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*Only for medical professionals to read and reference Alzheimer's disease treatment is expected to achieve new breakthroughs.
.
.
Expert profile: Professor Chen Xiaochun, President of Fujian Medical University, Professor of Neurology, Fujian Medical University Affiliated Union Hospital, Professor, Chief Physician, and Doctoral Supervisor, Ministry of Education New Medical Department Working group member, vice chairman of Fujian Association of Science and Technology, executive director of Chinese Medical Doctor Association, and president-elect of the branch of neurologists, head of the Dementia and Cognitive Disorders Group of Chinese Medical Association Neurology Branch, chairman of Fujian Medical Doctors Association, has been engaged in neurodegenerative diseases for a long time The clinical diagnosis and treatment and basic research work focused on Alzheimer's disease, Parkinson's disease, and the research on the pathogenesis and prevention and treatment strategies of depression are always young, but everyone will eventually get old
.
Regarding the old life, many people have imagined that after a busy life for most of their lives, they can enjoy the good fortune, travel, go to college for the elderly.
.
.
But, for the suffering of Alzheimer's disease (AD) For the elderly, such simple happiness is indeed beyond reach
.
AD is the most common type of dementia, with insidious onset and diverse clinical manifestations.
At present, the public's understanding of AD is still insufficient
.
Every September is World Alzheimer's Month, and this year's theme is "Know Dementia, Know Alzheimer's"
.
The "medical community" specially invited Professor Chen Xiaochun, the president of Fujian Medical University, to share his views on hot issues related to AD diagnosis and treatment
.
(Interview with Professor Chen Xiaochun) The early onset of AD is hidden, and early clues need to be paid attention to.
The scientific thinking of "change" emphasizes the importance of early detection, early treatment, and prevention of disease
.
Professor Chen Xiaochun said, “Many people call AD the most serious public health problem in this century.
Early recognition, early screening, early detection, early diagnosis and early treatment of AD are needed.
Among them, some clues can be used to achieve the early stage of AD.
Recognition is equally important for clinicians and patients’ families
.
”
The onset of AD is insidious, but patients still have characteristic memory impairments in the early stages of the disease, that is, they often manifest in the form of language repetition, long-winded forgetting and episodic memory impairment
.
In addition to the manifestations of memory impairment, early AD patients may also have abnormal emotions and mental behaviors.
More typically, they are suspicious of their spouses and children, hiding various valuables; they are indifferent to things around them, lacking emotions, and patients may also have complicated behaviors.
Instrumental daily ability impairment, such as difficulty in handling financial/tax issues, but the patient has no obvious abnormalities when examined by AD-related scales
.
The above symptoms are also of great significance for the early identification and screening of AD patients in the clinic, and laying the foundation for follow-up treatment
.
Professor Chen Xiaochun also specifically pointed out that attention should be paid to distinguish the early symptoms of AD from the "old confusion" that may occur in the elderly in traditional Chinese concepts.
The latter is mainly manifested as forgetfulness, but the patient can recall independently after being reminded.
There are obvious differences in the pathological status of recent events and forgetting.
However, due to insufficient awareness of patients and their families, some patients with mild cognitive impairment (MCI) or early AD cannot be treated in time, thus delaying the critical opportunity
.
The rate of early diagnosis of AD in China is still not ideal.
Two key problems restrict the development of early diagnosis.
In addition to the difficulties caused by the disease itself, the work of early diagnosis of AD also faces two major problems in China.
The first is the public's impairment of AD-related cognitive functions.
The second reason is the lack of professional medical teams with professional training and rich experience that can meet the needs of early diagnosis and treatment in China
.
Professor Chen Xiaochun pointed out, “There are about 100,000 neurologists in China, but previous surveys have shown that no more than 3,000 doctors specialize in the diagnosis and treatment of cognitive impairment
.
And they are facing more than 9 million AD patients (the prevalence of people over 60 years old is about 3.
9%), plus a huge population of about 38.
77 million MCI patients
.
"The situation of "more monks and less porridge" worries many medical workers.
They also want to do their best to allow more patients to receive the treatment they deserve, but they are constrained by the shortage of manpower
.
In recent years, relevant domestic associations and organizations have also We are making every effort to promote the establishment of prevention and control systems and professional outpatient clinics, such as setting up special "memory outpatient clinics" in hospitals, or through continuing education to popularize AD-related knowledge among community doctors, so as to send suspected AD patients to professional institutions and institutions as soon as possible.
Outpatient referral to improve the early diagnosis rate of AD
.
Strengthening the application of biological markers is of great significance to improving the diagnosis rate of AD.
AD diagnosis is currently mainly based on clinical manifestations to make possible AD diagnosis, but to make a diagnosis, Objective evidence of biological markers is still needed
.
Professor Chen Xiaochun pointed out that there are still two major obstacles on the way to improve the early diagnosis rate of AD: “Firstly, because there is still a lack of biological markers for accurate diagnosis of AD, doctors can only Diagnosis by clinical manifestations, the misdiagnosis rate in the real world will reach 1/3.
In recent years, there are some new detection methods abroad, such as cerebrospinal fluid tau protein detection reagents, molecular imaging detection, etc.
, but most of these methods have not been approved for application in China , I also hope that the relevant process can be accelerated; another major problem is that China has not yet included AD into the chronic disease management system.
Many patients cannot receive the ideal continuous treatment after being diagnosed.
This needs to be taken by the health, medical insurance and other departments to solve thousands of problems.
Difficulty in diagnosis and treatment of 10,000 patients"
.
With the overall development of medical science, especially the advancement of molecular biology and imaging technology, AD diagnosis has also got rid of the previous stage of neuropathological biopsy/post-mortem autopsy, and has entered an era when molecular markers have become an important basis for diagnosis.
It has been proposed The markers include Aβ40, Aβ42, tau and phosphorylated tau (such as p-tau181/217), etc.
, which can be detected by cerebrospinal fluid or PET-CT, and related diagnostic kits have been approved by the US FDA, but have not been introduced in China; Professor Chen Xiaochun also stated that some domestic medical institutions have been able to carry out Aβ, tau and other molecular marker imaging PET-CT inspections, and the inspection qualifications are internationally recognized, but the application is limited to clinical research
.
Professor Chen Xiaochun pointed out that the diagnosis of AD molecular markers has developed rapidly in China, but the application will be restricted by some objective conditions, such as equipment limitations, related testing methods are slow to be approved in China, patients and their families accept invasive cerebrospinal fluid extraction for examination and acceptance Therefore, the research focus in recent years has also shifted, such as relatively non-invasive peripheral blood for AD molecular markers
.
Professor Chen Xiaochun called for more accurate diagnostic kits to be marketed in China to empower clinical diagnosis and benefit more patients
.
AD grasp early intervention "time window", AD patients expected to delay progression to dementia five years Professor Chen Xiaochun that "the next 10--20 years may be the key to the development of the treatment of AD"
.
At present, the main focus of early intervention and precision treatment of AD is still the two classic targets of Aβ and Tau.
Monoclonal antibody drugs targeting Aβ are the main development direction.
The application needs to accurately grasp the time window
.
From the abnormal generation of Aβ to the appearance of clinical symptoms, AD patients may experience a long-term asymptomatic period of 20-30 years.
This is a theoretically ideal intervention period.
However, there is still a lack of objective indicators for judgment in clinical practice, and it is difficult to accurately grasp the timing of intervention.
, Only some patients with familial gene mutations may be able to grasp this period
.
Another ideal intervention period is the MCI/mild AD period, which is also the main indication for the exploration of anti-Aβ drugs
.
Professor Chen Xiaochun said, “From the results of existing modeling studies, effective treatment during this period is expected to delay the progression of AD patients to dementia for 5 years and reduce the number of patients by about 50%.
This data is very remarkable.
Therefore, we have been particularly looking forward to the anti-Aβ therapeutic drugs being introduced to the market as soon as possible
.
"
The treatment of tau protein is also a research hotspot, but most of them are still in the early stage of clinical research.
The progress is relatively slow compared with anti-Aβ drugs.
However, it may become a supplement to anti-Aβ drugs in the future.
Therefore, Professor Chen Xiaochun believes that anti-Aβ and Tau drugs Drugs are innovative in the field of AD treatment, and precise treatment of AD requires "grasp both hands"
.
Message At the end of the interview, Professor Chen Xiaochun left a message to AD patients and clinicians: "The theme of this year's World Alzheimer's Month is'Know dementia, Know Alzheimer's'.
It is the hope of clinicians.
Constantly strive to build a fast and benign diagnosis and treatment system, so that AD patients can be diagnosed and treated as early as possible, and the quality of life can be improved to the greatest extent
.
"In order to achieve this goal, it is necessary to increase the public awareness of AD and AD Screening rate, to maximize the role of AD prevention and treatment
.
I hope that China's AD prevention and treatment can be guided by the state from top to bottom, like the prevention and treatment of cerebrovascular disease and cancer.
At the same time, more clinical workers will participate in this A great career to create a better life for the elderly in their later years
.
"*This article is only used to provide scientific information to medical and health professionals, and does not represent platform views
.
.
Expert profile: Professor Chen Xiaochun, President of Fujian Medical University, Professor of Neurology, Fujian Medical University Affiliated Union Hospital, Professor, Chief Physician, and Doctoral Supervisor, Ministry of Education New Medical Department Working group member, vice chairman of Fujian Association of Science and Technology, executive director of Chinese Medical Doctor Association, and president-elect of the branch of neurologists, head of the Dementia and Cognitive Disorders Group of Chinese Medical Association Neurology Branch, chairman of Fujian Medical Doctors Association, has been engaged in neurodegenerative diseases for a long time The clinical diagnosis and treatment and basic research work focused on Alzheimer's disease, Parkinson's disease, and the research on the pathogenesis and prevention and treatment strategies of depression are always young, but everyone will eventually get old
.
Regarding the old life, many people have imagined that after a busy life for most of their lives, they can enjoy the good fortune, travel, go to college for the elderly.
.
.
But, for the suffering of Alzheimer's disease (AD) For the elderly, such simple happiness is indeed beyond reach
.
AD is the most common type of dementia, with insidious onset and diverse clinical manifestations.
At present, the public's understanding of AD is still insufficient
.
Every September is World Alzheimer's Month, and this year's theme is "Know Dementia, Know Alzheimer's"
.
The "medical community" specially invited Professor Chen Xiaochun, the president of Fujian Medical University, to share his views on hot issues related to AD diagnosis and treatment
.
(Interview with Professor Chen Xiaochun) The early onset of AD is hidden, and early clues need to be paid attention to.
The scientific thinking of "change" emphasizes the importance of early detection, early treatment, and prevention of disease
.
Professor Chen Xiaochun said, “Many people call AD the most serious public health problem in this century.
Early recognition, early screening, early detection, early diagnosis and early treatment of AD are needed.
Among them, some clues can be used to achieve the early stage of AD.
Recognition is equally important for clinicians and patients’ families
.
”
The onset of AD is insidious, but patients still have characteristic memory impairments in the early stages of the disease, that is, they often manifest in the form of language repetition, long-winded forgetting and episodic memory impairment
.
In addition to the manifestations of memory impairment, early AD patients may also have abnormal emotions and mental behaviors.
More typically, they are suspicious of their spouses and children, hiding various valuables; they are indifferent to things around them, lacking emotions, and patients may also have complicated behaviors.
Instrumental daily ability impairment, such as difficulty in handling financial/tax issues, but the patient has no obvious abnormalities when examined by AD-related scales
.
The above symptoms are also of great significance for the early identification and screening of AD patients in the clinic, and laying the foundation for follow-up treatment
.
Professor Chen Xiaochun also specifically pointed out that attention should be paid to distinguish the early symptoms of AD from the "old confusion" that may occur in the elderly in traditional Chinese concepts.
The latter is mainly manifested as forgetfulness, but the patient can recall independently after being reminded.
There are obvious differences in the pathological status of recent events and forgetting.
However, due to insufficient awareness of patients and their families, some patients with mild cognitive impairment (MCI) or early AD cannot be treated in time, thus delaying the critical opportunity
.
The rate of early diagnosis of AD in China is still not ideal.
Two key problems restrict the development of early diagnosis.
In addition to the difficulties caused by the disease itself, the work of early diagnosis of AD also faces two major problems in China.
The first is the public's impairment of AD-related cognitive functions.
The second reason is the lack of professional medical teams with professional training and rich experience that can meet the needs of early diagnosis and treatment in China
.
Professor Chen Xiaochun pointed out, “There are about 100,000 neurologists in China, but previous surveys have shown that no more than 3,000 doctors specialize in the diagnosis and treatment of cognitive impairment
.
And they are facing more than 9 million AD patients (the prevalence of people over 60 years old is about 3.
9%), plus a huge population of about 38.
77 million MCI patients
.
"The situation of "more monks and less porridge" worries many medical workers.
They also want to do their best to allow more patients to receive the treatment they deserve, but they are constrained by the shortage of manpower
.
In recent years, relevant domestic associations and organizations have also We are making every effort to promote the establishment of prevention and control systems and professional outpatient clinics, such as setting up special "memory outpatient clinics" in hospitals, or through continuing education to popularize AD-related knowledge among community doctors, so as to send suspected AD patients to professional institutions and institutions as soon as possible.
Outpatient referral to improve the early diagnosis rate of AD
.
Strengthening the application of biological markers is of great significance to improving the diagnosis rate of AD.
AD diagnosis is currently mainly based on clinical manifestations to make possible AD diagnosis, but to make a diagnosis, Objective evidence of biological markers is still needed
.
Professor Chen Xiaochun pointed out that there are still two major obstacles on the way to improve the early diagnosis rate of AD: “Firstly, because there is still a lack of biological markers for accurate diagnosis of AD, doctors can only Diagnosis by clinical manifestations, the misdiagnosis rate in the real world will reach 1/3.
In recent years, there are some new detection methods abroad, such as cerebrospinal fluid tau protein detection reagents, molecular imaging detection, etc.
, but most of these methods have not been approved for application in China , I also hope that the relevant process can be accelerated; another major problem is that China has not yet included AD into the chronic disease management system.
Many patients cannot receive the ideal continuous treatment after being diagnosed.
This needs to be taken by the health, medical insurance and other departments to solve thousands of problems.
Difficulty in diagnosis and treatment of 10,000 patients"
.
With the overall development of medical science, especially the advancement of molecular biology and imaging technology, AD diagnosis has also got rid of the previous stage of neuropathological biopsy/post-mortem autopsy, and has entered an era when molecular markers have become an important basis for diagnosis.
It has been proposed The markers include Aβ40, Aβ42, tau and phosphorylated tau (such as p-tau181/217), etc.
, which can be detected by cerebrospinal fluid or PET-CT, and related diagnostic kits have been approved by the US FDA, but have not been introduced in China; Professor Chen Xiaochun also stated that some domestic medical institutions have been able to carry out Aβ, tau and other molecular marker imaging PET-CT inspections, and the inspection qualifications are internationally recognized, but the application is limited to clinical research
.
Professor Chen Xiaochun pointed out that the diagnosis of AD molecular markers has developed rapidly in China, but the application will be restricted by some objective conditions, such as equipment limitations, related testing methods are slow to be approved in China, patients and their families accept invasive cerebrospinal fluid extraction for examination and acceptance Therefore, the research focus in recent years has also shifted, such as relatively non-invasive peripheral blood for AD molecular markers
.
Professor Chen Xiaochun called for more accurate diagnostic kits to be marketed in China to empower clinical diagnosis and benefit more patients
.
AD grasp early intervention "time window", AD patients expected to delay progression to dementia five years Professor Chen Xiaochun that "the next 10--20 years may be the key to the development of the treatment of AD"
.
At present, the main focus of early intervention and precision treatment of AD is still the two classic targets of Aβ and Tau.
Monoclonal antibody drugs targeting Aβ are the main development direction.
The application needs to accurately grasp the time window
.
From the abnormal generation of Aβ to the appearance of clinical symptoms, AD patients may experience a long-term asymptomatic period of 20-30 years.
This is a theoretically ideal intervention period.
However, there is still a lack of objective indicators for judgment in clinical practice, and it is difficult to accurately grasp the timing of intervention.
, Only some patients with familial gene mutations may be able to grasp this period
.
Another ideal intervention period is the MCI/mild AD period, which is also the main indication for the exploration of anti-Aβ drugs
.
Professor Chen Xiaochun said, “From the results of existing modeling studies, effective treatment during this period is expected to delay the progression of AD patients to dementia for 5 years and reduce the number of patients by about 50%.
This data is very remarkable.
Therefore, we have been particularly looking forward to the anti-Aβ therapeutic drugs being introduced to the market as soon as possible
.
"
The treatment of tau protein is also a research hotspot, but most of them are still in the early stage of clinical research.
The progress is relatively slow compared with anti-Aβ drugs.
However, it may become a supplement to anti-Aβ drugs in the future.
Therefore, Professor Chen Xiaochun believes that anti-Aβ and Tau drugs Drugs are innovative in the field of AD treatment, and precise treatment of AD requires "grasp both hands"
.
Message At the end of the interview, Professor Chen Xiaochun left a message to AD patients and clinicians: "The theme of this year's World Alzheimer's Month is'Know dementia, Know Alzheimer's'.
It is the hope of clinicians.
Constantly strive to build a fast and benign diagnosis and treatment system, so that AD patients can be diagnosed and treated as early as possible, and the quality of life can be improved to the greatest extent
.
"In order to achieve this goal, it is necessary to increase the public awareness of AD and AD Screening rate, to maximize the role of AD prevention and treatment
.
I hope that China's AD prevention and treatment can be guided by the state from top to bottom, like the prevention and treatment of cerebrovascular disease and cancer.
At the same time, more clinical workers will participate in this A great career to create a better life for the elderly in their later years
.
"*This article is only used to provide scientific information to medical and health professionals, and does not represent platform views
