With global ageing accelerating, cognitive impairment has emerged as a critical public health challenge. Although vegetarian diets are often promoted for their health benefits, their specific impact on cognitive function in older adults remains scientifically controversial and insufficiently studied, particularly across diverse populations. This multi-national study analyzed data from China, Europe and the United States. Using logistic regression and mixed-effects models, we examined graded vegetarian diets' association with cognitive impairment in older adults, adjusting for key covariates. Findings were validated through sensitivity analyses and cross-cohort verification. Both lacto-ovo vegetarian (28% higher risk) and vegan (33% higher risk) diets showed significantly increased cognitive impairment risk compared to omnivorous diets. A pronounced gradient effect was observed, with stricter vegetarian diets associated with greater risk. This association was particularly strong in rural populations. Validation analyses confirmed these patterns in European cohorts and showed consistent trends in U.S. Strict vegetarian diets are associated with elevated cognitive impairment risk in older adults, especially in rural areas. These findings highlight the need for careful consideration of dietary patterns in ageing populations and suggest that less restrictive vegetarian diets may be preferable for cognitive health.

BACKGROUND Hepatocellular carcinoma (HCC) remains a leading cause of cancer-related mortality globally. It is often diagnosed at advanced stages or in patients unsuitable for traditional curative treatments. Stereotactic body radiation therapy (SBRT), also known as stereotactic ablative radiotherapy (SABR), has emerged as a highly effective and non-invasive local treatment, demonstrating excellent local control rates across various HCC stages. This bibliometric study aims to comprehensively analyze the research trends, hotspots, and collaborative patterns in the field of SBRT for HCC from 2004 to 2025. OBJECTIVE This bibliometric study aims to comprehensively analyze the research trends, hotspots, and collaborative patterns in the field of stereotactic body radiation therapy (SBRT) for hepatocellular carcinoma (HCC) from 2004 to 2025. METHODS Literature on SBRT for HCC published between January 1, 2004, and November 12, 2025, was retrieved from the Web of Science Core Collection (WoSCC) database. A total of 2,216 relevant publications were identified and analyzed using bibliometric software including Biblioshiny (R version 4.4.1), VOSviewer (version 1.6.17), ScimagoGraphica (version 1.0.41), CiteSpace (version 6.1. R6), and Microsoft Excel (2019 edition). The analysis covered publication output, country/region, institution, author contributions, journal distribution, co-citation patterns, and keyword trends. RESULTS A total of 2,216 publications (1,796 articles, 420 reviews) were analyzed, revealing a significant upward trend in annual publications, with a peak of over 220 in 2021. The United States and China emerged as leading countries in research output and international collaboration, with the United States also having the highest citation count. Key institutions included the University of Toronto, the University of Texas System, and Harvard University. Laura A. Dawson and Marta Scorsetti were identified as the most prolific and influential authors. The International Journal of Radiation Oncology Biology Physics was the core journal, leading in H-index and citations. Keyword analysis identified “stereotactic body radiotherapy,” “radiotherapy,” “SBRT,” and “radiofrequency ablation” (RFA) as high-frequency terms. Recent research hotspots (2023-2025) include “Y90 radioembolization,” “open-label studies,” and “motion management,” indicating a shift towards integrated and technologically advanced approaches, along with growing interest in combining SBRT with immunotherapy and targeted therapy. CONCLUSIONS The field of SBRT for HCC has experienced rapid growth over the past two decades, with the United States and China at the forefront of research. SBRT has proven effective across early-stage, recurrent, and locally advanced HCC, particularly in combination with systemic therapies. Future research should prioritize large-scale randomized controlled trials (RCTs), explore SBRT’s synergy with novel immunotherapies, optimize patient selection with biomarkers, and refine advanced delivery techniques to further enhance patient outcomes and broaden its clinical application.