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The 10/66 Dementia Research Group has been formed to promote good-quality, internationally comparable research into dementia in developing countries through active research collaboration. In this position paper, we review existing research into dementia prevalence in developing regions of the world. Seven methodologically robust studies were identified. The prevalence of dementia, age-adjusted to the age structure of the Kerala population, ranged from 1.3% to 5.3% for all those aged 60 or over and from 1.7% to 5.2% for all those aged 65 and over. Two studies, from Ibadan, Nigeria and Ballabgarh, India, reported strikingly low prevalence figures. The reported prevalence for most studies was somewhat lower than the consistent figures for Europe reported by the EURODEM concerted action. Based on critical review of the literature, and on the practical research experience of members of the 10/66 group, recommendations have been made for procedure in the following areas: age limits for inclusion in dementia surveys, age ascertainment, sampling, scope for incidence studies, functional assessment and culture- and education-fair dementia diagnosis., (Copyright 2000 John Wiley & Sons, Ltd.)

Aims and Objectives: To evaluate the effectiveness of horticultural therapy on cognitive function, agitation, positive emotion and engagement in people with dementia., Background: The number of people with dementia is increasing rapidly, and nonpharmacological interventions such as horticultural therapy have been recommended as the first choice for these patients. Horticultural therapy involves participatory and ornamental horticultural therapy. Many original studies have examined the effectiveness of horticultural therapy in the last two decades. However, these studies vary in types of interventions, outcomes and measurement., Design: A quantitative systematic review and meta-analysis., Methods: This systematic review was conducted under PRISMA guidelines. Randomised controlled trials (RCTs) and quasi-experimental studies involving horticultural therapy for people with dementia were included. Risk of bias was assessed by the Cochrane's and Joanna Briggs Institute's tool. Reference lists and a relevant journal were searched. Meta-analyses were conducted using RevMan 5.3. PubMed, CINAHL, Embase, BIOSIS Previews, Web of Science Core Collection, China National Knowledge Infrastructure, Wanfang, SinoMed, Cochrane Library and ProQuest Health & Medical Complete were searched. Studies from database inception to 1 July 2019 were included., Results: This systematic review included 14 studies (4 RCTs and 10 quasi-experimental studies) involving 411 people with dementia. The results of meta-analyses indicated that significant differences were found in the effectiveness of participatory horticultural therapy on total score of cognitive function, agitation, positive emotion and engagement, but not in the effectiveness of ornamental horticultural activities on agitation and positive emotion., Conclusions: The existing evidence supports the effectiveness of participatory horticultural therapy on cognitive function, agitation, positive emotion and engagement. Future high-quality original studies are needed to draw more robust conclusions., Relevance to Clinical Practice: The results support the use of participatory horticultural therapy for improving cognitive function, agitation, positive emotion and engagement of people with dementia., (© 2020 John Wiley & Sons Ltd.)

China has the largest number of patients with dementia in the world. However, dementia in the Chinese population is still poorly understood and under-researched. Given the differences in genetic, demographic, sociocultural, lifestyle, and health profiles among Chinese and other ethnic/racial groups, it is crucial to build appropriate infrastructure for long-term longitudinal studies to advance Chinese cognitive aging and dementia research. We initiated a community-based prospective cohort-the Taizhou Imaging Study (TIS)-to accelerate the understanding of dementia and cerebrovascular diseases in Chinese. This article presents the rationale, aims, study design, and organization of TIS. In addition, we described some examples of the types of studies such a resource might support. The TIS provides a new framework for facilitating Chinese dementia research, encompassing invaluable resources including detailed epidemiological, sociocultural, neuroimaging, and omics data., (© 2020 the Alzheimer's Association.)

Aims: The objective of this study was to examine the relationship between caregiving burden and pre-death grief, with a specific focus on adult-child caregivers in mainland China. Additionally, the study explored whether coping strategies played a mediating role in this correlation., Methods: A convenience sample of 320 adult-child caregivers of older parents with dementia from Kunming, mainland China, was recruited for the study. Data were collected using the Chinese version of the Marwit-Meuser Caregiver Grief Inventory-Short Form, the Burden Scale for Family Caregivers, and the Ways of Coping Checklist-Revised., Results: Results using linear regression and multiple mediation analysis with Hayes' process model indicated that caregiving burden was positively related to pre-death grief and that active coping mediated the relationship between them. In the female group, active coping partially mediated the association between caregiving burden and pre-death grief, but in the male group, this mediating effect did not exist., Conclusion: The study found evidence supporting the link between caregiving burden and pre-death grief among adult-child caregivers of older parents with dementia in mainland China. Furthermore, the caregiving burden prevented the use of active coping, and this decrease in coping increased the perception of pre-death grief. These associations only existed in the female group., Implications: This paper presented the importance of active coping skills in the dementia caregiving process., Impact: The findings of this study emphasize the necessity for health practitioners to provide targeted interventions regarding pre-death grief among dementia caregivers and strengthen caregivers' active coping strategies to reduce their pre-death grief. Community-based and personal care support services should be promoted to alleviate their caregiving burden., Reporting Method: We have adhered to the transparent reporting of evaluations with quantitative design statements and the corresponding checklist was followed. PATIENT OR PUBLIC CONTRIBUTION: 'No patient or public involvement'., (© 2024 The Authors. Journal of Advanced Nursing published by John Wiley & Sons Ltd.)

Background: Due to the time-dependent effect of specific risk factors for dementia, multidomain interventions based on a life-course model might achieve optimal preventive effects against dementia., Objective: The purpose of this study was to investigate the effectiveness of multidomain interventions based on a life-course model of modifiable risk factors for dementia in at-risk Chinese older adults., Design: This was a two-arm, proof-of-concept, randomized controlled trial., Setting and Participants: We randomly assigned 96 community-dwelling at-risk adults aged 60 years or older in a 1:1 ratio to either the 6-month multidomain intervention group (dementia literacy, physical activity, cognitive training, social activity and optional modules) or the control group (health education)., Methods: The primary outcomes were the dementia risk score and cognitive composite Z score. The secondary outcomes included the individual components of the dementia risk score (protective and risk factors) and cognitive composite Z score (global cognition, memory, executive function and language), social isolation (loneliness, social contact, and social participation), dementia literacy and prevention belief. Linear mixed models with maximum likelihood estimation were used to calculate the outcomes between the groups over time., Results: The primary analyses showed that the dementia risk score was significantly lower (p < 0.001) and that the cognitive composite Z score was significantly higher (p = 0.013) in the multidomain intervention group than in the control group. Baseline characteristics did not modify the effects of the multidomain interventions (p value for interaction > 0.05). For secondary outcomes, statistically significant group × time interactions were observed for the protective (p = 0.001) and risk factors (p = 0.049), as well as in executive function (p = 0.020), loneliness (p = 0.029), dementia literacy (p < 0.001) and prevention belief (p < 0.001)., Conclusions: Multidomain interventions based on a life-course model are feasible and have the potential to reduce dementia risk and improve cognitive function in at-risk Chinese older adults., Registration: The trial was registered at the Chinese Clinical Trials Registry (ChiCTR2100053417)., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Limited evidence is available regarding the impact of ambient inhalable particulate matter (PM) on mental disorder (MD) or dementia-related deaths, particularly PM 1 , PM 1-2.5, and coarse particles (PM 2.5-10 ). Moreover, individual confounders have rarely been considered. In addition, evidence from low-pollution areas is needed but is inadequate. Using death records from the Death Registration System during 2015-2021 in Ningde, a coastal city in southeast China, we combined a conditional quasi-Poisson model with a distributed lag nonlinear model to estimate the nonlinear and lagged associations of PM exposure with MD or dementia-related deaths in Ningde, China, comprehensively controlling for individual time-invariant confounders using a time-stratified case-crossover design. The attributable fraction and number were calculated to quantify the burden of MD or dementia-related deaths that were related to PMs. We found J-shaped relationships between MD or dementia-related deaths and PMs, with different thresholds of 13, 9, 19, 33 and 12 μg/m 3 for PM 1 , PM 1-2.5 , PM 2.5 , PM 10 and PM 2.5-10 . An inter-quartile range increase for PM 1 , PM 1-2.5 , PM 2.5 , PM 10 and PM 2.5-10 above the thresholds led to an increase of 31.8% (95% confidence interval, 14.3-51.9%), 53.7% (22.4-93.1%), 32.6% (15.0-53.0%), 35.1% (17.7-55.0%) and 25.9% (13.0-40.3%) in MD-related deaths at lag 0-3 days, respectively. The associations were significant in the cool season rather than in the warm season and were significantly greater among people aged 75-84 years than in others. The fractions of MD-related deaths attributable to PM 1 , PM 1-2.5 , PM 2.5 , PM 10 and PM 2.5-10 were 5.55%, 6.49%, 7.68%, 10.66%, and 15.11%, respectively; however, only some of them could be protected by the concentrations recommended by the World Health Organisation or China grade I standard. Smaller associations and similar patterns were observed between PMs and dementia-related death. These findings suggest stricter standards, and provide evidence for the development of relevant policies and measures., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

Background: In this prospective study, we evaluated the usefulness of the advanced dementia prognostic tool (ADEPT) for estimating the 2-year survival of persons with advanced dementia (AD) in China., Methods: The study predicted the 2-year mortality of 115 persons with AD using the ADEPT score., Results: In total, 115 persons with AD were included in the study. Of these persons, 48 died. The mean ADEPT score was 13.0. The AUROC for the prediction of the 2-year mortality rate using the ADEPT score was 0.62. The optimal threshold of the ADEPT score was 11.2, which had an AUROC of 0.63, specificity of 41.8, and sensitivity of 83.3., Conclusions: The ADEPT score based on a threshold of 11.2 may serve as a prognostic tool to determine the 2-year survival rate of persons with AD in Chongqing, China. However, further studies are needed to explore the nature of this relationship., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier Inc. All rights reserved.)

Objectives: To assess the psychometric properties of Chinese version of Motivation to Change Lifestyle and Health Behaviors for Dementia Risk Reduction (MCLHB-DRR) scale in Chinese community-dwelling older adults., Methods: A convenience sample of 150 Chinese adults aged ≥50 was recruited from local community facilities. Reliability of MCLHB-DRR was evaluated using internal consistency and test-retest reliability over two weeks. Content validity and construct validity were assessed. Translation process followed Brislin's translation model., Results: After excluding two items with poor loadings, the confirmatory factor analysis revealed a good model fit (χ2/df=2.14; CFI=0.91; IFI=0.91; RMSEA=0.087). The scale exhibited good internal consistency (Cronbach's alpha = 0.865), as well as acceptable test-retest reliability (ICC=0.730)., Conclusions: The Chinese MCLHB-DRR showed satisfactory psychometric properties, providing valuable insights for promoting dementia risk reduction in Chinese population, considering cultural nuances that shape motivations and knowledge of lifestyle changes., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier Inc. All rights reserved.)

Accessible Summary: What is known on the subject?: Physical restraint is widely used in the elderly at home, and cognitive impairment is an important risk factor. Family caregivers of people with dementia are the main decision makers and implementers of physical restraint at home.Most people with dementia in China receive home care, and family caregivers face enormous care and moral pressures influenced by Confucian culture.Current research on physical restraints focuses on quantitative analysis of its prevalence and reasons within the institutions. There is little research on how family caregivers perceive physical restraints in home care context, especially under Chinese culture. What the paper adds to existing knowledge?: Many family caregivers face approach – avoidance conflict and moral dilemmas when making decisions to restrain, and they make difficult choices in these dilemmas.In China, family caregivers are influenced by many unique factors, including traditional Confucian culture, family affection, and rural home environment.Inadequate laws and policies provide the ground for abuse of physical restraints, and family caregivers rarely consider legal and policy restrictions when using physical restraints. What are the implications for practice?: With limited medical resources, nurse‐led dementia management is the hope to reduce physical restraints in home.Mental health nurses need to assess for the appropriateness of physical restraints associated with psychiatric symptoms in people with dementia.At both organizational and community levels, improving effective communication and relationships between professionals and family caregivers are important to address. Improvements in this context require education and time for staff to develop skills and experience which is necessary to provide family caregivers with ongoing information and psychological support within their communities.Considering Confucian culture will be of value for mental health nurses working in other countries where there are Chinese communities to better understand perceptions of family caregivers. Introduction: The use of physical restraints is a common practice in home care. Family caregivers face care‐related and moral pressures due to the influence of Confucian culture in China. The use of physical restraints in the Chinese cultural environment may differ from the use of such restraints in other cultures. Scientific Rationale: Current research on physical restraints focuses on quantitative analysis of its prevalence and reasons within the institutions. However, there is little research on how family caregivers perceive physical restraints in home care context, especially under Chinese culture. Aim: To explore the perceptions of family caregivers on physical restraints in people diagnosed with dementia receiving home care. Method: A descriptive, qualitative study of Chinese family caregivers of people diagnosed with dementia in home care. Framework method analysis was adopted using the multilevel socio‐ecological model. Results: Beliefs about benefit lead to a dilemma for family caregivers. Cherishing family's affection encourages caregivers to reduce physical restraints, but lack of help from family members, professionals and the community forces them to restrain their loved ones. Discussion: Future research should explore the complex issue of culturally specific physical restraints decisions. Implications for Practice: Mental health nurses must receive education regarding the negative outcomes of the use of physical restraints for family members of people diagnosed with dementia. A more liberal approach to mental health and relevant legislation, which is an emerging global phenomenon that is currently in an early phase of development in China, grants human rights to people diagnosed with dementia. Effective communication and relationships between professionals and family caregivers can contribute to the establishment of a dementia‐friendly community in China. [ABSTRACT FROM AUTHOR]

Background and Aims: Dementia is recognized globally as a massive burden on public health and wider society. It is a major cause of disability and mortality amongst older people. China has the largest population of people with dementia worldwide, accounting for approximately 25% of the entire global population of people with dementia. The study investigated the perceived experiences of care giving and care receiving in China, with one area identified in the data concerning the extent to which the participants discussed death. The research also explored the meaning of living with dementia in modern China, where the economy, demography and culture are rapidly changing., Method: The qualitative approach of interpretative phenomenological analysis was used for this study. Semi-structured interviews were used for data collection., Finding: The paper reports on one specific finding concerning death as a way out of the situation that participants found themselves in., Conclusion: The study described and interpreted one of the specific issues, 'death', in the participants' narratives. This finding reflects how psychological and social factors, such as stress, social support, healthcare cost, caring burden and medical practice have created the participants' thoughts of 'wishing to die' and the reasons why they believe 'death is a way to reduce burden'. It calls for an understanding, supportive social environment and a reconsideration of a culturally and economically appropriate family-based care system.

It remains unclear whether a total exposure to air pollution (AP) is associated with an increased risk of dementia. Little is known on the association in low- and middle-income countries. Two cohort studies in China (in Anhui cohort 1402 older adults aged ≥ 60 followed up for 10 years; in Zhejiang cohort 6115 older adults followed up for 5 years) were conducted to examine particulate matter - PM 2.5 associated with all dementia and air quality index (AQI) with Alzheimer's disease, respectively. A systematic literature review and meta-analysis was performed following worldwide literature searched until May 20, 2020 to identify 15 population-based cohort studies examining the association of AP with dementia (or any specific type of dementia) through PubMed, MEDLINE, PsycINFO, SocINDEX, CINHAL, and CNKI. The cohort studies in China showed a significantly increased relative risk (RR) of dementia in relation to AP exposure; in Anhui cohort the adjusted RR was 2.14 (95% CI 1.00-4.56) in people with PM 2.5 exposure at ≥ 64.5 μg/m 3 versus <63.5 μg/m 3 and in Zhejiang cohort the adjusted RR was 2.28 (1.07-4.87) in AQI>90 versus ≤ 80. The systematic review revealed that all 15 studies were undertaken in high income countries/regions, with inconsistent findings. While they had reasonably good overall quality of studies, seven studies did not adjust smoking in analysis and 13 did not account for depression. Pooling all eligible data demonstrated that dementia risk increased with the total AP exposure (1.13, 1.08-1.19). Data analysis of air pollutants showed that the RR significantly increased with PM 2.5 (1.06, 1.03-1.10 in 2nd tertile exposure; 1.13, 1.07-1.19 in 3rd tertile versus 1st tertile), PM 10 (1.05, 0.86-1.29; 1.62, 0.60-4.36), carbon monoxide (1.69, 0.72-3.93; 1.52, 1.35-1.71), nitrogen dioxide (1.06, 1.03-1.09; 1.18, 1.10-1.28) and nitrogen oxides (1.09, 1.04-1.15; 1.26, 1.13-1.41), but not ozone. Controlling air pollution and targeting on specific pollutants would reduce dementia globally., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023. Published by Elsevier Inc.)

Objectives: Whether household air pollution is associated with dementia risk remains unknown. This study examined the associations between solid fuel use for cooking and heating (the main source of household air pollution) and dementia risk., Methods: This analysis included data on 11,352 participants (aged 45+ years) from the 2011 wave of China Health and Retirement Longitudinal Study, with follow-up to 2018. Dementia risk was assessed by a risk score using the Rotterdam Study Basic Dementia Risk Model (BDRM), which was subsequently standardized for analysis. Household fuel types of cooking and heating were categorized as solid (e.g., coal and crop residue) and clean (e.g., central heating and solar). Multivariable analyses were performed using generalized estimating equations. Moreover, we examined the joint associations of solid fuel use for cooking and heating with the BDRM score., Results: After adjusting for potential confounders, we found an independent and significant association of solid (vs. clean) fuel use for cooking and heating with a higher BDRM score (e.g., β = 0.17 for solid fuel for cooking; 95% confidence interval [CI]: 0.15-0.19). Participants who used solid (vs. clean) fuel for both cooking and heating had the highest BDRM score (β = 0.32; 95% CI: 0.29-0.36). Subgroup analysis suggested stronger associations in participants living in rural areas., Conclusions: Solid fuel use for cooking and heating was independently associated with increased dementia risk in Chinese middle-aged and older adults, particularly among those living in rural areas. Our findings call for more efforts to facilitate universal access to clean energy for dementia prevention., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022 Elsevier Inc. All rights reserved.)

Dementia has been cited as a critical public health risk in the contemporary world, while few empirical researchers try to reveal the casual relationship between air pollutant concentrations (APCs) and dementia, especially given the increasing prevalence of air pollution on a global scale. Accordingly, this paper tries to infer the causal relationship between APCs and dementia. The 59,605 valid data was compiled through a combination of the statistic from the China Family Panel Study, China Environmental Statistics Yearbook, World Meteorological Association and China National Bureau of Statistics. The RD design of this study utilizes the discontinuous variation in APCs and dementia as one crosses the Huai River boundary, which is an arbitrary heating policy that causes the significant difference in APCs between the north and south of China. We used stata17.0 to analyze the data. The results of the RD regression indicated that a 100 μ g/m 3 rise in APCs led to an increase of 42.4% in the hazard ratio of suffering dementia (Coeff=-0.58, SD= 0.23, P < 0.05). Meanwhile, heterogeneous models revealed that the hazard ratio of suffering dementia by APCs was more significant in the older compared to younger (coeff= 1.35 vs coeff= 1.55, P < 0.05), male compared to female (coeff= 1.62 vs coeff= 0.71, P < 0.05), smoking compared to non-smoke (coeff= 2.12 vs coeff= 0.93, P < 0.05), and thin groups compared to medium and obesity (coeff= 2.05 vs coeff= 1.22, coeff= 1.28, P < 0.05). In addition, the O3 and SO2 were the air pollutants with the highest (coeff= 1.54, P < 0.05) and lowest effects (coeff= 0.81, P < 0.05) on the hazard ratio of suffering dementia among the five APCs, respectively. And the robustness of the results was ensured by changing the RD bandwidth, polynomial order. The results indicated that APCs significantly induced the hazard ratio of suffering dementia of Chinese residents, which provides empirical evidence in supporting the Chinese government to invest more in combating air pollution and ensure the public health of Chinese residents., (© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Aim: This study aimed to describe levels of social support and explore the factors predictive of social support for Chinese family caregivers of patients with dementia. Background: Social support levels and their predictive factors in Chinese dementia caregivers have not been well documented, which need to be further clarified to provide a basis for creating effective social support strategies. Methods: This was a cross‐sectional study with 91 participants who completed a demographic questionnaire and the Social Support Rating Scale from 2015 to 2016. Results: Chinese family caregivers of patients with dementia received moderate social support. Caregivers' subjective support domain scores and support utilization domain scores were significantly lower than those of the normal Chinese population, whereas caregivers' total social support scores were higher than those of the normal Chinese population. Family caregivers' monthly household income, educational level and place of residence were predictors of their own social support. Conclusion: Social support in Chinese caregivers of patients with dementia needs to be improved, especially the subjective support and support utilization. Healthcare professionals should pay special attention to caregivers with a lower monthly household income and educational level and caregivers who lived in the suburban area. Summary statement: What is already known about this topic? Social support is important for family caregivers of patients with dementia.Social support levels and their predictive factors in Chinese dementia caregivers have not been well documented. What this paper adds? Caregivers' subjective support and support utilization were significantly lower than the normal Chinese population; caregivers' total social support was significantly higher than the normal Chinese population.The best predictors of caregivers' social support were the monthly household income, educational level and place of residence of the caregivers. The implications of this paper: Healthcare professionals should pay special attention to caregivers with a lower monthly household income and educational level and caregivers who lived in the suburban area.Future research is needed to create effective nursing regimes, paying attention to caregivers with a lower educational level and caregivers who lived in the suburban area. [ABSTRACT FROM AUTHOR]

Background: Dementia is a progressive neurodegenerative condition, while metabolic syndrome (MetS) is characterized by a combination of metabolic abnormalities such as hypertension, high blood sugar, and obesity. There exists a connection and overlap between the two conditions in certain aspects, and both are influenced to varying degrees by the process of aging. This study presents an overview of the current research landscape regarding dementia and MetS through bibliometric analysis. Methods: A systematic search was conducted to retrieve relevant literature on dementia and MetS published between 1 January 2000, and 30 November 2023, from the Web of Science Core Collection database. Various bibliometric tools, including VOSviewer, CiteSpace, and the R software package “bibliometrix,” were utilized for analysis. Results: A total of 717 articles were identified, showing an upward trend in annual publications. Leading contributors included the United States, Italy, and China, with institutions such as the University of California System at the forefront. The Journal of Alzheimer’s Disease emerged as the top publisher, while research published in Neurology garnered significant citations. Noteworthy authors encompassed Panza, Francesco; Frisardi, Vincenza; and Feldman, Eva L, with Kristine Yaffe being the most cited author (280 citations). Recent studies have focused on themes like “gut microbiota,” “neuroinflammation,” “fatty acids,” and “microglia.” Conclusion: This bibliometric analysis summarizes the foundational knowledge structure in the realm of dementia and MetS from 2000 to 2023. By highlighting current research frontiers and trending topics, this analysis serves as a valuable reference for researchers in the field. [ABSTRACT FROM AUTHOR]

Objectives: This systematic review and meta‐analysis aimed to determine the prevalence of loneliness and social isolation among informal carers of individuals with dementia and to identify potential influencing factors. Methods: We conducted a comprehensive search across 10 electronic databases, including PubMed, Cochrane, Embase, Web of Science, PsycINFO, CINAHL, Scopus, Chinese Biomedical, China National Knowledge Internet, and WANFANG. Our search strategy covered the inception of the databases up to September 16, 2023, with an updated search conducted on March 8, 2024. Prevalence estimates of loneliness and social isolation, presented with 95% confidence intervals, were synthesized through meta‐analysis. Subgroup analyses and meta‐regression were employed to explore potential moderating variables and heterogeneity. Results: The study encompassed 27 research papers involving 11,134 informal carers from 17 different countries. The pooled prevalence of loneliness among informal carers of individuals with dementia was 50.8% (95% CI: 41.8%–59.8%), while the pooled prevalence of social isolation was 37.1% (95% CI: 26.7%–47.6%). Subgroup analyses and meta‐regression indicated that various factors significantly influenced the prevalence of loneliness and social isolation. These factors included the caregiving setting, study design, the intensity of loneliness, geographical location (continent), data collection time, and the choice of assessment tools. Conclusions: This study underscores the substantial prevalence of loneliness and social isolation among informal carers of individuals with dementia. It suggests that policymakers and healthcare providers should prioritize the development of targeted interventions and support systems to alleviate loneliness and social isolation within this vulnerable population. Key points: Informal carers of people with dementia contend with unique circumstances that render them susceptible to both loneliness and social isolation.There is a significant prevalence of loneliness and social isolation in informal carers of individuals with dementia.Several significant moderators influence the prevalence of loneliness and social isolation among informal carers of individuals with dementia.Moderator analysis can guide targeted interventions and support systems for at‐risk informal carers of people with dementia to alleviate loneliness and social isolation. [ABSTRACT FROM AUTHOR]

Background: Short-term exposure to ambient air pollution has been linked to an increased risk of mortality from a variety of causes, but its effects on mortality from dementia remain largely unknown., Objectives: To investigate the association between short-term exposure to ambient air pollution and dementia mortality, and quantitatively assess the excess mortality., Methods: In this time-stratified case-crossover study, 47,108 dementia deaths were identified in Jiangsu province, China during 2015-2019. Exposure to particulate matter with an aerodynamic diameter ≤ 2.5 μm (PM 2.5 ), PM 10 , sulfur dioxide (SO 2 ), nitrogen dioxide (NO 2 ), carbon monoxide (CO), and ozone (O 3 ) was assessed by extracting daily concentrations from a validated grid dataset based on each subject's residential address. Conditional logistic regression models were applied for exposure-response analyses., Results: There were 47,108 case days and 159,852 control days during the study period. Each 10 μg/m 3 increase of lag 04-day exposure to PM 2.5 , PM 10 , and NO 2 was significantly associated with a 1.43 % (95 % CI: 0.77, 2.09 %), 1.06 % (0.59, 1.54 %), and 2.80 % (1.51, 4.10 %) increase in odds of dementia mortality, corresponding to an excess mortality of 4.87 %, 5.50 %, and 6.43 %, respectively. We estimated that reducing ambient air pollutant exposures to the WHO air quality guidelines would avoid up to 4.17 % of the dementia deaths, while the ambient air quality standards in China would only help avoid up to 0.39 %., Conclusions: This study provides consistent evidence that short-term exposure to PM 2.5 , PM 10 , and NO 2 is associated with increased odds of dementia mortality, which can be translated to a considerable excess mortality. Our findings highlight a potential approach to prevent deaths from dementia by reducing individual exposures to ambient air pollution, especially in areas with high levels of ambient air pollution., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022 Elsevier B.V. All rights reserved.)

Background: Pisa syndrome (PS) is rarely reported in Dementia with Lewy bodies (DLB). The aim of this article is to investigate the prevalence rate of PS and the correlation with clinical features evaluated in patients with DLB., Methods: A total of 209 DLB patients were consecutively recruited and underwent standardized clinical evaluation in our multicenter study. The associations between PS and clinical factors were evaluated., Results: The prevalence rate of PS in patients with DLB was 15.3%, which was higher in the moderate and severe stages than mild cognitive impairment and mild stages (81.2% vs. 18.8%). Patients with PS had a longer duration of disease (P = 0.020) and parkinsonism (P = 0.003), higher scores of NPI (P = 0.028), ADL (P = 0.002) and UPDRS part III (P &lt; 0.001), lower scores of clock drawing test (P = 0.009), visuospatial/executive abilities (P = 0.018), attention (P = 0.020), language and praxis (P = 0.020), registration (P = 0.012), greater H&Y stage (P &lt; 0.001), and higher proportion of cholinesterase inhibitors used (P = 0.044) than those without PS. Longer disease duration (OR = 1.166, P = 0.023), presence of parkinsonism (OR = 7.971, P = 0.007), moderate and severe dementia (OR = 3.215, P = 0.021) were associated with the presence of PS. Patients had a longer duration of PS (P = 0.014) and lower mean age of onset (P = 0.040) in the group with severe lateral trunk flexion., Conclusion: The development of PS may be associated with longer disease duration, the presence of parkinsonism and severe stages of dementia in DLB. Cholinesterase inhibitors may have a correlation with PS. The severity of lateral flexion is related to the duration of PS and mean age of onset., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

Aims and Objectives: To establish an understanding of healthcare professionals' dementia knowledge and attitudes towards dementia care, and family carers' perceptions of dementia care in China., Background: Healthcare professionals and family carers of people with dementia deliver most of the dementia care in China. However, little research on healthcare professionals' dementia knowledge and attitudes towards dementia care, and family carers' dementia care perceptions has been conducted in China., Methods: An integrative review was conducted and reported based on the PRISMA guidelines and Whittemore and Knafl's framework. Eight English databases were searched without date restriction: CINAHL Plus with Full Text, MEDLINE, PubMed, Web of Science, Cochrane Library, Embase, PsycINFO and Scopus; and three Chinese databases: China National Knowledge Infrastructure, Chongqing Weipu and Wanfang, plus a manual search of reference lists., Results: Thirty-eight primary research papers were included in the review. Three themes were identified from the synthesis: (a) knowledge and competency; (b) attitudes towards dementia care; and (c) carers' burden and unmet needs. Healthcare professionals' dementia knowledge ranged from low to moderate levels and attitudes towards dementia care were generally negative. With low levels of knowledge of dementia and negative attitudes including stigma, family carers were under stress with insufficient support, and they expected more support from community nurses., Conclusions: There is an apparent need for a national policy on healthcare professional education and training to improve dementia care practice in China. Such a policy may improve support services for family carers., Relevance to Clinical Practice: Nurses, and particularly community nurses, are well-positioned to support family carers in China. However, healthcare professionals in China are not prepared for this. Therefore, education and training on dementia care should be integrated into medical and nursing undergraduate programmes and provided for healthcare professionals after commencing employment, and strategies to reduce stigma are needed., (© 2020 John Wiley & Sons Ltd.)

Aim: This study aimed to explore the experiences of family caregivers interacting with people with dementia. Background: A majority of people with mild‐to‐moderate dementia live at home with family caregivers. This interaction creates positive experiences and challenges for these caregivers. Design Descriptive phenomenological qualitative inquiry guided this study. Methods: This qualitative study involved semi‐structured interviews with the caregivers of people with mild‐to‐moderate dementia (n = 10). Data were collected from June to September 2018, and then data were thematically analysed. Results: Six categories of themes were identified from the interviews: (1) unexpected things often happen; (2) positive coping strategies; (3) sense of accomplishment because people with dementia actively participate in activities; (4) sense of frustration because of the reluctance of people with dementia to participate in activities; (5) hope for the happiness of people with dementia; and (6) want to have their own life. Conclusions: This study reveals that caregivers could positively interact with people with dementia through creating opportunities and arranging meaningful activities. Future research should focus on family management and training on how to help caregivers interact effectively with people with dementia. SUMMARY STATEMENT: What is already known about this topic? A majority of people with mild‐to‐moderate dementia live at home with family caregivers.Many caregivers suffer from depression, anxiety, fatigue, insomnia, family conflicts and low levels of life satisfaction.How caregivers interact with people with dementia at home remains unclear. What this paper adds? Caregivers experience various feelings, such as a sense of accomplishment and occasionally frustration, when interacting with people with dementia.Caregivers stated that they wanted people with dementia to be happy and live their life. Thus, the caregivers changed their attitude, accepted the situation and organized meaningful activities for people with dementia.Caregivers employed various strategies for handling situations involving people with dementia and shared how they interacted with such individuals. The implications of this paper: Care organizations that can offer certain services for people with dementia should be developed to lessen caregivers' burden.Community nurses should develop caregivers' strengths and enhance their abilities to improve interaction with people with dementia.Future research should focus on family management and training on how to help caregivers interact effectively with people with dementia. [ABSTRACT FROM AUTHOR]

Sensory activities are used to increase social engagement for people with dementia, who may struggle to participate in activities due to deteriorating cognitive functions. Sensory tools are used but these can be inappropriate since they are not designed for people with dementia. This paper details the design of an e-textile sensory tool for people with dementia, with stakeholders in Mainland China. The concept, a sensory wall, was derived from a previous co-design project in Hong Kong. However, the design context differs, and this work highlights barriers to implementing co-design in sensory tool design. Instead, this project took a collaborative customization approach. This paper describes the design processes and evaluations for the first and second sensory wall, with context on dementia care in Mainland China. This paper highlights considerations in the design of a sensory tool for people with dementia, and the benefits of stakeholder engagement in sensory tool design. [ABSTRACT FROM AUTHOR]

Zeng et al.'s Ethics Review highlights some of the challenges associated with clinical research in China. They found that only a minority of published clinical trials of anti-dementia drugs reported that they fulfilled the basic ethical principles as outlined in the Declaration of Helsinki. With recent reports of scientific misconduct from China, there is an urgent need to find approaches to compel researchers to adhere to ethical research practices. This problem does not call for a simple solution, but if forces are joined with governmental regulations, education in ethics issues for medical researchers, and strong reinforcement by Chinese journal editors not to publish studies with these flaws, then research ethics and publication standards will probably improve. Other solutions to foster ethical practice of drug trials are discussed including Chinese initiatives directed at managing conflict of interest from the pharmaceutical industry and educating clinical researchers. [ABSTRACT FROM AUTHOR]

Objectives: Older Asians and Chinese are among the least studied populations in the dementia caregiving literature. This review seeks to critically synthesize the literature on intervention characteristics, components and tailoring strategies for dementia family caregivers in Chinese communities globally., Methods: Five electronic databases (PsychINFO, PubMed, CINAHL, ScienceDirect and Google Scholar) were searched for articles published between 1980 and July 2018. The protocol of this review was registered with PROSPERO (CRD42019132800)., Results: Twenty-nine unique interventions across 39 papers met inclusion criteria. Results from descriptive and thematic syntheses revealed that most interventions were psychoeducational, CBT-based, multicomponent, structured, and less than a year in duration. Disease education, management of behavioral and psychological symptoms of dementia, stress coping techniques, and referral to community resources were frequently included in interventions. Community-, culture- and language-focused strategies were used to tailor interventions. The most common tailoring strategies were: (a) using community networks and media for outreach and recruitment; (b) making translations and language adaptations to the intervention materials; and (c) focusing on trust and therapeutic alliance. Most interventions produced desired outcomes, particularly reducing caregiver burden and increasing self-efficacy., Conclusions: To our knowledge, this is the first review to date that systematically synthesized the characteristics and tailoring of dementia caregiving interventions for Chinese families globally. Current findings suggest that most interventions are effective, although many only superficially address Chinese culture. Future research should incorporate Chinese values and cross-cultural challenges into caregiving interventions for deep-level adaptations that could potentially be more effective to engage and support Chinese caregivers., (© 2020 John Wiley & Sons Ltd.)

Introduction: Exercise has multiple benefits on maintaining or improving cognitive function for people with mild cognitive impairment (MCI)/dementia. However, many older adults with MCI/dementia are not sufficiently active to achieve these benefits. Allowing for the current studies on exercise adherence in older adults with MCI/dementia still have some deficiencies. This paper aims: (1) to identify the modifiable facilitators and barriers to exercise adherence for older adults with MCI/dementia in terms of the perspectives of patients, caregivers and healthcare professionals; (2) to organise the identified factors of exercise adherence based on the Theoretical Domains Framework (TDF) among included studies., Methods and Analysis: A systematic computerised literature search will be performed in the following online databases: PubMed, Embase, Cochrane Library, Web of Science, China National Knowledge Infrastructure and Wan Fang Database, which published between January 1990 and June 2020. We will identify peer-reviewed publications which examined facilitators and barriers to exercise adherence. Searches will have no limitation in language publications using search terms related to exercise interventions, adherence and MCI/dementia. Two independent reviewers will screen titles, abstracts and full-text articles according to the predetermined inclusion and exclusion criteria. We will use the statistical software Nvivo V.12 to manage the information. Basing on the TDF, we will map identified modifiable facilitators and barriers of literature to the domains of TDF., Ethics and Dissemination: This review will summarise modifiable facilitators and barriers to exercise adherence for older adults with MCI/dementia for the first time. Ethical approval is not required as no primary data are collected. We are going to disseminate our findings to the scientific and medical community in peer-reviewed journals. The review findings will facilitate adequate and accurate access to care and treatment to help older adults with MCI/dementia have a broader adoption to exercise., Prospero Registration Number: CRD42019117725., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Epimedii Herba (EH) is an herbal medicine originating from several plants of the genus Epimedium. It is a major therapeutic option for kidney yang deficiency syndrome, which is closely related to androgen hormones and also has been used to treat hemiplegia following a stroke in traditional medicine of Korea and PR China. To date, many clinical and basic researches of EH have shown the activities on functional recovery from brain diseases. Recently, neuroplasticity, which is the spontaneous reaction of the brain in response to diseases, has been shown to accelerate functional recovery. In addition, androgen hormones including testosterone are known to be the representative of neuroplasticity factors in the brain recovery processes. In this review, we described the neuro-pharmacological activities of EH, focusing on neuroplasticity. Thirty-three kinds of papers from MEDLINE/PubMed, EMBASE, and CNKI were identified and analyzed. We categorized the results into five types based on neuroplasticity mechanisms and presented the definition of each category and briefly described the results of these papers. Altogether, we can suggest that neuroplasticity is a novel viewpoint for guiding future brain research of EH and provide the evidence for the development of new clinical applications using EH in the treatment of brain diseases. Copyright © 2017 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Objectives: This paper provides an overview of the status of dementia care in Mainland China under the framework of the three-tier long-term care system proposed by the Chinese government, and gives the direction for service development., Methods: Official documents, annual reports of related associations, and studies conducted in Mainland China from 2006 to 2017, published both in English and Chinese were reviewed., Results: With the establishment of the three-tier long-term care system, the Government has invested a lot in long-term care, and improvements have been made. However, specific areas of dementia care still face challenges., Discussion: Strategies in improving the long-term care services have been achieved. These included training for informal caregivers at home settings, increased investment in community health centers, and increased institutional placements, etc. However, these are not enough to fulfill the needs of people with dementia and their caregivers., Implications for Nursing and Health Policy: Multiple levels of training and interaction within the framework of the three-tier long-term care system as well as more research are recommended for improving dementia care., (© 2018 Wiley Periodicals, Inc.)

Objectives: No study has reported secular trends in dementia prevalence, all-cause mortality, and survival status in rural China. Methods: We established two cohorts (XRRCC1 and XRRCC2) in the same region of China, 17 years apart, to compare dementia prevalence, all-cause mortality, and survival status, and performed regression analysis to identify associated factors. Results: Dementia prevalence was 3.49% in XRRCC1 and 4.25% in XRRCC2, with XRRCC2 showing a significantly higher prevalence (OR = 1.79, 95%CI: 1.2-2.65). Allcause mortality rates for dementia patients were 62.0% in XRRCC1 and 35.7% in XRRCC2. Mortality in the normal population of XRRCC2 decreased by 66% compared to XRRCC1, mainly due to improved survival rates in women with dementia. Dementia prevalence was positively associated with age >65, spouse-absent status, and stroke, and negatively associated with =6 years of education. Conclusion: Dementia prevalence in rural China increased over 17 years, while mortality decreased. Major risk factors include aging, no spouse, and stroke, with higher education offering some protection. [ABSTRACT FROM AUTHOR]

ABSTRACTBackground:Acknowledging increasing demand of dementia care for patients in China, this paper aims to understand the training needs of dementia care from the perspectives of mental health providers by examining who should be the trainees, what should be the contents of training, and how to deliver the training in China., Methods: Using purposive sampling, data were gathered via four focus group discussions with 40 mental health providers in Beijing, China, in 2011. Data were transcribed by independent investigators and then translated into English. Researchers used content analysis to separately identify themes and codes. Discrepancies were discussed until final agreement achieved., Results: To improve the quality of dementia care, all participants agreed there is a significant need to train both formal or professional (physicians, nurses, hospital administrators, community workers) and informal caregivers (family, friends, or non-kin hired caregivers). For formal or professional caregivers, suggested training content included clinical knowledge of dementia (i.e. pathogenesis, approaches for preventing dementia deterioration) and clinical practice skills (i.e. diagnostic, treatment, caregiving, counseling, communicating skills). For informal caregivers, basic dementia knowledge and home-based caregiving skills such as safety, restorative, stress management, and communication were identified as key training contents. Multilevel support from the government and community centers were considered crucial factors to delivering the training and educating the public to enhance awareness of dementia., Conclusions: Culturally, sensitive education and specific trainings for formal and informal dementia caregivers are urgently needed in China. Policy and program implications are discussed.

The number of older people in the population is increasing faster than for any other age group. This population growth, while positive, is associated with increasing incidence of chronic and progressive diseases such as dementia. This requires older people to navigate services that may not be designed to meet their needs. This issue can be further amplified in culturally and linguistically diverse populations who often have limited English language proficiency and limited knowledge of diseases such as dementia. Health literacy, a person's ability to access, understand, appraise and apply information about their health and health care, including navigating health services, is low among older people and even lower among older people born overseas. This paper describes findings from a recent research study which developed and used the Cultural Exchange Model. The model is based on a process of collaboration, whereby researchers, service providers and community members work together to build evidence about a particular topic, in this case dementia. The study demonstrated that the Cultural Exchange Model facilitates opportunities for researchers, health professionals, community workers and carers to improve their knowledge of conditions such as dementia and rapidly translate evidence into practice. It also showed that it is possible to recruit, engage and generate new knowledge within populations that are traditionally excluded from research but have high prevalence of dementia. This study shows health literacy is an evolving process. Access to ongoing education for professionals, not only of the clinical condition and the service system, but also the cultural elements of the communities they are working with, requires consideration.

Background: Global research hotspots and future research trends in the neurobiological mechanisms of late-life depression (LLD) as well as its diagnosis and treatment are not yet clear. Objectives: This study profiled the current state of global research on LLD and predicted future research trends in the field. Methods: Literature with the subject term LLD was retrieved from the Web of Science Core Collection, and CiteSpace software was used to perform econometric and co-occurrence analyses. The results were visualized using CiteSpace, VOSviewer, and other software packages. Results: In total, 10,570 publications were included in the analysis. Publications on LLD have shown an increasing trend since 2004. The United States and the University of California had the highest number of publications, followed consecutively by China and England, making these countries and institutions the most influential in the field. Reynolds, Charles F. was the author with the most publications. The International Journal of Geriatric Psychiatry was the journal with the most articles and citations. According to the co-occurrence analysis and keyword/citation burst analysis, cognitive impairment, brain network dysfunction, vascular disease, and treatment of LLD were research hotspots. Conclusion: Late-life depression has attracted increasing attention from researchers, with the number of publications increasing annually. However, many questions remain unaddressed in this field, such as the relationship between LLD and cognitive impairment and dementia, or the impact of vascular factors and brain network dysfunction on LLD. Additionally, the treatment of patients with LLD is currently a clinical challenge. The results of this study will help researchers find suitable research partners and journals, as well as predict future hotspots. [ABSTRACT FROM AUTHOR]

Aim: To describe the lived experiences of family caregivers of individuals with dementia during the coronavirus disease (COVID‐19) outbreak in China. Design: This study used a descriptive phenomenological research method. Methods: Between May and September 2021, semi‐structured interviews were conducted with 22 family caregivers of people with dementia. Colaizzi's method was used for manual analysis. Results: Qualitative data revealed an overarching experience of finding 'There is always good fortune in misfortune to encourage us in coping with difficulties'. Three themes emerged: family reactions to the COVID‐19 outbreak, feeling supported by multiple resources performing respective functions and resilient adaptation to new situations. Conclusion: During the COVID‐19 outbreak, family caregivers of people living with dementia in China looked for positive aspects among difficulties and experienced corresponding reactions, social support resources and resilient adapted coping styles. Implications for the Profession and/or Patient Care: Nurses in China and other countries facing similar pandemic characteristics, cultures or economic development levels, can guide family caregivers to look at family hardships from a positive perspective, develop interventions to rapidly respond to families' reactions after a disaster and help them identify social support resources and form adapted coping styles. Impact: We identified the resilience and the positive experiences of Chinese family caregivers of individuals with dementia during the COVID‐19 outbreak. The results can inform countries with similar cultures and economic levels, offering measures to support their adaptation to pandemics. Reporting Method: This study followed the COREQ guidelines. Patient or Public Contribution: Family caregivers of people with dementia who met the inclusion criteria and who were interested in sharing their understanding of their experiences, participated in the study. [ABSTRACT FROM AUTHOR]

Background: Dementia has become one of the leading causes of death across the world. Aims: The aim of this study was to investigate the incidence, prevalence, and mortality of dementia in China between 2010 and 2020, and to investigate any geographical, age, and sex differences in the prevalence and incidence of dementia. Methods: Five databases were searched. The Joanna Briggs Institute (JBI) critical appraisal tool was used to assess the quality of the included studies. A random-effects meta-analysis was performed to estimate the pooled prevalence of dementia. Subgroup analysis was based on the type of dementia. The incidence and mortality of dementia were synthesized qualitatively. Results: A total of 19 studies were included. The meta-analysis showed that the prevalence of dementia was 6% (95%CI 5%, 8%), the prevalence of Alzheimer's disease (AD) was 5% (95%CI 4%, 6%), and the prevalence of vascular dementia (VaD) was 1% (95%CI 0%, 2%). The subgroup analysis showed that the prevalence rates of dementia in rural (6%, 95%CI 4%, 8%) and urban areas were similar (6%, 95%CI 4%, 8%). Deaths due to dementia increased over time. Conclusion: The prevalence, incidence, and mortality of dementia increased with age and over time. Applying consistent criteria to the diagnosis of cognitive impairment and dementia is necessary to help with disease monitoring. Promoting dementia knowledge and awareness at the community level is necessary. [ABSTRACT FROM AUTHOR]

Individual cognitive interventions for Alzheimer's disease have been shown to be beneficial and cost effective when evaluated as sole interventions. However, there is a need for a systematic, person-centric, structured approach to guide non-pharmacological intervention selection based on disease stage, symptoms, outcome assessment, and individual requirements. Our Structured Cognitive Intervention Pathway aims to facilitate the selection of first-line, or subsequent, non-pharmacological management for people with Alzheimer's disease living at home and in elderly care facilities. We discuss the Pathway's conceptual basis and evaluation of implementation as a decision-support tool within a dementia care service in China. [ABSTRACT FROM AUTHOR]

Objective: We aimed to systematically search and summary the publications from 1990 to 2012 on Chinese dementia caregivers to understand the development in this field., Methods: We searched Pubmed and Chinese medical databases for all the original publications on the dementia caregivers in Chinese mainland until December 31st, 2012., Results: 126 papers involved 117 studies with 11178 participants were analyzed. The earliest study on Chinese caregivers with dementia patients was published in 1990. Most studies (92%) were reported in Chinese. 85% of studies were published between 2006 and 2012, while 42% were carried out in the most developed regions., Conclusions: In spite of the late start, the number of publications on Chinese dementia caregivers has rapidly increased since 2006. However, the quality of studies is still need to improve in sample size, intervention and outcome design. More attentions, policies and funds should be given to support the future study in dementia caregivers.

Background: Dementia is a serious and growing health problem, and since most people with dementia live at home, caring responsibilities generally fall on family members. Caregivers are often inadequately supported by formal health services and have poorer psychological and physical health. Our study aimed to compare the contributions of publications from different countries, institutions and authors and present a bibliometric analysis to determine the hotspots and trends in research concerning the health of and interventions for family dementia caregivers.Methods: Studies published during 1988-2018 were extracted from the Science Citation Index Expanded of the Web of Science. Each abstract of publications was evaluated to obtain the basic information. A bibliometric analysis was used to evaluate the number or cooperation networks of publications, countries, institutions, journals, citations, authors, references, and keywords. The resulting articles were analyzed descriptively, and the publication keywords were visualized using VOSviewer.Results: Five hundred forty-two articles were identified. The annual number of relevant publications has steadily increased since approximately 2006. The USA has the highest number of publications (36.2%), followed by the UK (12.9%). China entered the field late, but research conducted in China has rapidly developed. The most productive institution, journal, and author in this field are University College London, the Journal of the American Geriatrics Society, and Orrell M from the UK, respectively. A co-occurrence analysis of the keywords reveals a mainstream research focus on burden, depression, quality of life, and corresponding interventions for people with dementia caregivers. The keywords "psychosocial intervention", "long-term", "e-learning/online", "communication", and "qualitative research" reflect the latest hotspots, appearing in approximately 2017-2018.Conclusion: Our study details the performance statistics, main topics and trends research on the health of and interventions for dementia caregivers from 1988 to 2018 and provides a comprehensive analysis. [ABSTRACT FROM AUTHOR]

Objectives: Person-centered care (PCC) is one of the most desirable approaches for elderly with dementia. However, it has not been initiated and systematically studied in China, on which lacking of reliable and valid measurement tools is one of the key barriers. This paper aims to validate person-centered care assessment tools (P-CAT) in a Chinese context., Method: The original 13-item was translated and back translated. And 11 items were added based on literature review and expert consultation. The resulting 24-item P-CAT-C was validated among a sample of formal caregivers (n = 330) in all 34 residential care facilities in urban Xi'an, a representative city in north-western China. Chinese versions of staff-based measures of individualized care for institutionalized persons with dementia (IC) and caregiver psychological elder abuse behavior (CPEAB) scale were used to test the criterion validity., Results: Confirmatory factor analysis (CFA) showed that a three-factor 15-item solution provided adequate fit indices to the data (χ(2) = 145.691, df = 81, p < 0.001, comparative fit index (CFI) = 0.926, Tucker-Lewis index (TLI) = 0.905, root mean square error of approximation (RMSEA) = 0.050). Four new items were identified and two original items were excluded. The three factors are named as (1) individualized care (6-item); (2) organizational support (6-item); and (3) environmental accessibility (3-item). The internal consistency coefficient (Cronbach's α = 0.684) is satisfactory. The interscale correlation among P-CAT-C, IC, and CPEAB showed good criterion validity., Conclusion: P-CAT-C is a culturally adapted version of the original P-CAT, which showed satisfactory reliability and validity for evaluating PCC in Chinese residential care facilities. It also provides insight to other developing countries.

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Aim: This paper is a report of a study to describe the lived experiences of people with early-stage dementia and their ways of coping with the illness., Background: Emerging models of subjective experience and coping with early dementia have been developed in Western cultures. Understanding how Chinese people with early-stage dementia adjust and cope is an important starting point in developing interventions that can enhance their adaptive coping., Method: A convenience sample of 15 Chinese people in the early stages of dementia were interviewed and observed during home visits. The study involved in-depth transcribed interview data using a phenomenological approach. The data were collected in 2005., Results: Four themes were identified in the data: attribution of illness, experiencing losses resulting in frustration and uncertainty, adapting to a new role in relationships with family and friends and continuing to live. People with early dementia who adopted a positive outlook did so because they had made sense of and accepted the illness, received understanding and support from family and friends and were being listened to and respected., Conclusion: The themes emerging from the findings could be used as a framework in understanding how people cope with the onset of early dementia. The framework includes specific implications for the provision of intervention services and highlights the importance of understanding people's own constructions of their illness and how they adjust their lives in coping.

Aim: This paper is a report of a study undertaken to translate the Cohen-Mansfield Agitation Inventory from the original English into a Chinese language version and to establish the content, semantic and technical equivalence of the Chinese version., Background: Ensuring the equivalence of a translated Chinese version of the Cohen-Mansfield Agitation Inventory for patients with dementia is an essential requirement for identifying culturally specific expressions of agitated behaviours., Methods: In Phase I, five experts scrutinized the Inventory items to determine whether the behaviour described was relevant to the agitated behaviours present in the Taiwanese culture. In Phase II, experts did the initial translation into Chinese and then back-translated it into English. Four bilingual observers rated 31 residents with dementia to determine semantic equivalence across versions. In Phase III, the agitated behaviours of 32 residents were assessed by four observers using staff ratings and direct observation to determine the technical equivalence of the Chinese version. The study was carried out in Taiwan from August 2004 to April 2005., Findings: In Phase I, the rating of behaviours described on the Cohen-Mansfield Agitation Inventory was relevant to the agitated behaviours based on Taiwanese culture with a content validity index (CVI) value of 0.993. In Phase II, intra-class coefficients for all items on the Chinese version and split-halves of Chinese and English versions ranged from 0.69 to 0.74. In Phase III, six possible results for estimation of reliability across methods and raters for the Chinese version ranged from 0.63 to 0.86., Conclusion: The Chinese Cohen-Mansfield Agitation Inventory had modest psychometric properties. Further studies are needed to assess criterion and conceptual equivalence.

Background: Subjective memory complaints in subjects with mild cognitive impairment may represent a genuine decline in episodic memory. This paper evaluates the neuropsychological correlates of the semantic fluency test in subjects with questionable dementia (QD)., Methods: A total of 331 Chinese subjects (118 normal controls, NC, 150 with QD and 63 with mild Alzheimer's disease, AD) were assessed with the Category Verbal Fluency Test (CVFT), the AD Assessment Scale-cognitive subscale (ADAS-Cog), and digit and verbal span tests. CVFT performance was evaluated in each Clinical Dementia Rating (CDR) group. The total number of exemplars, the subcategory and the category size generated were evaluated. Neuropsychological correlates of CVFT scores were computed., Results: Significant differences in CVFT performance were found between the different CDR groups. The subjects with QD had intermediate scores compared to the NC and AD subjects (1-way ANOVA, p < 0.001, post-hoc Bonferroni comparisons). In NC the CVFT scores were significantly associated with ADAS-Cog total, and immediate and delayed recall scores (partial correlations controlled for age and education, p < 0.005). In the QD group the CVFT scores were correlated with ADAS-Cog total, and immediate recall and object naming scores (partial correlation controlled for age and education, p < 0.005). Regression analysis revealed that age and delayed recall were significant predictors of CVFT performance in NCs. In the QD group, age, ADAS-Cog immediate recall and object naming scores predicted the CVFT performance., Conclusions: The CVFT was impaired in the subjects with QD. Apart from episodic memory, semantic memory deficits also occur early in AD. The different cognitive predictors of CVFT scores in the NC and QD groups suggest that the test is associated with specific psychological functions at different stages of cognitive impairment., (Copyright (c) 2006 S. Karger AG, Basel.)

We aim to provide an overview of clinical and demographical features and neuropathological research on frontotemporal dementia (FTD) from China over the past decade. We reviewed the demographic features, clinical presentations, and neuropathology of the FTD-spectrum disorders from the 49 cases in China published since 1998. On the basis of these findings, we retrospect the history and speculate on future progress in terms of FTD in China. We found that most published papers comprise case reports with a few retrospective studies with small sample sizes. Behavior variant FTD (bvFTD) was the most common diagnostic subtype, of which 35% were associated with amyotrophic lateral sclerosis or Parkinsonian syndrome. More than 47% patients with FTD had age onset before 65. There were no differences in age of onset and sex distribution between diagnostic subtypes. The spectrum of neuropathological diagnosis of bvFTD was frontotemporal lobe degeneration (FTLD) with tau protein or ubiquitin-immunopositive inclusions, and FTLD without intracellular inclusions. Median survival in bvFTD was 14 years. This paper provides an overview of the current status and pointers for future research directions of FTD in China. [ABSTRACT FROM AUTHOR]

The article discusses the highlights of an International Association of Gerontology and Geriatrics (IAGG) workshop on nursing homes. One of the paper presented in the workshop focused on the state of nursing homes within long-term care in Catalonia, Spain. The event also addressed the challenges posed by the increasing elderly population in China, as well as the occupancy rate in Chinese nursing homes. Another topic addressed in the workshop was chronic pain in long-term care facilities.

There is little information on dementia research in China in the international literature. This paper is an overview of studies on dementia conducted in China. Studies on dementia research in China were identified through a literature search, as well as through consulting Chinese psychiatrists and neurologists with expertise in the field. These studies were then reviewed. Epidemiological studies on dementia in China find the rates of dementia at the lower end of rates in Caucasians. There seems to be regional variation in the ratio of vascular dementia to Alzheimer's disease in China. In addition to epidemiological studies, there are studies on the genetics, psychopathology, neurophysiology and drug treatment in dementia. There is much research activity in China in the field of dementia and further cross-cultural studies are useful to examine the cultural differences in various areas of dementia research., (Copyright 2000 John Wiley & Sons, Ltd.)

Background This paper describes the development and validation of the Memory Inventory for Chinese (MIC), for measuring the awareness of memory deficits in the Chinese population with Alzheimer's disease (AD). Methods A combination of qualitative and quantitative approaches was adopted. The MIC was developed with focus group discussion and pilot testing. It has a patient and a caregiver version. A consecutive series of 79 new out-patients with the National Institute of Neurological and Communicative Disorders and Stroke and the Alzheimer's Disease and Related Disorder Association (NINCDS-ADRDA) criteria of probable and possible AD and 20 non-demented elderly subjects were recruited. Results A high internal consistency was found, with Cronbach alpha of 0.89 for the patient version and 0.90 for the caregiver version of MIC. The inter-rater reliability was satisfactory. For validity assessment, the caregiver score of the MIC correlated significantly with cognitive score of the subject as assessed by the Mini-Mental State Examination (rp = -0.37; p < 0.01). The Memory Deficit Awareness Score, calculated by subtracting the patient score from the caregiver score, correlated significantly with clinician ratings of awareness of memory impairment (rs = -0.67; p < 0.01). Conclusions The MIC appears to be a culturally appropriate and valid instrument for the measurement of awareness of memory deficits in Chinese patients with AD. Potential applications of the MIC should be further explored in other subtypes of dementia and in prospective studies. Copyright © 2006 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

The goal of this retrospective pilot study was to provide a naturalistic description of the decision-making process regarding dementia, a chronic illness. The hypothesis was that in-depth descriptions by caregivers in a community setting would provide a more comprehensive and realistic representation of decision-making in the case of chronic illness than has been provided by most models. Data were gathered from in-depth, qualitative interviews with seven Chinese-American families living in the Boston area and caring for an elderly family member with dementia. These were supplemented with interviews with medical professionals and ethnography done in the community regarding the care of elders with dementia. Based on the findings, this paper proposes a dynamic, more comprehensive model for the social process of decision-making which is particularly applicable to clinical and life situations of decision-making in the case of chronic illness. The model describes: 1) the decision-maker constellation, including multiple family members, professionals and service systems; 2) relationships between decision-makers as "allies" or "competitors"; 3) variations in the nature of the decision-making process; and 4) the interaction of decision-making with larger social, economic and cultural forces. Decision-making in the case of dementia is placed within the conceptual framework of the "social course" of chronic illness.

Background: A rapid digital instrument is needed to facilitate community-based screening of mild cognitive impairment (MCI) and Alzheimer's disease (AD) in China. Objective: We developed a voice recognition-based cognitive assessment (Shanghai Cognitive Screening, SCS) on mobile devices and evaluated its diagnostic performance. Methods: Participants (N = 251) including healthy controls (N = 98), subjective cognitive decline (SCD, N = 42), MCI (N = 80), and mild AD (N = 31) were recruited from the memory clinic at Shanghai Sixth People's Hospital. The SCS is fully self-administered, takes about six minutes and measures the function of visual memory, language, and executive function. Participants were instructed to complete SCS tests, gold-standard neuropsychological tests and standardized structural 3T brain MRI. Results: The Cronbach's alpha was 0.910 of the overall scale, indicating high internal consistency. The SCS total score had an AUC of 0.921 to detect AD (sensitivity = 0.903, specificity = 0.945, positive predictive value = 0.700, negative predictive value = 0.986, likelihood ratio = 16.42, number needed for screening utility = 0.639), and an AUC of 0.838 to detect MCI (sensitivity = 0.793, specificity = 0.671, positive predictive value = 0.657, negative predictive value = 0.803, likelihood ratio = 2.41, number needed for screening utility = 0.944). The subtests demonstrated moderate to high correlations with the gold-standard tests from their respective cognitive domains. The SCS total score and its memory scores all correlated positively with relative volumes of the whole hippocampus and almost all subregions, after controlling for age, sex, and education. Conclusion: The SCS has good diagnostic accuracy for detecting MCI and AD dementia and has the potential to facilitate large-scale screening in the general community. [ABSTRACT FROM AUTHOR]

Objectives: More people with dementia live in low‐ and middle‐income countries (LMICs) than in high‐income countries, but best‐practice care recommendations are often based on studies from high‐income countries. We aimed to map the available evidence on dementia interventions in LMICs. Methods: We systematically mapped available evidence on interventions that aimed to improve the lives of people with dementia or mild cognitive impairment (MCI) and/or their carers in LMICs (registered on PROSPERO: CRD42018106206). We included randomised controlled trials (RCTs) published between 2008 and 2018. We searched 11 electronic academic and grey literature databases (MEDLINE, EMBASE, PsycINFO, CINAHL Plus, Global Health, World Health Organization Global Index Medicus, Virtual Health Library, Cochrane CENTRAL, Social Care Online, BASE, MODEM Toolkit) and examined the number and characteristics of RCTs according to intervention type. We used the Cochrane risk of bias 2.0 tool to assess the risk of bias. Results: We included 340 RCTs with 29,882 (median, 68) participants, published 2008–2018. Over two‐thirds of the studies were conducted in China (n = 237, 69.7%). Ten LMICs accounted for 95.9% of included RCTs. The largest category of interventions was Traditional Chinese Medicine (n = 149, 43.8%), followed by Western medicine pharmaceuticals (n = 109, 32.1%), supplements (n = 43, 12.6%), and structured therapeutic psychosocial interventions (n = 37, 10.9%). Overall risk of bias was judged to be high for 201 RCTs (59.1%), moderate for 136 (40.0%), and low for 3 (0.9%). Conclusions: Evidence‐generation on interventions for people with dementia or MCI and/or their carers in LMICs is concentrated in just a few countries, with no RCTs reported in the vast majority of LMICs. The body of evidence is skewed towards selected interventions and overall subject to high risk of bias. There is a need for a more coordinated approach to robust evidence‐generation for LMICs. Key points: While the majority of people with dementia reside in low‐ and middle‐income countries (LMICs), it is not known what types of interventions have been studied in these settings and how effective they are.We conducted the first comprehensive mapping study of interventions for people with dementia or mild cognitive impairment (MCI) and/or their carers in LMICs.This high‐level overview of dementia intervention research in LMICs identified the following gaps: dementia intervention research is highly concentrated in just a few LMICs, and skewed towards Traditional Chinese Medicine, Western pharmaceuticals, and supplements, with comparatively little evidence generated on interventions for carers.Lack of robust and locally relevant evidence on effective interventions presents a substantial challenge to designing evidence‐based treatment and care systems that help people with dementia or MCI and their carers to live better lives. [ABSTRACT FROM AUTHOR]

This paper reports the results of a longitudinal study carried out in urban China on the health and mental status of 200 elders 70 years of age or older and focuses on the experience of dementia. While older people and their families are aware of the phenomenon of dementia, it does not evoke the kind of dread that is common among Americans. This different response can be traced to beliefs about dementia, cultural values, and situational features of contemporary Chinese life.

Background: This study was designed to identify all elderly people of ethnic minorities living in a defined geographical area in inner-city Liverpool and to identify psychiatric morbidity and barriers to use of services. This paper reports the prevalence of dementia and depression., Method: A survey of the community was carried out using the Geriatric Mental State Examination, AGECAT and ethnically matched interviewers. The sampling frame consisted of Family Health Services Authority lists as a basis, with additional information from community lists, 'snow-balling' and a door-to-door survey., Results: 418 people were interviewed, with a high percentage (55%) of young elderly (65-74) men. The prevalence of dementia ranged from 2 to 9% and of depression from 5 to 19%, and there were no significant differences in levels between English-speaking ethnic groups and the indigenous population. Higher levels of dementia were found among non-English-speaking groups., Conclusions: A complete enumeration of the elderly in ethnic minority groups is best achieved by using several different methods. Diagnosis of dementia may be misleading among those who do not speak the dominant language.