study conducted a detailed review of the current management of community screening and diagnosis, specific items for screening and diagnosis, and peri-diagnostic support for the MCI population, and found that community screening and diagnosis of MCI need to be comprehensively assessed in terms of population definition, history taking, cognitive assessment and auxiliary testing; peri-diagnostic support should include post-diagnostic disclosure, development of post-diagnostic support program and guidance on post-diagnostic support. Thus, it is suggested that community healthcare workers should carry out comprehensive assessment and diagnosis of the MCI population, and actively carry out rapid post-diagnostic support actions to promote the dementia prevention to be really moved forward.

China has now launched the Alzheimer's disease prevention and treatment promotion action, and local communities are actively carrying out cognitive function screening around the community elderly population. However, there is no suitable evaluation standard to be used as the basis for the screening of cognitive impairment in the community.

To construct an evaluation system for cognitive impairment screening services applicable to the community, and to provide a reference for the appraisal and quality control of large-scale community-based cognitive function screening programs among older adults in various regions of China.

By literature research and policy analysis, the first draft of the indicator system was proposed around the five elements of the RE-AIM framework, and 15 experts were selected to carry out a Delphi expert consultation to construct an evaluation indicator system for community-based cognitive impairment screening services from October 2023 to January 2024. The weights of the indicators were determined using the multiplier method.

The positive coefficients of experts in the two rounds of Delphi were 100.0% and 93.3%, the experts' authority coefficients were 0.83 and 0.86, and the coordination coefficients of experts' opinions were 0.242 and 0.265 (P<0.001), and the final evaluation system consisted of 5 first-level indicators, 15 second-level indicators, and 20 third-level indicators. The first-level indicators and their weights were screening reachability (0.203 5), screening efficacy (0.203 5), program adoption by the organization (0.194 8), program implementation (0.203 5), and program maintenance (0.194 8).

The evaluation index system of the community cognitive impairment screening service initially constructed in this study, which contains 5 first-level indicators, 15 second-level indicators, and 20 third-level indicators, is of good scientific validity and reliability, and has certain reference value for improving the assessment system of cognitive impairment screening.

The aging process in China is accelerating, and the number of older adults with chronic diseases is increasing. The association between hypertension, along with its comorbidities, and dementia in older adults requires further investigation.

To investigate the association between hypertension, its comorbidities, and dementia in community-dwelling older adults, and to provide evidence for dementia prevention.

This study utilized cross-sectional data from 14 732 individuals aged ≥65 years from the China Multicenter Dementia Survey (CMDS, 2018-2023). Data on sociodemographic characteristics, chronic diseases, and cognitive function were collected. We employed a multivariate Logistic regression model to analyze the association between hypertension and its comorbidities and dementia in the total population and different age and sex groups.

Among the 14 732 older adults (≥65 years), 8 293 (56.3%) had two or more comorbidities, and 7 786 (52.9%) had hypertension along with other comorbidities. Of these hypertensive individuals, the numbers with 1, 2, 3, and 4 comorbidities were 2 569 (17.4%), 2 064 (14.0%), 1 018 (6.9%), and 443 (3.0%), respectively. Dementia was identified in 1 111 participants (7.5%). After adjusting for covariates, multivariate Logistic regression results showed that the risk of dementia in the hypertension-only group was 1.516 times (95%CI=1.014-2.267, P=0.042), and the risk of dementia among those with hypertension and 1 to 4 comorbidities was 1.879 times (95%CI=1.312-2.692, P=0.001), 2.071 times (95%CI=1.428-3.004, P<0.001), 2.338 times (95%CI=1.612-3.392, P<0.001), 2.591 times (95%CI=1.634-4.108, P<0.001). The highest risk of dementia was observed in individuals with hypertension coexisting with cerebrovascular disease (OR=2.550, 95%CI=1.384-4.700, P=0.003). In analyses stratified by sex and age, the risk of dementia increased significantly with the number of hypertension comorbidities (P<0.05). The strongest association was observed for hypertension coexisting with cerebrovascular disease, with adjusted odds ratios of 2.842 (95%CI=1.095-7.375, P=0.032) in men and 2.348 (95%CI=1.060-5.203, P=0.036) in women. In the group aged <75 years, the highest risk was observed for hypertension coexisting with diabetes (OR=2.833, 95%CI=1.046-7.675, P=0.041), while in the group aged≥75 years, the highest risk was observed for hypertension coexisting with cerebrovascular disease (OR=2.707, 95%CI=1.168-6.273, P=0.020). Among participants with hypertension and two comorbidities, the highest dementia risk was observed in those with coexisting heart disease and cerebrovascular disease (OR=3.559, 95%CI=1.338-9.468, P=0.011). Similarly, among those with hypertension and three comorbidities, the highest prevalence of dementia was observed in individuals with coexisting heart disease, cerebrovascular disease, and autonomic dysfunction (OR=3.881, 95%CI=1.736-8.677, P=0.001).

The prevalence of hypertension and its comorbidities is high among Chinese older adults. Patients with hypertension and its comorbidities have a significantly elevated risk of dementia, which varies by age and sex. These findings underscore the importance of optimized management of chronic diseases in this population. Implementing tailored prevention and treatment strategies based on individual characteristics could contribute to reducing the risk of dementia.

Alzheimer's disease (AD) , the most common type of dementia, poses a significant threat to the global elderly population. In recent years, alcohol consumption in China has been steadily increasing. As a potential lifestyle factor, drinking behavior may influence AD progression, but the relationship with AD-related brain changes remains insufficiently understood.

To investigate the impact of alcohol consumption on brain structural changes in AD patients using voxel-based morphometry (VBM) analysis.

Data were retrospectively collected from AD patients hospitalized at Huashan Hospital, Fudan University, between 2020 and 2023. Information on alcohol consumption, brain MRI scans, and other clinical variables was obtained through medical records and telephone follow-up. A total of 66 AD patients with complete data were included in the analysis. Patients were stratified by disease severity (based on Mini-mental State Examination scores) and drinking status into mild-to-moderate AD with and without a history of alcohol consumption, severe AD with and without a history of alcohol consumption. VBM was used to compare differences in gray matter volume (GMV) among the groups.

Among the 66 patients, 42 had mild-to-moderate AD, and 24 had severe AD. Among the mild-to-moderate group, 16 had a history of alcohol consumption and 26 did not. Among patients with mild to moderate AD, the proportion of males with a history of alcohol consumption and the proportion of those with a history of smoking were higher than those without such histories (P<0.05) . Among the 24 patients with severe AD, 9 had a history of alcohol consumption and 15 did not. Among the patients with severe AD, the proportion of males with a history of alcohol consumption and the proportion of those with a history of smoking were higher than those without a history of alcohol consumption (P<0.05) . In patients with mild to moderate AD, the GMV of the right angular gyrus in those without a history of alcohol consumption was lower than that in those with a history of alcohol consumption (t=-3.698, P<0.05) . In patients with severe AD who had a history of alcohol consumption, the GMV of the left superior temporal gyrus was lower than that of those without a history of alcohol consumption (t=5.774, P<0.05) .

A history of alcohol consumption appears to significantly influence patterns of gray matter atrophy in AD patients. In mild-to-moderate AD, drinking may be associated with attenuated atrophy in the right angular gyrus, whereas in severe AD, it is linked to increased atrophy in the left superior temporal gyrus. These findings suggest a dual role of alcohol consumption in the progression of AD.

The accelerated aging process, combined with the increase in widowhood and social isolation, has led to a rise in chronic diseases, further increasing the social burden.

To explore the association between the marital status of older adults and the prevalence of cognitive impairment, as well as the impact of social support and lifestyle on this association.

A total of 9 466 older adults aged 65 years and above from Wuhan and Xiaogan, Hubei Province, were included in this study from 2018 to 2023. Participants were categorized into a married group (n=7 055) and an unmarried group (n=2 411) based on their marital status. Baseline information was collected through structured questionnaires, and cognitive function was assessed using the Mini-mental State Examnation and the Montreal Cognitive Assessment-basic China (MoCA-BC). A multivariable Logistic regression model was employed to analyze the association between marital status and cognitive impairment in the overall population as well as in subgroups stratified by age and sex. Further analyses explored the independent and combined effects of marital status, social support, and lifestyle habits on cognitive impairment risk.

Compared with the elderly with spouses, no spouse was an independent risk factor for cognitive impairment (OR=1.299, 95%CI=1.227-1.376, P<0.001). Further subgroup analysis showed that never married (OR=1.679, 95%CI=1.448-1.947, P<0.001) and widowed (OR=1.282, 95%CI=1.206-1.362, P<0.001) were independent risk factors for cognitive impairment in the elderly. Gender and age stratified analysis showed that never married (OR=2.316, 95%CI=1.680-3.193, P<0.001) and widowed (OR=1.731, 95%CI=1.405-2.131, P<0.001) were independent risk factors for cognitive impairment in elderly men. Widowed was an independent risk factor for cognitive impairment in elderly women (OR=1.163, 95%CI=1.002-1.351, P=0.047). In the 65-74 years old group, never married (OR=1.953, 95%CI=1.390-2.746, P<0.001) and widowed (OR=1.315, 95%CI=1.120-1.545, P=0.001) were independent risk factors for cognitive impairment. In the ≥75 years old group, widowed was an independent risk factor for cognitive impairment (OR=1.470, 95%CI=1.238-1.747, P<0.001). Multivariate Logistic regression analysis on marital status, social support and living habits associated with cognitive impairment showed that compared with the elderly with spouse and social support and healthy living habits, the elderly with spouse and social support but unhealthy living habits (OR=1.262, 95%CI=1.169-1.363, P=0.002), spouse and no social support but healthy lifestyle (OR=1.650, 95%CI=1.479-1.841, P<0.001), spouse and no social support but unhealthy lifestyle (OR=1.777, 95%CI=1.575-2.005, P<0.001), no spouse and social support with healthy lifestyle (OR=1.284, 95%CI=1.189-1.397, P<0.001), no spouse and social support with unhealthy lifestyle (OR=1.999, 95%CI=1.768-2.260, P<0.001), no spouse and social support with unhealthy lifestyle (OR=1.999, 95%CI=1.768-2.260, P<0.001), no spouse and no social support but healthy lifestyle (OR=1.680, 95%CI=1.500-1.882, P<0.001), no spouse and no social support but unhealthy lifestyle (OR=2.422, 95%CI=2.141-2.740, P<0.001), no spouse and no social support but healthy lifestyle (OR=2.422, 95%CI=2.141-2.740, P<0.001) were at increased risk for cognitive impairment.

The prevalence of cognitive impairment, especially among older adults without spouses, notably increases, particularly for those who have never married or are widowed. Regardless of marital status, the lack of social support and unhealthy lifestyle are risk factors for cognitive impairment. This study highlights the importance of paying attention to marital status, social support, and lifestyle in the health management of older adults.

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.

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.

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.

Currently, the number of research papers on the application of artificial intelligence to the field of Alzheimer's disease (AD) has increased significantly. It is important to clarify the latest research hotspots and future development trends in this field.

To summarize the relevant research on the application of artificial intelligence to AD through bibliometric analysis, and clarify the research hotspots and trends from 2004 to 2023.

Literature on the application of artificial intelligence to AD from January 2004 to June 2023 was searched for in the Web of Science core database, and Microsoft Office Excel, CiteSpace, and VOSviewer software were used to visually analyze the number of publications, countries, authors, institutions, keywords, and co-citation networks of the literature.

Ultimately 3 189 articles were included. The number of literature on the application of artificial intelligence to AD has steadily increased since 2004 and has grown rapidly since 2015, with a maximum of over 600 articles. A total of 94 countries, 3 930 institutions, 13 563 authors, and 52 019 cited authors participated in this study. Among them, the United States and China were in a leading position in this field; Republic of Korea universities ranked first in terms of the number of publications; In addition, ZHANG DAOQIANG, LIU MINGXIA, SUK HEUNG-IL, and CLIFFORD R. JACK Jr were not only prolific authors but also the authors with the most citations. The visualization analysis of keywords and literature citations revealed that regarding the application of artificial intelligence to AD, the diagnosis and disease course classification of AD, as well as the prediction of its risk factors, are current research hotspots and that task analysis are future research trends.

The application of artificial intelligence to AD has attracted widespread attention from researchers worldwide. The diagnosis and classification of AD, as well as the prediction of its risk factors, are current research hotspots. Developing adjunctive drugs in task analysis, personalized treatment and care, and improving the algorithm performance of artificial intelligence may be research trends in the future.

As the primary place of treatment for mild cognitive impairment (MCI), community primary medical institutions need to carry out cognitive function health management for the MCI population. At present, the community still lacks the specific process and program of MCI cognitive function health management. Based on the "Structure-Process-Results" three-dimensional quality structure theoretical model, this study reviewed the community MCI cognitive function health management strategies from three dimensions of functional departments and organizational structure (Structure), health management program (Process) and effect evaluation system and methods (Results), aiming to provide support and reference for the standardized and process-oriented MCI cognitive function health management practice in Chinese communities.

Type 2 diabetes mellitus (T2DM) and mild cognitive impairment (MCI) are common health problems in the elderly in the community. Research on the status and influencing factors of MCI in the elderly with T2DM who participate in community management is needed.

To explore the cognitive characteristics and related factors of elderly patients with T2DM complicated with MCI under community management.

From July to October 2022, a total of 399 patients with type 2 diabetes over 60 years of age in a community health service center in Shanghai were selected by systematic sampling method. General demographic data and health problems, physical examination and laboratory test results, including fasting blood glucose (FBG), total triglyceride (TG), total cholesterol (TC), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), glycosylated hemoglobin (HbA_1c) were collected. They were divided into MCI group (n=157) and non-MCI group (n=242) according to the presence or absence of MCI. Binary Logistic regression analysis was used to explore the influencing factors of MCI in elderly patients with type 2 diabetes under community management.

The prevalence of MCI was 39.3% (157/399) in community-managed elderly patients with type 2 diabetes. The comparison of cognitive characteristics between MCI group and non-MCI group showed that the MCI group had higher abnormality rates in executive function, orientation, calculation, abstraction, delayed memory, visual perception, naming and attention than the non-MCI group, and the differences were statistically significant (P<0.05), and delayed memory impairment (92.4%) was the most common. There were significant differences in age, marriage, years of education, drinking, FBG, HbA_1c, TC, LDL-C between the two groups (P<0.05) ; Binary Logistic regression analysis showed that age≥80 years old (OR=3.002, 95%CI=1.379-6.534), FBG≥7.0 mmol/L (OR=2.432, 95%CI=1.436-4.119), HbA_1c 7%-9% (OR=2.349, 95%CI=1.380-3.997), HbA_1c>9% (OR=5.106, 95%CI=2.150-12.130), LDL-C (OR=2.451, 95%CI=1.266-4.743), 7-12 years of education (OR=0.419, 95%CI=0.183-0.960) and >12 years (OR=0.243, 95%CI=0.086-0.692) was the influencing factor for MCI in elderly patients with type 2 diabetes (P<0.05) .

The prevalence of MCI in community-managed elderly patients with type 2 diabetes is high, and there are multiple cognitive impairment, age≥80 years old, FBG≥7.0 mmol/L, HbA_1c 7%-9%, HbA_1c>9% and high level of LDC. High level of education is a protective factor for MCI in community-managed elderly patients with type 2 diabetes. Early cognitive impairment screening, long-term blood glucose control, and lowering LDL-C levels are helpful to improve the cognitive function of community-managed elderly patients with type 2 diabetes.

Under the background of an aging population, maintaining brain health has become an inevitable requirement of building a healthy China, and it is of great significance to carry out research on community populations' perceptions of cognitive impairment diseases. However, there is no suitable tools for investigating community populations' perceptions level of Mild Cognitive Impairment (MCI) .

To develop a questionnaire on perceptions toward MCI and test its reliability and validity, so as to provide a basis for promoting the management of cognitive disorders.

On the basis of literature review and special group discussion, the theoretical framework of questionnaire was put forward and the items of the questionnaire were preliminarily worked out. Then the items were evaluated according to the results of two rounds of mail-based Delphi surveys conducted by 13 experts in related fields in April-May 2021. The description of the items was revised through pre-survey, and the items were analyzed through questionnaire survey by difficulty index analysis, discrimination analysis, correlation coefficient analysis, reliability and validity evaluation in October-December 2021, so as to further improve the questionnaire.

(1) Delphi survey: The positive degree of experts in the two rounds of Delphi survey was 100.0% and 84.6%, and the expert authority coefficient were 0.858 and 0.845, respectively. The range of "importance" average score of each item in the two rounds of letter inquiry was 3.77-4.92 and 3.91-4.91, and the coefficient of variation of the two rounds was 0.056-0.246 and 0.061-0.213, respectively. The harmony coefficients of Kendall in the two rounds of consultation were 0.197 and 0.252, respectively (P<0.001). 29 and 12 expert opinions and suggestions were received in the two rounds of consultation. (2) Questionnaire survey: A total of 809 questionnaires were sent out and 797 valid questionnaires were recovered, with an effective recovery rate of 98.52%. The difficulty index of each item was concentrated in 10%-90%. The discrimination index of each item is mostly above 20%. The scores of each item and each dimension were positively correlated with the total score of the questionnaire (P<0.05). The Cronbach'sα coefficient of the questionnaire was 0.712, and the split-half reliability was 0.764. The KMO value of model test was 0.800, and the Chi-square value of Bartlett spherical test was 3 049.278 (P<0.05), which suggested that it was suitable for factor analysis. The results of exploratory factor analysis showed that the cumulative variance contribution rate was 54.930%. The final questionnaire included 20 items, including "understanding of basic knowledge of MCI" "personal experience" "expectation of treatment"and "decision and behavior of seeking medical treatment" four dimensions.

The questionnaire on perceptions toward MCI based on Delphi method has good reliability and validity, and can be used as a tool to investigate the perceptions toward MCI among residents.

Management of mild cognitive impairment (MCI) can reduce the burden of disease on society, families and individuals. The performance of family doctor team is the key to the quality of service, which acts as the main force of chronic disease management in China.

To explore the factors influencing the performance of family doctor teams in providing chronic disease management service for patients with MCI.

In July 2021, a total of 28 medical workers from 8 community health service centers in 4 districts of Shanghai were selected by purposive sampling method to conduct semi-structured interviews, the interview data were coded and analyzed after the interviews.

After three levels of coding, 114 concepts, 49 categories and 8 main categories were sorted out, 4 core categories of factors influencing performance were concluded of service organizer (government), service provider (doctor), service demander (patient) and task implementation. The theoretical framework was organized into five main processes, including organizers driving both provider and demander, provider taking the initiative to implement, demander cooperating with implementation, interaction between provider and demander, task execution cycle improvement.

Although performance of family doctor teams in providing chronic disease management service for patients with MCI is affected by many factors, the process and results are the key to test performance. The driving role of the organizer, execution function of the provider and cooperation of demander are the premise for execution process and result. However, the feedback effect of task execution can improve the quality of service, and eventually form a circular optimization mechanism from organizer drive, to provider execution and demander cooperation, to task execution feedback.

Proactive health is an important measure to implement the Healthy China strategy. Mild cognitive impairment (MCI) is an important breakthrough point for early detection and intervention of cognitive impairment disorders and it is also a key link in the realization of brain health.

To activate the initial health intervention among community population and fully realize the construction of a healthy China by understanding the perceptions and medical willingness among community populations aged over 55 years in Shanghai.

From October to December 2021, one district of Shanghai's urban and suburban areas was randomly selected (Yangpu District for the urban area and Jiading District for the suburban area), and 1-2 community health service centers were randomly selected from each district (Daqiao Community Health Service Center and Dinghai Community Health Service Center for Yangpu District, and Jiading Town Community Health Service Center for Jiading District). An on-site face-to-face questionnaire survey was conducted among the residents waiting for outpatient consultation at the community health service centers in accordance with the inclusion criteria. The content of community populations' perceptions questionnaire included: (1) general demographic characteristics; (2) the level of MCI disease awareness among the community population; (3) the medical willingness of the community population. Logistic regression analysis was used to explore the factors influencing the medical willingness of the community population.

A total of 970 questionnaires were distributed and 951 valid questionnaires were recovered, with a valid recovery rate of 98.04%. (1) The total score of the community populations' perceptions questionnaire for MCI was (14.55±5.24), 51.3% (488/951) of the community populations were aware of "mild cognitive impairment", mainly through the media (61.7%, 301/488) ; 59.9% (570/951) of the populations believede that "mild cognitive impairment occurs in old age"; 14.1% (134/951) of the population had participated in relevant screening activities; 6.2% (59/951) had consulted a doctor for memory impairment or suspected cognitive impairment. (2) Univariate and multivariate analysis showed that family history of cognitive impairment, knowledge and understanding of MCI as well as personal experience were all influencing factors of community populations' medical willingness for MCI.

Community population aged over 55 years have poor MCI disease perceptions and poor medical willingness. The community populations with poor knowledge, biased understanding of MCI and lack of relevant practical experience had poor medical willingness. It is suggested that multi-angle publicity should be carried out to improve the perceptions of MCI disease in the community and provide comprehensive support, to improve the accessibility of proactive health, and explore effective ways to promote proactive health.

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.

Lifestyle is an important modifiable risk factor for dementia. Knowledge and beliefs are important factors affecting lifestyle. However, there is a lack of research on the types of knowledge, beliefs, behaviors of reducing dementia risk, and it remains unclear whether there are differences in dementia risk and cognitive function among residents with different types of knowledge, belief, and behavior.

To understand the current situation of knowledge, beliefs, behaviors of reducing dementia risk in the middle-aged and elderly adults in the community, explore and analyze the types of knowledge, beliefs and behaviors and the differences of cognitive function, and provide a basis for the development of targeted dementia prevention measures in the community.

From March 2021 to February 2022, middle-aged and elderly adults who participated in free health checkups at community health centers and established health management files in five communities in Shapingba District of Chongqing were selected as the survey objects by convenience sampling method. The general information questionnaire, Dementia Knowledge Assessment Scale (DKAS), Motivation to Change Lifestyle and Health Behaviors for Dementia Risk Reduction (MCLHB-DRR), Dementia Risk Reduction Lifestyle Scale (DRRLS), Beijing version of Montreal Cognitive Assessment (MoCA) and Cardiovascular Risk Factors, Aging and Dementia (CAIDE) scores were used for the investigation. K-means cluster analysis was used to classify the knowledge, beliefs, behaviors of reducing dementia risk of residents, and the differences in demographic characteristics, cognitive function and dementia risk among different types were compared and analyzed.

A total of 232 questionnaires distributed and 211 valid questionnaires were recovered, with an effective recovery rate of 90.9%. The cluster analysis results showed that the knowledge, beliefs and behaviors of reducing dementia risk of the middle-aged and elderly adults in the community could be divided into three types of good knowledge, beliefs and behaviors type, low knowledge-poor behaviors type, low beliefs-poor behaviors type, which accounted for 39.8% (84/211), 37.4% (79/211), and 22.8% (48/211), respectively. The average years of education of middle-aged and elderly residents in good knowledge, beliefs and behaviors type were significantly higher than those in low knowledge-poor behaviors type (t=2.703, P<0.001), and low beliefs-poor behaviors type (t=1.524, P=0.022). The CAIDE scores of residents in low knowledge-poor behaviors type (t=1.431, P<0.001) and low beliefs-poor behaviors type (t=1.080, P=0.002) were significantly higher than those in good knowledge, beliefs and behaviors type. The MoCA scores of residents in low knowledge-poor behaviors type were lower than those in good knowledge, beliefs and behaviors type (t=-2.529, P<0.001) and low beliefs-poor behaviors type (t=-1.869, P=0.018) .

The knowledge, beliefs, behaviors of reducing dementia risk of the middle-aged and elderly adults in the community could be divided into three types of good knowledge, beliefs and behaviors type, low knowledge-poor behaviors type, low beliefs-poor behaviors type, and there are significant differences in years of education, dementia risk and cognitive function scores among the different types. Developing targeted dementia prevention measures based on the characteristics of different types of knowledge, beliefs, behaviors of reducing dementia risk, may be effective in reducing the risk of dementia and maintaining or slowing cognitive decline.

Alzheimer's disease (AD) is a common and irreversible neurodegenerative brain disease that severely affects the quality of life and survival of patients, while there is still a lack of effective treatments to delay or stop disease progression. Traditional Chinese medicine (TCM) and its active ingredients have important potential in the prevention and treatment of AD.

To investigate the effects of poric acid (PA) on cognitive impairment and nuclear factor E2-related factor 2 (Nrf2) /solute carrier family 7A11 (SLC7A11) /glutathione peroxidase 4 (GPX4) signaling pathway in AD rats.

Seventy-five male SPF grade SD rats aged 6 to 8 weeks were divided into the control group (Control group), AD Model group (Model group), PA treatment group (PA group) and PA+Nrf2 inhibitor group (PA+ML385 group) by random number table method to prepare AD rat model from January to September, 2022. After successful modeling 50 mg/kg PA was intraperitoneally injected into the PA group, 50 mg/kg PA and 30 mg/kg ML385 was intraperitoneally injected into the PA+ML385 group, and 0.9% sodium chloride solution was intraperitoneally injected into the Control group and Model group. The Morris water maze experiment was performed 24 h after the last dose, and the positioning navigation experiment was carried out on days 2, 4 and 6 to record the time when the rats arrived at the platform (escape latency). The platform was removed on day 7, and the duration of the rats staying on the platform and the number of times they crossed the platform within 120 s were recorded. The pathological changes of hippocampal neurons in each group were observed after Nissl staining. Iron deposition was detected by Prussian blue staining, GPX4 expression and GSH, MDA and Fe²⁺ contents were detected by immunofluorescence staining. The protein expression levels of Nrf2, SLC7A11 and GPX4 in rat hippocampus were detected by Western blotting.

The escape latency of the Model group was higher than that of the Control group and PA group, and escape latency of the PA+ML385 group was higher than that of the PA group at 2, 4 and 6 days after the last administration. The platform residence time and platform crossing times in the Model group were lower than those in the Control group and PA group, and those in the PA+ML385 group were lower than those in PA group, and the difference was statistically significant (P<0.05). The results of Nissl staining showed severe neuronal necrosis, nucleus shrinkage and decreased number of Nissl bodies in the Model group, decreased neuronal necrosis with tight arrangement and increased number of Nissl bodies in the PA group, significantly increased neuronal damage and decreased the number of Nissl bodies in the PA+ML385 group. The Prussian blue staining results showed that iron deposition in the Model group was higher than that in the Control group, iron deposition in the PA group was lower than that in the Model group, and iron deposition in the PA+ML385 was higher than that in the PA group. The results of immunofluorescence staining showed that green fluorescence was weakened and GPX4 positive cells were reduced in the Model group, green fluorescence was enhanced and GPX4 positive cells were increased in the PA group compared with the Model group, and GPX4 positive cells were decreased in the PA+ML385 group compared with the PA group. GSH in the Model group was lower than that in the Control group and PA group, GSH in the PA+ML385 group was lower than that in the PA group. MDA and Fe²⁺ in the Model group were higher than those in the Control group and PA group, and those in the PA+ML385 group were higher that the PA group, and the differences were statistically significant (P<0.05). The relative expression levels of Nrf2, SLC7A11 and GPX4 in the Model group were lower than those in the Control group and PA group, and those in the PA+ML385 group were lower than those in the PA group, and the differences were statistically significant (P<0.05) .

PA can improve the cognitive impairment of AD rats, and its mechanism may be related to the inhibition of iron death by activating Nrf2/SLC7A11/GPX4 signal pathway.

Recent studies have identified a trend toward cognitive decline and even progression to dementia in patients with metabolic syndrome (MetS), and Alzheimer's disease (AD) is the most important subtype of dementia. In reviewing the correlation between cognitive impairment due to MetS and development of AD in previous studies, this paper highlights the growing body of data that supports MetS as a whole as well as its components of hypertension and hyperglycemia as risk factors for AD, whereas insulin resistance, neurologic chronic inflammation, and adipokine disorders play important roles in the pathogenesis. Since there are now no viable treatment alternatives available to stop or reverse the degenerative progression of AD, it is expected to provide scientific evidence for a comprehensive strategy for early prevention and treatment of AD by targeting relatively curable MetS for intervention.

There are many types of assessment tools for dementia patients both domestically and internationally. However, assessments using single-dimensional measurement tools often have limitations, and there is still a lack of reports on comprehensive assessment tools specifically for dementia patients in current. Based on this, the comprehensive assessment tools for the elderly with dementia are reviewed both domestically and internationally, 8 assessment tools from the perspectives of demand and function for the elderly with dementia are summarized, and the content, reliability and validity, application of each tool are discussed in this paper, in order to provide reference for the use and development of assessment tools for the elderly with dementia in China.

Lifestyle factors are important modifiable influencing factors for cognitive decline and dementia. Understanding the status and influencing factors of community-dwelling middle-aged and elderly adults adhering to the lifestyles conducive to dementia risk reduction will be a basis for medical workers to formulate individualized interventions for primary prevention of dementia, yet there are still few related studies.

To understand the status and influencing factors of dementia risk reduction lifestyle in community-dwelling middle-aged and elderly adults.

Five hundred and six middle-aged and elderly adults (aged 45 years and older) who had received free health check-ups in a community health center were selected from five communities in Chongqing's Shapingba District by convenience sampling from January to October 2021. The self-designed general information questionnaire and the Dementia Risk Reduction Lifestyle Scale (DRRLS) were used to investigate. The level of DRRLS score in the participants was compare by sociodemographic characteristics. Ordinal and multinomial Logistic regression analysis was performed to identify the influencing factors of the levels of DRRLS scores.

The average score of DRRLS was (88.00±13.27). The median scores of items in mental activity and brain-benefiting exercise were at a low level (≤2.00). The level of DRRLS score in the participants varied significantly by gender, age, personal monthly income and experience of receiving dementia-related health education (P<0.05). Ordinal and multinomial Logistic regression revealed that gender, educational level, personal monthly income and experience of receiving dementia-related health education were important influencing factors of the level of DRRLS score (P<0.05) .

In general, the lifestyles for dementia risk reduction were assessed at a moderate level in the community-dwelling middle-aged and elderly adults. In the primary prevention of dementia, the effects of mental activity and brain-benefiting exercise should be emphasized. Moreover, priority in community health management should be given to men, those with a low educational level or no previous experience of receiving dementia-related health education, and relevant health education and preventive interventions should be strengthened for them. All these efforts will urge these adults to adopt a lifestyle for dementia risk reduction and brain health promotion.

With the rapid population aging in China, cognitive impairment in older adults has become a growing public health concern.

To examine the association between nighttime sleep duration and cognitive impairment among community-dwelling older adults.

Data were derived from the cohort of Older Adult Health and Modifiable Environmental Factors established in Fuyang City from July to September 2018, among whom a total of 4 837 older adults with complete data on cognitive function and sleep time were included in this study. General demographic characteristics〔gender, age, living area (urban or rural), education level, occupation, marital status〕, living habits, the history of chronic diseases, sleep duration, and overall cognitive function were extracted. Binary Logistic regression models were used to analyze the association between nighttime sleep duration and cognitive impairment. Restrictive cubic splines were used to further determine potential dose-response relationships between them.

The participants had a mean nighttime sleep duration of (6.95±1.75) hours, among whom 1 773 (36.65%) slept ≤6 hours per day, 2 088 (43.17%) slept >6-8 hours per day, and 976 (20.18%) slept >8 hours per day. The detection rate of cognitive impairment was 37.44% (1 811/4 837). After adjusting for gender, age, living area, education level and other confounding factors, the detection rate of cognitive impairment was 1.26〔95%CI (1.09, 1.46) 〕 times higher in older adults with nighttime sleep duration of ≤6 hours, and was 1.22〔95%CI (1.03, 1.46) 〕 times higher in older adults with nighttime sleep duration of >8 hours than in those with nighttime sleep duration of >6-8 hours (P<0.05). The detection rate of cognitive impairment in male older adults with nighttime sleep duration of >8 hours was 1.35〔 (95%CI (1.06, 1.72) 〕 times higher than in those with nighttime sleep duration of >6-8 hours (P<0.05). The detection rate of cognitive impairment in female older adults with nighttime sleep duration of≤6 hours was 1.29〔95%CI (1.06, 1.58) 〕 times higher than in those with nighttime sleep duration of >6-8 hours (P<0.05). The restriction cube spline curve showed an approximate U-shaped relationship between nighttime sleep duration and the risk for cognitive impairment, with the lowest risk at 7 hours.

Both shorter and longer nighttime sleep duration may be independent and dose-dependent risk factors for cognitive impairment in older adults. The optimal sleep time is about 7 hours. The association between longer sleep duration and cognitive impairment is pronounced in males, while the association between shorter sleep duration and cognitive impairment is pronounced in females.

Both frailty and potentially inappropriate medication (PIM) are relatively highly prevalent in adults with mild cognitive impairment (MCI) in the community, but the association of PIM with frailty in MCI population remains to be further explored.

To examine the association between PIM and frailty in older adults with MCI in the community.

This study was conducted between March to July 2021. By use of multistage sampling, older adults with MCI (n=230) were recruited from Baohe District, Hefei City. Sociodemographics, lifestyle indicators and physical functions of the subjects were collected by using the General Information Questionnaire developed by our research team. Frailty was assessed by the Comprehensive Frailty Assessment Instrument. PIM was assessed by the 2017 Criteria of Potentially Inappropriate Medications for Older Adults in China. Logistic regression analysis was applied to analyze the association of the number and types of PIM with frailty.

The prevalence of frailty and PIM in these older adults with MCI was 59.1% (136/230) and 59.1% (136/230) , respectively. The prevalence of PIM in the frailty group was much higher than that of non-frailty group〔80.9% (110/136) vs 27.7% (26/94) 〕 (P<0.05) . Multivariate Logistic regression analysis demonstrated that compared with MCI older adults without PIM, the risk of frailty was 4.591 times higher in those with only one PIM〔95%CI (1.903, 11.076) 〕, and 8.859 times higher in those with two or more PIMs〔95%CI (2.589, 30.321) 〕. Compared with MCI older adults with neurological disease but without PIM, the risk of frailty was 5.310 times higher in those with PIM〔95%CI (1.011, 27.877) 〕. The risk of frailty was 3.108 times higher in those with cardiovascular disease and PIM than that in those without PIM〔95%CI (1.173, 8.241) 〕.

The prevalence of frailty and PIM was higher in older adults with MCI in the community, and PIM was significantly associated with frailty. To decrease the prevalence of frailty and delay the progression of dementia in this population via reducing the prevalence of PIM, community-based health efforts should be made to strengthen the screening for frailty, enhance the identification of frailty related to medication use, and promote medication review and management.

China is seeing an increasing number of people suffering from dementia as aging advances and life expectancy prolongs. Early diagnosis is extremely important for dementia.

To understand the attitudes and views of community general practitioners (GPs) regarding dementia screening, providing suggestions for the development of dementia screening in the community.

In July 2021, by use of purposive sampling, GPs were recruited from community health centers (stations) in Lanzhou, Gansu, and invited to attend a semi-structured, in-depth, face-to-face individual interview for understanding their attitudes and views toward dementia screening. The interview results were analyzed using phenomenological analysis and thematic analysis.

Ten GPs from five community health centers and five community health stations were finally enrolled, including five males and five females, with an average age of (46.6±6.5) years〔range (35, 57) 〕, an average years of (14.90±8.46) working as a GP〔range (5, 26) 〕; seven with a bachelor degree; four with a title of attending physician. Three themes were extracted: insufficient basic conditions for carrying out community-based dementia screening, difficulties in carrying out community-based dementia screening, and improvement of community GPs' abilities to participate in dementia screening. Nine subthemes were also extracted.

Community GPs supported community-based dementia screening, but had insufficient capacities to carry out the screening. The following may be effective measures for promoting early screening and intervening dementia: improving the ability of community GPs to screen dementia, strengthening the publicity and popularization of dementia-related knowledge to reduce social discrimination against dementia, and deepening the development of contracted family doctor services.