ObjectiveTo investigate the clinical research development of dementia in the UK Biobank database in SCIE and PubMed. MethodsThe literatures of dementia in the UK Biobank database published in SCIE and PubMed from January 1, 2018 to November 30, 2022 were searched, and the number of articles, publishing institutions, journals, citations, authors and keywords were statistically analyzed. ResultsA total of 279 papers were included, and the number of papers presented an annual growth trend. The United Kingdom has the largest number of publications, the United States journals have the greatest influence, and China has the third largest number of publications. Springer Nature from Germany published the most papers, with the largest number of 47 papers. Among the authors, Yu JT from China published the most, with 11 articles, and the most major keyword in the research content is Alzheimer. ConclusionThe literatures of dementia in the UK Biobank-related field included in SCIE and PubMed databases show an increasing trend year by year, mainly in English, and the core author group has not yet formed. The papers published by Chinese scholars are concentrated in 2020-2022, and there are few transnational cooperative papers.
Objective To analyze the characteristic and temporal trend in mortality and disease burden of Alzheimer’s disease (AD) and other forms of dementia in Guangzhou from 2008 to 2019, and estimate the disease burden attributable to smoking to provide evidence for promoting local health policy of prevention and intervention of dementia. Methods Based on the data of Guangzhou surveillance point of the National Mortality Surveillance System (NMSS), the crude mortality, standardized mortality, years of life lost (YLL) of AD and other dementia were calculated. The indirect method was used to estimate years lived with disability (YLD) and disability-adjusted life years (DALY).The distribution and changing trends of the index rates were compared from 2008 to 2019 using Joinpoint Regression Program. Based on the data of Guangzhou Chronic Disease and Risk Factors Monitoring System in 2013, the indexes of disease burden of AD and other forms of dementia attributable to smoking in 2018 was calculated. Results The standardized mortality rate, YLL rate, YLD rate and DALY rate of AD and other forms of dementia in Guangzhou increased from 0.45/100 000, 0.05‰, 0.02‰ and 0.07 ‰ in 2008 to 1.28/100 000, 0.15‰, 0.07‰ and 0.22‰ in 2019, respectively. The average annual changing trend was statistically significant (AAPC=11.30%, 13.09%, 13.09%, 13.09%, P<0.001）. In most years, the mortality and disease burden of women were higher than those of men, but men had higher growing trend than women in standardized mortality rate, YLL rate, YLD rate and DALY rate from 2008 to 2019, with a slower growing speed after the year 2012.The disease burden of dementia attributable to smoking in men was significantly higher than that in women. Conclusion The mortality and disease burden of AD and other forms of dementia in Guangzhou have dramatically increased over the past twelve years. Intervention against modifiable factors such as smoking, and prevention and screening for dementia in key populations should be strengthened. Support policies for dementia care management should be adopted to reduce the disease burden caused by premature death and disability.
【摘要】 目的 了解老年门诊患者痴呆症的发生率及其相关危险因素。方法 对2007年7月—2009年5月,年龄≥60岁644例门诊患者进行简易智能表(MMSE简易评分)评价,并收集患者文化程度、吸烟、基础疾病、用药史进行危险因素相关分析。结果 样本人群老年痴呆症的发病率为16.0%。与老年性痴呆密切相龄、高血压、脑卒中史、听力受损和视力受损。结论 高龄、高血压、脑卒中是老年性痴呆主要的危险因素,当前的医疗卫生机构应该积极有效地采取措施,控制可变因素,减少老年性痴呆的发生。
Metaiodobenzylguanidine (MIBG) is an analog of norepinephrine that accumulates in sympathetic nerve endings soon after intravenous administration. The degree of accumulation reflects the uptake, storage and release of transmitters by noradrenergic neurons. Myocardial imaging with 123I labeled MIBG (123I-MIBG) can be used to estimate the extent of local myocardial sympathetic nerve damage, which has been widely used in the diagnosis and treatment of various heart diseases. In recent years, numerous studies have been carried out on the application of 123I-MIBG in the diagnosis of degenerative diseases of the nervous system (such as Parkinson's disease and dementia of Lewy body), and have made some achievements. The purpose of this review is to summarize the current clinical application of 123I-MIBG myocardial imaging in the diagnosis of dementia with Lewy bodies, the problems in imaging technology and the possible research directions in the future, so as to provide valuable reference information for clinicians to reasonably and accurately apply this technology in the early diagnosis and discrimination of dementia.
ObjectiveTo systematically review the data of peripheral inflammatory markers in patients with Alzheimer’s disease (AD) and vascular dementia (VaD) to further indicate pathogenesis and antidiastole.MethodsPubMed, EMbase, The Cochrane Library, CNKI, WanFang Data and VIP databases were electronically searched to collect studies on peripheral inflammatory markers in patients with AD and VaD from inception to July 2020. Two reviewers independently screened literature, extracted data, and assessed risk of bias of included studies, and meta-analysis was performed by using Stata 15.1SE software.ResultsA total of 30 studies involving 2 377 patients were included. The results of meta-analysis showed that the IL-6 level was higher in VaD group than that in AD group (SMD=−0.477, 95%CI −0.944 to −0.009, P=0.046). However, there were no statistical difference in peripheral IL-1β (SMD=−0.034, 95%CI −0.325 to 0.257, P=0.818), TNF-α (SMD=0.409, 95%CI −0.152 to 0.970, P=0.153) or CRP (SMD=0.277, 95%CI −0.228 to 0.782, P=0.282) levels.ConclusionsThese findings suggest that IL-6 may be sensitive markers to distinguish AD from VaD. Due to limited quality and quantity of the included studies, more high-quality studies are required to verify the conclusions.
Vascular dementia is one of the most common types of dementia in China. How to better prevent and treat vascular dementia is still an unresolved problem, and the risk predictor of vascular dementia may help provide clinical targeted prevention measures to intervene in the development process of vascular dementia early. This article reviews the current research status of vascular dementia predictors from four aspects: blood markers, predictors based on disease characteristics, predictors based on assessment tools and neuropsychological tests, and predictors based on activity dysfunction. It aims to provide a basis for establishing a risk prediction model for patients with vascular dementia suitable for China’s conditions in the future.
Post-stroke cognitive impairment (PSCI) is the most common dysfunction after stroke, which seriously affects patients’ quality of life and survival time. To strengthen the management and prevention of PSCI, the European Stroke Organization and the European Academy of Neurology jointly developed the guidelines for PSCI in 2021. This paper introduces the background, compilation method and structure, management suggestions and expert consensus of PSCI, the next research direction, etc. Compared with the current prevention and treatment measures of PSCI in China, it aims to provide methodological reference for Chinese scholars to develope PSCI guidelines and reference evidence for clinical prevention and treatment of PSCI.
ObjectiveTo provide the best evidence for an old diabetic patient who combined with frailty syndrome with the goal of glycemic control, treatment strategy and their prognosis. MethodsPubMed, MEDLINE (Ovid), EMbase, The Cochrane Library (Issue 11, 2015) and CNKI were searched from their inception to Nov. 2015, to collect evidence about the management of glycemic control. Evidences were analyzed by the way of evidenced-based criterions. ResultsOne clinical guideline, one meta-analysis, three RCTs, seven cohort studies and four case-control studies were included. Evidence showed that compared with patient uncombined with frailty, old diabetic patients with frailty had a higher prevalence of dementia, cardiovascular diseases and death; Aggressive glycemic control could not reduce the prevalence of cardiovascular events and the risk of death, while it could increase the risk of falling. Glycemic control was more comprehensive which would be taken frailty into consideration. Diet rich in protein (especially leucine), resistance exercise and reasonable medications based on comprehensive geriatric assessment were proved benefit for the old diabetic patient. ConclusionThe incidence of cardiovascular events, hypoglycemia and mortality are increased in this old diabetic patient who combined with frailty. Maintaining HbA1c around 7.5% is reasonable and diet with enough calorie and rich in protein (especially leucine), resistance exercises should be recommended for the person.
目的：总结我们对表现为麻痹性痴呆的晚期神经梅毒的诊治经验。方法：报道4例麻痹性痴呆病例，并复习相关文献。结果和结论：麻痹性痴呆的临床表现复杂多变，早期误诊率高；诊断主要根据临床特点、血清学及脑脊液检查综合考虑；治疗上仍首选水剂青霉素G。
ObjectiveTo systematically review the efficacy and safety of non-pharmacological interventions for sleep disturbance in dementia, and to provide evidence for clinical practice.MethodsDatabases including CNKI, WanFang Data, VIP, PubMed, EMbase and The Cochrane Library were searched to collect randomized controlled trials (RCTs) on non-pharmacological interventions for sleep disturbance in dementia from inception to May 2020. Two reviewers independently screened literature, extracted data, and assessed risk of bias of included studies. Meta-analysis was then performed using RevMan 5.3 software.ResultsA total of 9 RCTs were included, involving 720 patients. Light therapy was the most commonly used treatment, followed by special activity and sleep education program. The results of meta-analysis showed that compared with the control intervention, light therapy could improve sleep efficiency (MD=2.21, 95%CI 1.09 to 3.33, P=0.0001) and the night-time sleep (MD=14.27, 95%CI 5.01 to 23.53, P=0.003) of patients with dementia in the community and nursing institutions, special activity could increase the night-time sleep (MD=29.74, 95%CI 20.44 to 39.04, P<0.00001), and sleep education program could also improve sleep efficiency (MD=6.19, 95%CI 5.22 to 7.16, P<0.00001) and night-time sleep (MD=33.95, 95%CI 25.40 to 42.50, P<0.00001). In addition, it was superior to obtain 120 or 60 minutes of light exposure than 30 minutes to improve the quality of sleep (RR=−2.62, 95%CI −3.56 to −1.68, P<0.001) and reduce daytime sleep (RR=−4.75, 95%CI −5.71 to −3.42, P<0.001). However, there was significant difference in incidence of adverse reactions between groups of 120 minutes and 30 minutes of light exposure (RR=2.57, 95%CI 1.44 to 4.58, P=0.001).ConclusionsThe current evidence shows that non-pharmacological intervention can improve sleep efficiency and night-time sleep in patients with dementia. Due to limited quantity and quality of the included studies, more high quality studies are required to verify above conclusions.