A culturally integrated framework for infant nutrition beyond health education: lessons and a model from the Tibetan population.

The progressive increase in life expectancy and population aging have led to greater research interest into cognitive impairment, including dementia, among the elderly, and overcoming the condition represents a difficult public health challenge (). Cognitive impairment refers to dysfunctional performance in one or more cognitive domains, such as memory, language, executive function, attention, and motor function (). According to the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD), the number of individuals with dementia is expected to increase from 57.4 million globally in 2019 to 152.8 million in 2050. In China, specifically, the number of people with dementia is expected to increase twofold by 2050 (). For people aged 60 years, the prevalence of dementia in China was estimated to be 6.0%, representing 15.07 million adults aged 60 years or older with dementia (). Previous studies have shown that cognitive decline and dementia in older people are associated with multiple factors, including, but not limited to, advanced age, female sex, low levels of education, and history of hypertension, hyperlipidemia, diabetes, and heart and cerebrovascular diseases (, ). Older adults with prior military service may face an elevated risk of cognitive impairment in later life. Several risk factors associated with cognitive impairment that have been identified in the general population may be more prevalent among military veterans. For example, vascular risk factors, which increase the overall risk of dementia, appear more common in veteran populations compared to the general public (). Furthermore, data from the 2010 Behavioral Risk Factor Surveillance Survey indicated that male veterans were more likely than male civilians to report current smoking and heavy alcohol consumption (). Military experience may also be associated with a higher likelihood of exposure to events that can significantly increase cognitive health risks. For example, traumatic brain injury (TBI) and posttraumatic stress disorder (PTSD) are particularly common among military personnel owing to their unique set of exposures (). One study showed that in a sample of active-duty U.S. military service members, cognitive impairment associated with TBI adversely affected performance in tasks related to working memory and basic neural processing (). A large national study of U.S. military veterans with TBI demonstrated that mild TBI, even without loss of consciousness, was associated with a more than twofold increase in the risk of dementia (). Recent research has also shown that veterans with comorbid TBI and cannabis use disorder (CUD) may be more susceptible to early-onset cognitive disorders, including dementia (). The prevalence of PTSD is also high among service members and veterans, and those with PTSD are more likely than those without the disorder to meet the criteria for memory impairment and to exhibit impairment in any cognitive domain (). A recent meta-analysis quantifying the association between PTSD and the risk of dementia demonstrated that PTSD is a strong risk factor for all-cause dementia in both military and non-military populations (). Overall, these military-associated factors may contribute collectively to the development of cognitive impairment.