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allied
academies
13
th
International Conference on
Alzheimers Disease and Dementia
November 25-26, 2019 | Frankfurt, Germany
Journal of Psychology and Cognition | Volume: 04
J Psychol Cognition, Volume: 04
Dementia situation and clinical trials in China
Jianping Jia
Capital Medical University, China
China has the largest population with dementia in the
world, imposing a heavy burden on the public. The number
of dementia patients in China accounts for approximately
25% of the entire dementia population worldwide,1
creating a huge challenge for policy makers, healthcare
professionals and family members.
Over the last decade, many studies have focused on the
prevalence of dementia in the Chinese population Two
large-sample multi-region studies across China were
conducted in 20142 and 20193 and revealed that the
prevalence rates of dementia were 5•14% (4•71-5•57%)
and 5•60% (3•50-7•60%), respectively, for individuals
≥65 years of age. The latest Global Burden of Disease
study in 2019 showed that the age-standardised dementia
prevalence increased by 5•6% in China from 1990 to 2016,
while the global prevalence increased by 1•7%.1 The
increasing trend may be partly due to extended lifespan
and progress in the diagnostic criteria, which have resulted
in an increased number of elderly people and a higher
diagnostic rate for dementia patients, respectively.
Currently, the number of dementia patients in China is
estimatedtobe10-11millionor9-10millionamongindividuals
aged ≥60 or ≥65 years, respectively;4,5 more than 60% of
these patients have AD, and approximately 70%-80% of these
AD patients have not received treatment.6 Although VaD
patients constitute the second largest dementia population
in China (2.49 million people ≥65 years), no treatment data
for this population are available. China has approximately
11•8 million stroke patients, 9•5 million of whom have
experienced post-stroke cognitive impairments.7,8 Overall,
China is estimated to have approximately 31 million MCI
patients, with MCI-A accounting for more than 9 million.9
Taken together, China currently has approximately 50 million
individuals suffering from dementia and MCI. This enormous
patient population has a large negative impact on society,
which should be reiterated.
In the past 10 years, the number of clinical trials has
increased in China. Twenty-eight clinical trials (≥150
subjects) have been conducted in China, including four
phase IV, phase III, four phase II/III, and six phase II studies.
Since 2003, no FDA approved drugs that halt or even
slow the progression of AD have been introduced.10,11
Most likely, the reason is the single-target mechanisms
of these drugs and the fact that AD is a complex disease
that involves a variety of pathophysiological changes.12,13
Chinese medicines may have the potential to overcome
this issue due to the incorporation of multiple anti-AD
components that have multiple physiological targets.14
In addition to AD, several studies have investigated the
abilities of Chinese medicine to treat vascular-related
cognitive impairments. In a clinical trial in 2016, a
modern Chinese medicine compound called DL-3-n-
butylphthalide (NBP) was shown to be safe and effective
in improving cognitive and global functioning in patients
with subcortical vascular cognitive impairment with
no dementia.15 Another Chinese medicine compound
known as SLT was shown to improve memory, orientation,
language and executive functions and daily activities for
patients with VaD in clinical trials.16 Taken together, these
studies provide evidence that Chinese medicines may be
effective in treating vascular cognitive impairments and
may inspire further clinical trials of Chinese medicines for
the treatment of AD.
Biography
Jianping Jia is working in the Department of Neurology, at Xuan Wu
Hospital, Capital Medical University, in Beijing, China. He is also working
in the Beijing Key Laboratory of Geriatric Cognitive Disorders, Beijing,
China. He is one of the researcher in the Center of Alzheimer's Disease,
Beijing Institute for Brain Disorders, Beijing, China.
e:
jjp@ccmu.edu.cn