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Primary care promotes wellness and prevents disease. This care includes health promotion, education, protection (such as immunizations), early disease screening, and environmental considerations. Settings providing this type of healthcare include physician offices, public health clinics, school nursing, and community health nursing.
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Disease surveillance is the systematic collection, analysis, and interpretation of health data essential to the planning, implementation, and evaluation of public health practice. This process integrates data dissemination to entities responsible for preventing and controlling disease, injury, and disability. Surveillance systems provide crucial information for action, helping public health authorities make informed decisions to manage and prevent outbreaks, ensure public safety, optimize...
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There are various healthcare agencies in the United States—some of which are managed by religious institutions and others by different government branches.
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Public Health.

Xuhao Zhao1, Zhiying Lin2, Haoran Zhang1

  • 1School of Public Health, the Second Affiliated Hospital of School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China.

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|December 23, 2025
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Summary
This summary is machine-generated.

Cardiovascular-Kidney-Metabolic (CKM) syndrome is linked to increased risks of psychiatric disorders and dementia in older adults. Early intervention for CKM progression is crucial for managing these conditions.

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Area of Science:

  • Geriatric Medicine
  • Neuroscience
  • Metabolic Disorders

Background:

  • Cardiovascular-Kidney-Metabolic (CKM) syndrome involves complex interactions between metabolic risk factors, chronic kidney disease, and cardiovascular dysfunction.
  • These interconnected conditions are recognized as shared risk factors for the development of psychiatric disorders and dementia.

Purpose of the Study:

  • To investigate the associations between Cardiovascular-Kidney-Metabolic (CKM) syndrome and the incidence of psychiatric disorders and dementia in middle-aged and older adults.
  • To identify specific metabolic predictors associated with CKM stage-related neuropsychiatric outcomes.

Main Methods:

  • Utilized UK Biobank data from 389,314 participants, categorizing CKM syndrome into five stages (0-4).
  • Employed multi-state and competing risk models to analyze transitions to psychiatric disorders and dementia, accounting for death as a competing risk.
  • Applied Cox regression and XGBoost classifiers to identify key metabolomic predictors.

Main Results:

  • Each one-stage increase in CKM stage was associated with higher hazards for developing psychiatric disorders and transitioning to dementia.
  • Worsening CKM stages correlated with increased risks of pre-dementia psychiatric disorders (bipolar, depressive, anxiety), while advanced stages (3/4) were linked to all-cause, Alzheimer's, and vascular dementia.
  • Identified specific metabolites, such as citrate and degree of unsaturation, as predictors for psychiatric disorders at different CKM stages.

Conclusions:

  • Cardiovascular-Kidney-Metabolic (CKM) syndrome is significantly associated with pre-dementia psychiatric disorders and dementia.
  • Highlights the critical need for regular monitoring and timely intervention to manage CKM progression and mitigate geriatric neuropsychiatric disturbances.