Chinese expert consensus on prevention and intervention for the elderly with malnutrition (2022).

Malnutrition is a state of altered body composition and body cell mass due to inadequate intake or utilization of energy or nutrients, leading to physical and mental dysfunction and impaired clinical outcomes. As one of the most common geriatric syndromes, malnutrition in the elderly is a significant risk factor for poor clinical outcomes, causing a massive burden on medical resources and society. The risk factors for malnutrition in the elderly are diverse and include demographics, chronic diseases, and psychosocial factors. Presently, recommendations for the prevention and intervention of malnutrition in the elderly are not clear or consistent in China. This consensus is based on the latest global evidence and multiregional clinical experience in China, which aims to standardize the prevention and intervention of malnutrition in the elderly in China and improve the efficacy of clinical practice and the prognosis of elderly patients.

Connection between Systemic Inflammation and Neuroinflammation Underlies Neuroprotective Mechanism of Several Phytochemicals in Neurodegenerative Diseases.

Oxidative damage, mitochondrial dysfunction, and neuroinflammation are strongly implicated in the pathogenesis of neurodegenerative diseases including Alzheimer's disease (AD) and Parkinson's disease (PD), and a substantial portion of elderly population at risk of these diseases requires nutritional intervention to benefit health due to lack of clinically relevant drugs. To this end, anti-inflammatory mechanisms of several phytochemicals such as curcumin, resveratrol, propolis, polyunsaturated fatty acids (PUFAs), and ginsenosides have been extensively studied. However, correlation of the phytochemicals with neuroinflammation or brain nutrition is not fully considered, especially in their therapeutic mechanism for neuronal damage or dysfunction. In this article, we review the advance in antioxidative and anti-inflammatory effects of phytochemicals and discuss the potential communication with brain microenvironment by improved gastrointestinal function, enhanced systemic immunity, and neuroprotective outcomes. These data show that phytochemicals may modulate and suppress neuroinflammation of the brain by several approaches: (1) reducing systemic inflammation and infiltration via the blood-brain barrier (BBB), (2) direct permeation into the brain parenchyma leading to neuroprotection, (3) enhancing integrity of disrupted BBB, and (4) vagal reflex-mediated nutrition and protection by gastrointestinal function signaling to the brain. Therefore, many phytochemicals have multiple potential neuroprotective approaches contributing to therapeutic benefit for pathogenesis of neurodegenerative diseases, and development of strategies for preventing these diseases represents a considerable public health concern and socioeconomic burden.

Challenges of Dementia Care in China.

Dementia results in brain dysfunction, disability and dependency among affected people, causing an overwhelming burden for caregivers. China has the largest number of people with dementia worldwide and is facing severe challenges with respect to dementia care, including poor awareness of dementia in the public, inadequate knowledge of dementia for medical professionals and caregivers, an underdeveloped dementia service system, and high costs of dementia care. To address these challenges, China is taking action to increase dementia awareness and education among the public and care providers, and develop policies, services and resources for dementia care.

Neuroprotective Effect of Several Phytochemicals and Its Potential Application in the Prevention of Neurodegenerative Diseases.

The detrimental effects of oxidative stress and chronic neuroinflammation on neuronal cell death have been implicated in the pathogenesis of neurodegenerative disorders such as Alzheimer's disease (AD) and Parkinson's disease (PD). The nutritional neuroscience is quickly growing, and phytochemicals or phytobioactive compounds such as curcumin, resveratrol, propolis, ginsenoside, and ω-3 polyunsaturated fatty acids (PUFAs) have been extensively applied to potential therapeutic purposes for numerous neurodegenerative diseases for their anti-oxidative and anti-inflammatory effects. However, their administration as food supplements in the daily diet of the elderly is normally a voluntary and less-organized behavior, indicating the uncertainty of therapeutic effects in this sporadic population; specifically, the effective physiological dosages and the real positive effects in preserving brain health have not yet been fully elucidated. In this review, we collect several lines of evidence on these compounds, which constitute a major type of nutraceuticals and are widely integrated into the daily anti-aging caring of elderly patients, and discuss the underlying anti-oxidative and anti-inflammatory mechanisms of these phytochemicals. In conclusion, we highlight the implications of these compounds in the prevention and treatment of geriatric diseases, and of the potential supplementation procedures used as a dietary therapeutic program in clinical nursing services for patients with neurodegenerative diseases or for the elderly in certain communities, which we hope will lead to more beneficial health outcomes with respect to brain function, innate immunity, and gastrointestinal function, as well as more economic and social benefits.

Overview of Chinese research on senile dementia in mainland China.

Studies of senile dementia (SD) on the Chinese mainland, done over the decades, have furthered the understanding of its epidemiology, basic and clinical medical aspects, and effects on health economics, to name a few areas. There are 6-7 million Chinese people with SD, with an incidence of 5-7% of people over 65 years of age. In this group, Alzheimer's accounts for 50-60% of SD. The pathogenesis of Alzheimer's disease has been investigated, and known risk factors include ß-amyloid, formaldehyde, acetyl cholinesterase, inflammation, neuronal dysfunction and death. Mild cognitive impairment (MCI) is an independent risk factor of SD. Comprehensive treatment can improve clinical efficacy, and quality of life can be improved by appropriate and reasonable care and rehabilitation therapy. However, swallowing disorders, infection and systemic failure remain the main causes of death among SD patients. In the Chinese mainland, SD extracts a total annual economic loss of 83.5-97.4 billion yuan and is responsible for 51.3-59.8 billion yuan in annual healthcare costs. Despite the progress to date, basic research and drug development for SD are needed. Also, a more evidence-based approach to Chinese medicine research would be prudent. Such research results can hopefully provide valuable cues for governmental decision-making and assist in addressing and halting the incidence of SD in China.

Aging Beijing: challenges and strategies of health care for the elderly.

Following the global trend of population aging, China became an aging society at the end of the 20th century. The ever-growing medical demands of the elderly, the lag in medical insurance policy, and the late development of geriatric services make the present situation of public health in China worrying. To meet these challenges, the Beijing municipal government has actively adjusted its development strategies and has been building up a medical service and healthcare system suitable for the elderly. The core of the system is a three-level management of geriatric diseases: prevention and treatment for chronic diseases, functional rehabilitation, long-term care, and family attendance at rural and urban community health service centers (stations); post-acute rehabilitation, long-term care, and palliative treatment in the specialized geriatric hospitals of every district (county); and rescue and treatment for acute and serious geriatric diseases in the geriatric sections of all general hospitals and Beijing Geriatric Hospital. By raising awareness and gaining support from all of society, the implementation of this system will benefit millions of elderly people and promote the sustainable financial development and social harmony of Beijing.

Falls in aged people of the Chinese mainland: epidemiology, risk factors and clinical strategies.

Falls are a common and serious problem for aged people, causing an enormous amount of morbidity, mortality and burden to both the immediate family and the society in terms of healthcare utilization and costs. In the Chinese mainland, epidemiological data indicates a predilection for single falls, with women more at risk than men. A variety of risk factors such as weakness, unsteady gait, mental confusion and use of certain medications are associated with falls in the elderly. Addressing these risk factors can be expected to reduce rates of falling. Targeted fall risk assessments are the most effective preventive procedures, and include a plethora of assessment instruments that have been developed and designed for different purposes over the decades. Strategies for control of elderly falls have been established differently, taking into account the complex physiological and pathological conditions of the elderly. The optimal approach involves interdisciplinary assessments, physical exercise, medical intervention, environmental inspection and hazard abatement. In China, the 25 million falls suffered annually by the estimated 20 million elderly population exacts direct medical costs of about 5 billion yuan and social costs of 60-80 billion yuan. Fall-prevention strategies will thus have profound social and economic benefits.

[The database and its data sharing of neuropathic images].

This paper introduces the basic principle and method of establishing a database for neuropathic images, and discusses its significance and data sharing. The database is composed of three data volumes about basic knowledge for images, cranial sectional anatomy and neuropathic images. The data sharing is achieved by using a method of linking the dynamic network of neuropathic images with database of neuropathic images. There are three searching approaches: catalog searching, key words searching and code searching.