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The "China Alzheimer's Disease Report 2024" was recently released at a conference held at Renji Hospital, affiliated with Shanghai Jiao Tong University School of Medicine. The report indicates that as of 2021, there are over 16.99 million cases of Alzheimer's disease (AD) in China, with an incidence rate of 1194.2 per 100,000 people and a mortality rate of 34.6 per 100,000.

Alzheimer's disease is a chronic neurodegenerative disorder that is prevalent globally. This report, collaboratively compiled by various government bodies and universities in China, provides a detailed regional perspective on the disease.

Professor Wang Gang from Renji Hospital, the lead initiator of the report, stated that this dynamic report compares the burden, mortality, incidence, and prevalence of AD and other dementias in China and globally. It summarizes the current state of neuroimaging, neuropsychological assessments, fluid biomarkers, and genetic testing in China, revealing the country's diagnostic and treatment landscape for AD. It also meets the information needs of relevant groups by providing public support information, such as medical consultation, insurance policies, healthcare resource allocation, and related care services. Utilizing internet technology, the report offers a "Memory Clinic Map" and the "Shanghai Brain Health Alliance Cognitive Map."

Gender Differences in AD and Other Dementias

The "China Alzheimer's Disease Report 2024" highlights that the prevalence and mortality rates of AD and other dementias in China are slightly higher than the global average, with women showing higher rates than men. Women's prevalence rate is 1558.9 per 100,000, and the mortality rate is 47.4 per 100,000, compared to men's prevalence rate of 846.3 per 100,000 and a mortality rate of 22.5 per 100,000. Age-specific data shows that the mortality rate and number of deaths from AD and other dementias increase with age, peaking in the 80+ age group. In this age group, the mortality rate for men is 780.5 per 100,000 (102,135 deaths), while for women, it is 1228.4 per 100,000 (243,253 deaths). The report also notes that in 2021, there were 1.955 million deaths globally due to AD and other dementias, with China accounting for 492,774 of these deaths, representing 25.2% of the global total. From 1990 to 2021, China's crude incidence rate of AD and other dementias increased by 242.5%.

Is Genetic Testing Suitable for Everyone?

Common imaging methods for AD clinical diagnosis include magnetic resonance imaging (MRI) and computed tomography (CT). MRI is preferred for its clearer imaging of brain tissue. For those unable to undergo MRI due to metal implants or claustrophobia, multi-slice CT thin-layer scanning is recommended. Besides imaging, molecular imaging methods such as Aβ pathology biomarkers and fluid biomarkers from cerebrospinal fluid, blood, and urine, as well as neuropsychological assessments, are used. However, these methods are currently insufficient for early rapid screening and diagnosis of AD. Genetic testing is primarily relied upon for early screening, but the report highlights many issues and confusion regarding the purpose, methods, and interpretation of results of genetic testing for AD and related cognitive impairments. Familial AD is rare, accounting for only 5%, and early-onset autosomal dominant AD is even rarer, at 1%. This means widespread genetic testing would pose a significant financial burden on China's healthcare system and patients. Therefore, the report does not recommend genetic testing for everyone.

Prevention and Treatment of AD

The report mentions that China's current prevention and treatment strategies mainly involve non-pharmacological community interventions such as cognitive, exercise, computer, and VR training to enhance patients' overall cognitive abilities. Professor Wang Gang noted that many hospitals in China's large and medium-sized cities have established memory clinics, renamed from the original "dementia clinics" or "Alzheimer's clinics." By 2022, China had established 273 memory clinics.

"Memory clinics can offer patients with abnormal self-assessment scales comprehensive evaluations, including physical exams, professional neuropsychological tests, blood tests, imaging, electrophysiological exams, and, when possible, cerebrospinal fluid tests, positron emission tomography, and genetic testing. These clinics diagnose and assess the severity of cognitive impairment and develop pharmacological or non-pharmacological treatment plans," Wang said.

According to the "2023 China Alzheimer's Disease: Facts and Figures" survey results, awareness and timely consultation rates for AD have significantly increased in recent years.

"Currently, the Chinese government and society are paying increasing attention to cognitive impairment diseases like Alzheimer's disease. However, there is still room for improvement in intervention and diagnosis and treatment levels, which require the involvement of multiple medical disciplines," Wang acknowledged. He also mentioned that at his institution, Renji Hospital in Shanghai, a specialized integrated cognitive disorder clinic has been established. This clinic is led by neurologists and supported by nuclear medicine, radiology, psychology, rehabilitation, and neurosurgery departments. All specialists will be present in the same clinic to discuss cases and develop individualized diagnostic and treatment plans for patients.