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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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Public Health.

Longbing Ren1, Fan Hu2, Sebastian Walsh3

  • 1China Centers for Health Development Studies, Peking University, Beijing, Beijing, China.

Alzheimer'S & Dementia : the Journal of the Alzheimer'S Association
|December 23, 2025
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Summary
This summary is machine-generated.

Healthy lifestyles significantly extend cognitively healthy life expectancy in Chinese older adults, regardless of APOE genotype. Lifestyle modifications can delay cognitive impairment onset and reduce dementia duration.

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Area of Science:

  • Gerontology
  • Neuroscience
  • Public Health

Background:

  • Cognitive health in aging is influenced by genetic and lifestyle factors.
  • Understanding these interactions is key for improving late-life quality.

Purpose of the Study:

  • Examine the impact of Apolipoprotein E (APOE) genotypes and healthy lifestyles on life expectancy.
  • Assess effects on life expectancy with and without cognitive impairment in Chinese older adults.

Main Methods:

  • Utilized 15-year data from 6,488 Chinese adults (≥65 years) from the Chinese Longitudinal Healthy Longevity Survey (CLHLS).
  • Assessed cognitive function via Mini-Mental State Examination (MMSE) and five healthy lifestyle factors.
  • Employed continuous-time three-state Markov models to analyze APOE genotype and lifestyle impacts on cognitive transitions and life expectancy.

Main Results:

  • APOE ε4 carriers showed a higher risk of cognitive decline (HR: 1.23), while APOE ε2 carriers had a decreased risk of death (HR: 0.88).
  • Adopting 4-5 healthy lifestyle factors extended cognitively healthy life expectancy by 4.78 years (men) and 5.26 years (women), surpassing APOE genotype effects.
  • Healthy lifestyle benefits were consistent across all APOE genotypes.

Conclusions:

  • Public health interventions promoting lifestyle modifications can delay cognitive impairment onset.
  • Lifestyle changes can compress the duration of dementia and cognitive impairment, irrespective of genetic background.