Alzheimer Dementia: To prevent cognitive decline and dementia, Beijing is on the move!

China is rapidly becoming an aging society.
As of the end of 2018, among China's 1.
4 billion people, 249.
5 million (17.
8%) were over 60.
It is estimated that by 2050, this proportion will reach 33.
3%.
Of course, the steps towards an aging society are not even nationwide.

As the capital of the country, Beijing leads the country.
In 2018, the population of Beijing over 60 accounted for 25.
4%.
Due to the aging of the population, the incidence of dementia in China has increased significantly in recent decades, from 1990 to 1990.
In 2016, the age-standardized prevalence of dementia in China increased by 5.
6%, while the global prevalence increased by 1.
7% during the same period.
Dementia has now become the eighth leading cause of death in China, and it has brought considerable challenges to patients, their families, and the broader social and economic development of the country.
Therefore, the early prevention and effective management of the disease brooks no delay.

The key to early prevention is to discover the precursors of Alzheimer's.
Recent studies have shown that Alzheimer's disease (AD) is the most common form of dementia, and its underlying disease pathology can be discovered as early as 20 years before obvious clinical symptoms appear.
In patients with mild cognitive impairment (MCI) and even middle-aged people with normal cognition, abnormal amyloid biomarkers and neurodegeneration biomarkers (such as tau pathology, hippocampal atrophy) have been found, and the risk of dementia Higher.
However, due to the lack of awareness of the disease, early detection of dementia and cognitive impairment has been greatly hindered.
According to a meta-analysis, the global aggregate rate of undetected dementia is 61.
7%, which is even higher in low-income countries (93.
2% in Asia, 62.
9% in North America, and 53.
7% in Europe).
The community has not been discovered, and no timely intervention can be obtained.

There is evidence that outpatients are at an advanced stage of disease than community patients.
This fact is also emphasized, because compared with community cohorts, clinic-based cohorts transform from normal cognition to MC and progress from MCI to The risk of dementia is significantly increased.
As the accumulated evidence shows that it is possible to delay or prevent dementia by intervening with changeable risk factors, more work is needed to advance research on health differences related to dementia, specifically, to promote community awareness Early detection of the disease and get more details on what (cognitive training or medical treatment), how (based on clinical or community living), and when (in the early stages of symptomatic or asymptomatic) early prevention will take effect.

These issues appear to be more urgent and important in China.
Compared with other countries, national plans on Alzheimer’s have been published (such as the United States, the United Kingdom, Australia), and cohort studies (such as the Alzheimer’s Disease Neuroimaging Program [ADNI]) or interventional clinical trials (such as Finland The elderly intervention study to prevent cognitive impairment and disability [FINGER]), but there is still a huge gap in the number of studies on aging and dementia in China.

In addition, due to the large differences between the Chinese population and the populations of other countries, such as physical conditions, living habits, cognitive patterns and other dementia risk factors that can be changed, and there are large differences in the diagnosis and treatment of dementia in urban and rural areas , so The establishment of a Chinese population database is also necessary for the development of regional dementia prevention strategies for the elderly in China.
As the national plan for aging and dementia is reviewed and released in the next few years, the following specific issues need to be considered.
(1) The number of Alzheimer’s patients is the largest, the undetected rate is high, the awareness is low, and the understanding of Alzheimer’s is insufficient; (2) The long-term follow-up data on aging and Alzheimer’s are lacking; (3) Gender differences, among the elderly population The proportion of women is higher, and the risk of individual women suffering from Alzheimer's disease is higher; (4) Due to the different levels of economic development, there are regional and urban-rural differences in aging and disease management; (5) The lack of community-based early prevention and intervention strategies for Alzheimer's disease.

BABRI was established at Beijing Normal University in 2008 to conduct cohort research based on the population registration of large communities in the Beijing metropolitan area.
BABRI's ultimate goal is to reach 10,000 cohort participants by 2028, collect comprehensive information on aging, track changes in cognitive function and brain structure and function over the years, and design it for the elderly with normal cognition and patients with cognitive impairment Preventive clinical trials.

BABRI intends to establish a multi-dimensional database as a whole, and accomplish the following four specific goals by combining basic disease research with clinical trials.
(1) Identify the markers of different stages of cognitive impairment and dementia/AD; (2) Understand the basic principles of cognitive aging and its underlying brain mechanisms; (3) Develop and verify the cognitive screening of Chinese elderly in a community environment (4) Formulate prevention strategies and potential alternative interventions for early cognitive impairment and dementia.

Original source: ncbi.