Abstract
Population aging has brought about a number of challenges to public health and primary health care systems due to increases in the prevalence of non-communicable diseases (NCDs). As a country with one of the largest populations globally, China is confronting a rising number of chronic NCDs including cardiometabolic related conditions. This mini-review investigates the link between NCDs and cognitive impairment through common risk factors. Identifying risk factors is important for the prevention and management of these chronic conditions. In addition, this review also identifies the role of primary health care services in reducing behavioral risk factors for NCDs and cognitive impairment. Addressing shared determinants and pathways is important in the design of public health interventions and primary health care services in China. Monitoring and management of NCD biomarkers and behavioral risk factors may also be beneficial for cognitive health among older Chinese.
Highlights
As China’s population ages, the country is confronted with rapidly changing health profiles
This review looks at common pathways for non-communicable diseases (NCDs), Cognitive Impairment (CI), and Mild Cognitive Impairment (MCI) whereby CI is a broad term that can range from mild to severe [13]
We focus on CI and MCI as there is evidence that these conditions could lead to an increased risk of developing more severe neurological conditions such as dementia and Alzheimer’s disease [2, 11, 12]
Summary
As China’s population ages, the country is confronted with rapidly changing health profiles. According to the Global Burden of Diseases, the pattern of causes of deaths has changed significantly away from communicable diseases and as of 2016, the main causes of death were cardiovascular diseases (41%), cancers (25%), chronic respiratory diseases (10%), and diabetes (4%) [1] In addition to these “Big 4” non-communicable diseases (NCDs), neurological disorders including Alzheimer’s disease and other dementias further contributed to 5% of pre-mature mortality. This figure is expected to increase as China’s population ages [1, 2]. There has been emerging literature on the potential links between chronic non-communicable diseases and cognitive impairment, notably highlighting common mid-life modifiable risk factors (e.g., mid-life hypertension, diabetes, smoking), improving integrated chronic care management, and reducing impacts on overall quality of life [6,7,8]
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