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China’s population has rapidly aged over the recent decades of social and economic development as neurodegenerative disorders have proliferated, especially Alzheimer’s disease (AD) and related dementias (ADRD). AD’s incidence rate, morbidity, and mortality have steadily increased to make it presently the fifth leading cause of death among urban and rural residents in China and magnify the resulting financial burdens on individuals, families and society. The ‘Healthy China Action’ plan of 2019–2030 promotes the transition from disease treatment to health maintenance for this expanding population with ADRD. This report describes related epidemiological trends, evaluates the economic burden of the disease, outlines current clinical diagnosis and treatment status and delineates existing available public health resources. More specifically, it examines the public health impact of ADRD, including prevalence, mortality, costs, usage of care, and the overall effect on caregivers and society. In addition, this special report presents technical guidance and supports for the prevention and treatment of AD, provides expertise to guide relevant governmental healthcare policy development and suggests an information platform for international exchange and cooperation.

Previous studies have shown that both cognitive training and aerobic exercise benefit cognition and brain structure in healthy older adults, yet direct comparisons are limited. This study aimed to compare the effects of three months of cognitive training and aerobic exercise on regional gray matter volume and inter‑regional covariance in community‑dwelling older adults. Structural magnetic resonance imaging (MRI) was conducted at baseline and 12-month follow-up. Repeated-measures analysis of covariance (ANCOVA) revealed nominally significant time-by-group interactions in the left posterior orbital gyrus (POrG), left posterior insula (PIns), left subcallosal area (SCA), and left transverse temporal gyrus (TTG), with only the left POrG remaining significant after false discovery rate (FDR) correction. At the 12-month follow-up, left POrG volume increased only in the aerobic exercise group, whereas the control group showed decreases in the left POrG, left PIns, and left SCA. Inter-regional covariance analyses revealed weaker covariance between volume changes in the left SCA and left TTG in the aerobic exercise group compared with controls, although this effect did not survive FDR correction, suggesting a lower degree of coordinated structural change between these regions. Overall, these findings suggest that both cognitive training and aerobic exercise are associated with attenuated age-related gray matter volume reduction, though they differ in the extent and coordination patterns of these volume changes.

With the sustained growth of the economy and significant changes in social demographics, the issue of elderly-related diseases has increasingly drawn attention, particularly. Alzheimer’s disease (AD), as a representative disease of neurodegenerative diseases, has become a major challenge, affecting the health and quality of life of the elderly population severely. In recent years, the incidence, prevalence and mortality rates of AD have increased in China, imposing substantial economic burdens on families, society and the entire healthcare system. To proactively address this challenge and respond to the national ‘Healthy China Action’ initiative, leading experts from authoritative institutions jointly authored the China Alzheimer Report 2025. Building on previous editions, this report updates epidemiological data on AD in China, thoroughly analyses the latest economic burdens of the disease and comprehensively evaluates the current status of AD diagnosis and treatment services, as well as the allocation of public health resources in our country. Its release reflects China’s progress in AD research and prevention, underscores societal concern for elderly health and aims to provide scientific guidance and data support for AD prevention, diagnosis and treatment. It also facilitates academic exchanges and cooperation, enhancing public awareness and promoting active participation in elderly healthcare, towards achieving ‘healthy ageing’ in China.

The human microbiome is a mixed group of microorganisms, which individually consists of 10–100 trillion symbiotic microbial cells. The relationship between gastrointestinal microbiota and blood pressure has been verified and the intestinal microbiota of chronic kidney disease (CKD) patients in the distribution of bacterial species is different from the flora of people with no CKD. The purpose of this research is to study the different intestinal microbiota of hypertensive patients with and without nephropathy and to find possible biomarkers of hypertensive nephropathy (H-CKD). The subjects of this research were divided into three groups, healthy control group, hypertension group, and hypertensive nephropathy group. Sequencing, bioinformatics, and statistical analysis were performed on the 16S rRNA gene of the subjects’ stool samples. This research study showed the differences of intestinal flora as biomarkers in hypertension patients with and without nephropathy; it investigated the relationship of the differences in the intestinal microbiota with bile-acid metabolism; it also explored bile-acid metabolism mechanism of intestinal microbiota differences in hypertension with or without nephropathy. In summary, the difference in the combination of O. formigenes and V. parvula in the gastrointestinal microbiota is related to bile-acid metabolism in hypertensive patients and can be one of the factors causing CKD. It is the first time to report such a biomarker or pathogenic factor of H-CKD in the world.

Background: Cohort studies have shown that older adults with hearing impairment as assessed by self-report or behavioural measures are at higher risk of developing dementia many years later. A fine-grained examination of auditory processing holds promise for more effective screening of older adults at risk of cognitive decline. The auditory mismatch negativity (MMN) measure enables one to gain insights into the neurobiological substrate of central auditory processing. We hypothesized that older adults showing compromised indexes of MMN at baseline would exhibit cognitive decline at the one-year follow-up. Methods: We performed cognitive evaluations with the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS; Form A and Form B) in 108 community-dwelling older adults and acquired EEG via the classic passive auditory oddball paradigm at baseline and 12-month follow-up.The results showed that young-old adults with future cognitive decline showed a decrease in MMN peak amplitude, accompanied by a forward-shifting latency, whereas in older adults it showed a delay in MMN latency, and unchanged MMN peak amplitude at midline electrodes(Fz, FCz and Cz). Furthermore, the peak amplitude of the MMN decreases with age in older adults aged 70-80 years rather than 60-70 years or >80 years. Conclusions: The altered MMN model exists in different aging stages and it's a promising electrophysiological predictor of cognitive decline in older adults. In addition, further research is needed to determine the neural mechanisms and potential implications of the accelerated decline in MMN in older adults.

Recent research suggests a possible association between midlife obesity and an increased risk of dementia in later life. However, the underlying mechanisms remain unclear. Little is known about the relationship between body mass index (BMI) and hippocampal subfield atrophy. In this study, we aimed to explore the associations between BMI and hippocampal subfield volumes and cognitive function in non-demented Chinese older adults. Hippocampal volumes were assessed using structural magnetic resonance imaging. Cognitive function was evaluated using the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). A total of 66 participants were included in the final analysis, with 35 females and 31 males. We observed a significant correlation between BMI and the hippocampal fissure volume in older females. In addition, there was a negative association between BMI and the RBANS total scale score, the coding score, and the story recall score, whereas no significant correlations were observed in older males. In conclusion, our findings revealed sex-specific associations between BMI and hippocampal subfield volumes and cognitive performance, providing valuable insights into the development of effective interventions for the early prevention of cognitive decline.

The combination external-beam radiotherapy and high-dose-rate brachytherapy is a standard form of treatment for patients with locally advanced uterine cervical cancer. Personalized radiotherapy in cervical cancer requires efficient and accurate dose planning and assessment across these types of treatment. To achieve radiation dose assessment, accurate mapping of the dose distribution from HDR-BT onto EBRT is extremely important. However, few systems can achieve robust dose fusion and determine the accumulated dose distribution during the entire course of treatment. We have therefore developed a toolbox (FZUImageReg), which is a user-friendly dose fusion system based on hybrid image registration for radiation dose assessment in cervical cancer radiotherapy. The main part of the software consists of a collection of medical image registration algorithms and a modular design with a user-friendly interface, which allows users to quickly configure, test, monitor, and compare different registration methods for a specific application. Owing to the large deformation, the direct application of conventional state-of-the-art image registration methods is not sufficient for the accurate alignment of EBRT and HDR-BT images. To solve this problem, a multi-phase non-rigid registration method using local landmark-based free-form deformation is proposed for locally large deformation between EBRT and HDR-BT images, followed by intensity-based free-form deformation. With the transformation, the software also provides a dose mapping function according to the deformation field. The total dose distribution during the entire course of treatment can then be presented. Experimental results clearly show that the proposed system can achieve accurate registration between EBRT and HDR-BT images and provide radiation dose warping and fusion results for dose assessment in cervical cancer radiotherapy in terms of high accuracy and efficiency.

•The Elderly Nutritional Indicators for Geriatric Malnutrition Assessment (ENIGMA), a nutritional risk screening scale originally developed to predict mortality in communities, could also predict cognitive impairment, functional limitation, and frailty in Chinese community-dwelling older adults.•The ENIGMA performed better than the Geriatric Nutritional Risk Index in predicting the above adverse health outcomes.•The ENIGMA would be a feasible nutritional risk screening tool that has the potential to guide early nutritional intervention in communities and primary care settings in China. Malnutrition and nutritional risk are risk factors for many adverse health outcomes in older adults, but they have rarely been assessed in China. The aim of this study was to evaluate the availability of Elderly Nutritional Indicators for Geriatric Malnutrition Assessment (ENIGMA), a nutritional scale originally developed to predict mortality, in assessing nutritional risks and predicting adverse health outcomes in Chinese community-dwelling older adults. This was a population-based longitudinal cohort study (Chinese Longitudinal Healthy Longevity Survey), with a 4-y follow-up of 2063 community-dwelling adults aged 65 y or older. Nutritional risks were assessed via the use of ENIGMA and Geriatric Nutritional Risk Index (GNRI) at baseline (the 2014 wave). Cognitive impairment, functional limitation, and frailty were evaluated using the Chinese version of the Mini-Mental State Examination, Instrumental Activities of Daily Living/Instrumental Activities of Daily Living scale, and Frailty Index, respectively, at baseline and 4-y follow-up (the 2018 wave). Mortality was measured by survival status and duration of exposure to death from baseline to follow-up. The associations of nutritional risks with prevalent/incident cognitive impairment, functional limitation and frailty, and 4-y mortality were estimated using logistic regression and Cox proportional hazards regression models, adjusting for confounders. The discriminatory accuracy of ENIGMA and GNRI for these adverse health outcomes were compared by receiver operating characteristic analyses. According to ENIGMA, 48.6% of the Chinese community-dwelling older adults (age: 86.5±11.3 y) showed moderate and high nutritional risk. Nutritional risks defined by the ENIGMA were significantly associated with increased prevalence and incidence of cognitive impairment, functional limitation, and frailty (odds ratio ranging from 1.79 to 89.6, values ranging from P < 0.001 to 0.048) but were mostly insignificant for that defined by GNRI. With respect to 4-y mortality, nutritional risks as defined by GNRI showed better prediction effects than those defined by ENIGMA. Receiver operating characteristic analyses indicated that nutritional risks defined by ENIGMA had better discriminatory accuracy than those defined by GNRI for prevalent and incident cognitive impairment (C = 0.73 vs 0.64, P < 0.001; C = 0.65 vs 0.59, P = 0.015, respectively), functional limitation (C = 0.74 vs 0.63, P < 0.001 at baseline; C = 0.61 vs 0.56, P = 0.016 at follow-up), frailty (C = 0.85 vs 0.67, P < 0.001 at baseline; C = 0.64 vs 0.55, P < 0.001 at follow-up), and even 4-y mortality (C = 0.68 vs 0.64, P = 0.020). ENIGMA could serve as a nutritional risk screening tool that has a robust role in predicting cognitive impairment, functional limitation, and frailty in Chinese community-dwelling older adults. It may be recommended for early nutritional risk screening and has the potential to guide early nutritional intervention in communities and primary care settings in China.

Background: Healthy diets and physical exercise, two modifiable lifestyle factors, are protective against depression in older adults. This study aimed to investigate whether physical exercise may influence the associations of dietary habits with depression in Chinese community-dwelling older adults. Methods: In the 2018 wave of the Chinese Longitudinal Healthy Longevity Survey, 12,708 community-dwelling older adults aged ≥65 years were included for analyses. Older adults’ dietary habits (including daily intake of food components such as fruits, vegetables, animal oil, and so on) and physical exercise were assessed. Depression was evaluated via the 10 item Center for Epidemiologic Studies Depression (CES-D-10) scale. The influences of physical exercise on the associations of dietary habits with depression were estimated using logistic regression models adjusted for confounders. Results: Older adults who took physical exercise had a significantly decreased probability of depression (adjusted OR = 0.73, p < 0.001). As for dietary habits, the intake of fruits, vegetables, eggs, nut products, mushrooms or algae, and vitamins were inversely associated with the prevalence of depression (adjusted ORs = 0.61–0.81; p-values: from <0.001 to 0.025), while animal oil was positively associated with it (adjusted OR = 1.52, p < 0.001). When stratified by physical exercise, older adults who ate fruits or vegetables had consistent decreased risk of depression, no matter whether they took physical exercise or not (adjusted ORs = 0.52–0.70), while the intake of eggs, nut products, and vitamins were inversely associated, and animal oil was consistently positively associated with depression only in older adults who did not take physical exercise (adjusted ORs = 0.79, 0.68, 0.63, and 1.67, respectively). Conclusions: Physical exercise may conceal the potential protective effects of some healthy dietary habits in terms of depression and counteract the detrimental effects of the unhealthy habits. Some dietary habits may be considered as alternative protective measures for depression in community-dwelling older adults when physical exercise cannot be performed.

Frequent oil spills and oily wastewater discharge have caused serious damage to the ecological environment, which make it urgent to address these challenges. Herein, we report an effective strategy and low-cost method to transform commercially available melamine foams into superhydrophobic/superoleophilic absorbents, which has a high separation ability for both oil-water mixtures and emulsions. Our approach involves the co-deposition of tannic acid and 3-aminopropyltriethoxysilane on the foam surface to form a hierarchical structure, followed by the covalent grafting of palmitic acid with low surface energy onto the foam backbones via acylation. The resulting foam maintained a cross-linked porous structure with a water contact angle of 153° and a sliding angle of 7°, exhibiting a high degree of water repellency. Absorption experiments with chloroform and engine oil showed that the foam has high absorption capacity, reaching 99.2 and 172.8 times its own weight, respectively, and the foam still retains excellent elasticity after 1000 compression cycles. In addition, the superhydrophobic foam has a high demulsification ability to oil-in-water emulsions by repeated compression and violent stirring, and its separation ability for toluene-in-water emulsions was up to 99.25%. Based on these results, the superhydrophobic foam has significant potential for large-scale oil spill cleanup and wastewater purification.