Alzheimer’s disease (AD) and other dementias are major public health concerns with an increasing global impact. The burden of these conditions varies by region, age, and gender, and the COVID-19 pandemic has further exacerbated these disparities, potentially influencing disease prevalence, mortality, and disability burden. This study aimed to assess the global and regional burden and trends of Alzheimer’s disease and other dementias in adults aged 60 years or older from 1990 to 2021, with a particular focus on the impact of the COVID-19 pandemic on mortality, prevalence, and disability-adjusted life years. Using Global Burden of Disease (GBD 2021) data, we analyzed age-standardized death rates (ASDR), incidence rates (ASIR), prevalence rates (ASPR), and disability-adjusted life years (DALYs) from 1990 to 2021. Temporal trends were assessed using the Estimated Annual Percentage Change (EAPC). Projections were modeled using Bayesian Age-Period-Cohort (BAPC) techniques. We evaluated excess mortality by comparing actual versus expected deaths during the pandemic. Decomposition analysis examined the contributions of population growth, aging, and epidemiological shifts. We analyzed health inequality to highlight and address disparities in health status and resource access across regions. All plots and tables were created using Joinpoint Regression model (Version 4.8.0.1), StataMP 18, and R statistical packages (Version 4.4.1). In 2021, global mortality from AD and other dementias among individuals aged 60 and older reached approximately 1,922,970.75 cases (95% CI: 480,348.08 to 5,104,315.95), and the prevalence was 52,560,253.51 cases (95% CI: 41,399,948.84 to 65,633,448.71). High Body Mass Index (BMI) and High Fasting Plasma Glucose (FPG) were prominent risk factors. Projections suggest a near fourfold increase in AD cases by 2050, driven by population growth and aging, with females disproportionately affected. Health inequalities persist, with higher disease burdens in high-SDI regions. The pandemic impacted mortality unevenly, highlighting regional disparities. Although incidence rates declined from 1990 to 2021, the overall burden of AD and dementias remains substantial and is expected to rise significantly by 2050. The findings underscore the need for targeted interventions addressing risk factors like High FPG, gender disparities, and the socioeconomic effects of COVID-19, particularly in high-SDI countries.

Apatinib was the first anti-angiogenic agent approved for treatment of metastatic gastric cancer (GC). However, the emergence of resistance was inevitable. Thus investigating new and valuable off-target effect of apatinib directly against cancer cells is of great significance. Here, we identified extra spindle pole bodies-like 1 (ESPL1) was responsible for apatinib resistance in GC cells through CRISPR genome-wide gain-of-function screening. Loss of function studies further showed that ESPL1 inhibition suppressed cell proliferation, migration and promoted apoptosis in vitro, and accordingly ESPL1 knockdown sensitized GC cells to apatinib. In addition, we found ESPL1 interacted with mouse double minute 2 (MDM2), a E3 ubiquitin protein ligase, and the combination of MDM2 siRNA with apatinib synergistically ameliorated the resistance induced by ESPL1 overexpression. In summary, our study indicated that ESPL1 played a critical role in apatinib resistance in GC cells. Inhibition of MDM2 could rescue the sensitivity of GC cells to apatinib and reverse ESPL1-mediated resistance.

Background: Biobanks are fundamental infrastructures for medical research, and their sustainable development depends on public participation and support. Older adults are at high risk of age-related diseases, making their biospecimens particularly valuable for scientific research. Amid global population aging, understanding the perceptions and willingness of older adults regarding biobank participation is essential. However, empirical evidence on this topic remains scarce in China. Methods: A cross-sectional survey was conducted using a self-administered questionnaire among 1,143 Chinese participants, of whom 745 (65.18%) were aged ≥ 60 years (older group) and 398 (34.82%) were aged 20–60 years (control group). The questionnaire covered demographic information, awareness of biobanks, donation willingness, informed consent preferences, and related attitudes. Chi-square tests and Spearman’s rank correlation were used for statistical analysis. Results: Awareness of biobanks among older adults was low, with 14.96% of the total sample reporting having heard of biobanks, willingness to donate was divergent, with 34.03% of the total sample expressing willingness. The primary motivations were “research will improve disease diagnosis and treatment” (41.03%) and “understanding my own health” (30.10%). Major concerns included “potential harm to personal health” (35.52%) and “privacy leakage” (34.12%). Regarding informed consent, 32.28% opposed the “broad” consent model, 53.98% were unaware of the right to withdraw consent at any time, and 36.48% opposed the use of samples beyond the initial consent scope. Age was positively correlated with awareness (ρ = 0.326) and donation willingness (ρ = 0.227) (both P < 0.001). Chi-square tests showed that age, marital status, income, education, self-rated health, and activities of daily living were influencing factors of donation willingness (all P < 0.05). Conclusions: Older adults have limited knowledge of biobanks but display a split willingness, a substantial minority (34.03% of the total sample) expressed willingness, with a notable proportion remaining uncertain, forming an “awareness-willingness gap”. Their donation decisions are driven by both altruistic and self-oriented motives, whereas concerns center on health risks and privacy protection. There is a substantial information deficit regarding informed consent. These findings highlight the need for tailored public communication, optimized consent procedures (e.g., tiered consent), enhanced privacy protection, and transparent governance to promote the informed and sustained participation of older adults in biobank research.