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Ma H, Mu X, Jin Y, Luo Y, Wu M, Han Z. Multimorbidity, lifestyle, and cognitive function: A cross-cultural study on the role of diabetes, cardiovascular disease, cancer, and chronic respiratory diseases. J Affect Disord 2024; 362:560-568. [PMID: 39019233 DOI: 10.1016/j.jad.2024.07.053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Revised: 06/18/2024] [Accepted: 07/12/2024] [Indexed: 07/19/2024]
Abstract
BACKGROUND The effect of lifestyle factors on cognitive function related to four major noncommunicable diseases (NCDs) including diabetes, cardiovascular disease, cancer, and chronic respiratory diseases, and the relationship between these NCDs and cognitive function have not been fully studied. We aimed to investigate the longitudinal associations between these NCDs and cognitive function in middle-aged and older people, and the combined effects of lifestyle factors. METHODS By employing the data from three large-scale cohort studies from the U.S. Health and Retirement Study (2010-2019), English Longitudinal Study of Aging (2014-2019), and China Health and Retirement Longitudinal Study (2011-2019), this study carried out a multi-cohort analysis to 77, 210 participants. Fixed-effects regression models were used to examine associations between NCD status and cognitive function. Margin plots were used to illustrate the effect of lifestyle factors. RESULTS Our findings revealed the dose-dependent association between mounting these NCDs and declining cognitive performance, ranging from one NCD (β = -0.05, 95 % CI: -0.08 to -0.02) to four NCDs (β = -0.51, 95 % CI: -0.75 to -0.28). Decline in cognitive function associated with NCDs was exacerbated with physical inactivity, current smoking status, and an increase in unhealthy lifestyle behaviors. LIMITATIONS The observational study design precludes causal interrogation of lifestyles and four NCDs on cognitive function. CONCLUSIONS An increasing number of these NCDs were dose-dependently associated with the decline in cognitive function score. Unhealthy lifestyle factors expedite decline in cognitive function linked to these NCDs.
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Affiliation(s)
- Huifen Ma
- School of Medical Management, Shandong First Medical University, Jinan, China
| | - Xiaomin Mu
- School of Healthcare Security, Shandong First Medical University, Jinan, China
| | - Yinzi Jin
- Department of Global Health, School of Public Health, Peking University, Beijing, China; Institute for Global Health and Development, Peking University, Beijing, China
| | - Yanan Luo
- Department of Global Health, School of Public Health, Peking University, Beijing, China; Institute for Global Health and Development, Peking University, Beijing, China
| | - Min Wu
- School of Healthcare Security, Shandong First Medical University, Jinan, China
| | - Zhiyan Han
- School of Healthcare Security, Shandong First Medical University, Jinan, China.
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Chen L, Li D, Tang K, Li Z, Xiaoyun Huang. Sleep duration and leisure activities are involved in regulating the association of depressive symptoms, muscle strength, physical function and mild cognitive impairment. Heliyon 2024; 10:e33832. [PMID: 39027538 PMCID: PMC11255586 DOI: 10.1016/j.heliyon.2024.e33832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2024] [Revised: 06/11/2024] [Accepted: 06/27/2024] [Indexed: 07/20/2024] Open
Abstract
Background In order to lessen the burden of Alzheimer's disease (AD), timely and efficient management and intervention methods for mild cognitive impairment (MCI) are crucial. MCI is seen as a transitional stage between normal aging and dementia. Although sarcopenia is an important risk factor for MCI, it is unclear what factors mediates and regulates the brain-muscle communication. Our objective was to investigate the indirect moderating effects of sleep duration and leisure activity on depressive symptoms, sarcopenia and MCI. Method Panel data from the 2015 China Health and Retirement Longitudinal Study (CHARLS) database was used in this investigation. we used Bootstrap sampling to determine the relationship between sleep duration, leisure activity, depressive symptoms, sarcopenia, and MCI in mediation and indirect moderation models. The outcome measurements were odds ratio (OR) and confidence interval (CI). Result After adjusting for confounding variables, we discovered that sarcopenia and its traits, such as handgrip strength, gait speed, standing test, and muscle mass, were significantly correlated with MCI. Second, the results implied that depressive symptoms played a role in modulating the link between physical function, muscle strength, and MCI. This moderating effect was impacted by short sleep duration and moderate to high levels of leisure activities. Conclusion We discovered that MCI was highly correlated not only with physical function and muscle strength but also with depressed symptoms, which acted as a partially mediating factor in this connection. Handgrip strength, gait speed, and standing test mediated the correction of MCI caused by depression symptoms. Importantly, leisure activities and sleep duration had indirect moderating effects on the above associations, and future management policies should take these factors into account.
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Affiliation(s)
- Linfeng Chen
- Department of Neurology, Songshan Lake Central Hospital of Dongguan City, Guangdong Medical University, Dongguan, Guangdong, People's Republic of China
| | - Dan Li
- Department of Neurology, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, GuangDong, People's Republic of China
| | - Ke Tang
- Department of Neurology, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, GuangDong, People's Republic of China
| | - Zhong Li
- Department of Neurology, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, GuangDong, People's Republic of China
- Shenzhen Research Institute of Sun Yat-Sen University, Shenzhen, Guangdong, People's Republic of China
- Guangdong Provincial Key Laboratory of Brain Function and Disease, Guangzhou, GuangDong, People's Republic of China
| | - Xiaoyun Huang
- Department of Neurology, Songshan Lake Central Hospital of Dongguan City, Guangdong Medical University, Dongguan, Guangdong, People's Republic of China
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He Y, Huang Y, Li R, Zhang M, Zhu M, Wang F. Switching indoor fuels and the incidence of physical-psychological-cognitive multimorbidity: A prospective cohort study. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2024; 282:116719. [PMID: 39002375 DOI: 10.1016/j.ecoenv.2024.116719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/01/2024] [Revised: 07/07/2024] [Accepted: 07/09/2024] [Indexed: 07/15/2024]
Abstract
BACKGROUND In developing countries, including China, solid-fuel-based heating and cooking is common. For older people, the multimorbidity prevalence is exceptionally high. Nevertheless, studies on the associations of indoor solid fuels use, especially switching fuels types, on multimorbidity in middle-aged and older people is scarce. METHODS Data from five waves of the China Health and Retirement Longitudinal Study were used in this study. Indoor fuels were classified as solid or clean fuels. Physical-psychological-cognitive multimorbidity (PPC-multimorbidity) was defined as the simultaneous presence of three disease types (physical illness, psychological disorders, cognitive impairment). Using Cox proportional risk models, hazard ratios (HRs) and 95 % confidence intervals (95 % CI) were calculated to investigate the associations of heating- and cooking-related baseline indoor fuels and switching indoor fuels with PPC-multimorbidity incidence. RESULTS In the heating (n=3121, mean age=56.55 years, male proportion=54.25 %) and cooking (n=3574, mean age=56.67 years, male proportion=52.94 %) analyses, 75.07 % and 45.64 % of the participants used solid fuels at baseline, and 564 (18.07 %) and 613 (17.15 %) PPC-multimorbidity cases were diagnosed during follow-up, respectively. Participants with baseline heating- and cooking-based solid fuels use had greater PPC-multimorbidity incidences [HRs (95 % CIs): 1.23 (0.98, 1.55) and 1.44 (1.21, 1.73)], respectively. Additionally, combined baseline heating- and cooking-based solid fuels use was associated with even greater PPC-multimorbidity incidence [HR (95 % CI): 1.55 (1.18, 2.04)]. Persistent solid fuels use obviously increased the PPC-multimorbidity incidence [HRs (95 % CIs): 2.43 (1.67, 3.55) for heating and 2.63 (2.03, 3.40) for cooking]. Moreover, switching from solid to clean fuels was associated with a significantly decreased PPC-multimorbidity incidence [HRs (95 % CIs): 0.27 (0.20, 0.35) for heating and 0.36 (0.28, 0.46) for cooking]. CONCLUSIONS Long-term solid-fuels use is associated with an increased PPC-multimorbidity incidence, and switching to cleaner fuels is associated with a decreased PPC-multimorbidity incidence in adults aged ≥45 years.
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Affiliation(s)
- Yurou He
- Group of Chronic Disease and Environmental Genomics, School of Public Health, China Medical University, Shenyang, Liaoning 110122, China.
| | - Yuwei Huang
- Group of Chronic Disease and Environmental Genomics, School of Public Health, China Medical University, Shenyang, Liaoning 110122, China.
| | - Runze Li
- Group of Chronic Disease and Environmental Genomics, School of Public Health, China Medical University, Shenyang, Liaoning 110122, China
| | - Mingqi Zhang
- Group of Chronic Disease and Environmental Genomics, School of Public Health, China Medical University, Shenyang, Liaoning 110122, China
| | - Mingye Zhu
- Group of Chronic Disease and Environmental Genomics, School of Public Health, China Medical University, Shenyang, Liaoning 110122, China
| | - Fang Wang
- Group of Chronic Disease and Environmental Genomics, School of Public Health, China Medical University, Shenyang, Liaoning 110122, China; Key Laboratory of Environmental Stress and NCDs Control, Ministry of Education, China Medical University, Shenyang, Liaoning 110122, China; The Key Laboratory of Liaoning Province on Toxic and Biological Effects of Arsenic, China Medical University, Shenyang, Liaoning 110122, China.
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Zhao Q, Seow WJ. Association of solid fuel use with cognitive function and the modifying role of lifestyle: A nationwide cohort study in China. ENVIRONMENTAL RESEARCH 2024; 260:119538. [PMID: 38971352 DOI: 10.1016/j.envres.2024.119538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Revised: 05/24/2024] [Accepted: 06/30/2024] [Indexed: 07/08/2024]
Abstract
BACKGROUND As opposed to a healthy lifestyle, indoor air pollution from solid fuel use may be harmful for cognitive function. However, the extent to which lifestyle modifies the association between solid fuel use and cognitive function remains unknown. METHODS A total of 21,008 individuals aged 16 to 92 were enrolled in 2010 and followed up to 2014 in the China Family Panel Studies (CFPS). Cognitive function was assessed using standardized math and word tests in two waves. Solid fuel use at baseline was assessed by self-reporting of firewood, straw, or coal used for cooking. Lifestyle profile was classified into two groups (favorable vs. unfavorable) based on five modifiable lifestyle factors including alcohol drinking, smoking, body mass index, diet, and physical activity. Linear mixed-effects models were employed to assess the association of solid fuel use and lifestyle with cognitive function. The effect modification of lifestyle was analyzed. RESULTS A total of 49.7% of the study population used solid fuels for cooking and 17.4% had a favorable lifestyle. Solid fuel use was associated with a significant decrease in cognitive function (β = -0.29, 95% CI: -0.39, -0.19 for math test; β = -0.62, 95% CI: -0.84, -0.41 for word test). Lifestyle significantly modified this association (p-interaction: 0.006 for math test; 0.016 for word test), with the corresponding association being less pronounced among participants adhering to a favorable lifestyle compared to those with an unfavorable lifestyle. CONCLUSION A favorable lifestyle may attenuate the adverse association between solid fuel use and cognitive function. Adopting a favorable lifestyle has the potential to mitigate the adverse neurological effects due to indoor air pollution.
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Affiliation(s)
- Qi Zhao
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore
| | - Wei Jie Seow
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore; Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore.
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Luo Y, Zhao D, Pan X, Lingling Z. Household Environments and Cognitive Decline Among Middle-Aged and Older Adults in China: Exploring Gender, Age, and Residential Variations. Int J Aging Hum Dev 2024:914150241260824. [PMID: 38859750 DOI: 10.1177/00914150241260824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2024]
Abstract
This study examined the relationship between household environments and trajectories of cognitive function among middle-aged and older adults in China and its urban/rural, gender, and age variations. We estimated multi-level linear growth curve models using a representative sample of 16,111 respondents aged 45 years and over from the China Health and Retirement Longitudinal Study (2011-2018). Older people who lived with a spouse, but not with children, and those with higher living expenditures, better housing quality, and indoor clean fuels for cooking had a slower cognitive decline. Living arrangement more strongly predicted men's cognitive decline, while living expenditure, solid fuel use, and housing quality significantly predicted only women's cognitive decline. Only for older adults and rural residents, those living alone had significantly faster cognitive decline than those living with a spouse only. These findings underscore the importance of improving the living conditions of older adults to help alleviate their cognitive decline.
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Affiliation(s)
- Ye Luo
- Department of Sociology, Anthropology and Criminal Justice, Clemson University, Clemson, SC, USA
| | - Dandan Zhao
- Department of Sociology, Anthropology and Criminal Justice, Clemson University, Clemson, SC, USA
| | - Xi Pan
- Department of Sociology, Texas State University, San Marcos, TX, USA
| | - Zhang Lingling
- Department of Nursing, University of Massachusetts Boston, Boston, MA, USA
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Yang R, He J, Zhong KK, Fan MX, Bao T, Liu XC, Zhong Q. Relationship of solid fuels use with cognitive function and efficacy of switching to cleaner fuels or using ventilation: A systematic review and meta-analysis. ENVIRONMENTAL RESEARCH 2024; 249:118314. [PMID: 38331145 DOI: 10.1016/j.envres.2024.118314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/10/2023] [Revised: 01/06/2024] [Accepted: 01/24/2024] [Indexed: 02/10/2024]
Abstract
BACKGROUND A growing number of studies have examined the relation between solid fuels use and cognitive function in the mid-elderly, but results are inconsistent. Therefore, a systematic review and meta-analysis was carried out to evaluate their relevance and the efficacy of switching to cleaner fuels or using ventilation. METHOD We used PubMed, Web of Science, and Cochrane Library databases to identify 17 studies in which the primary outcome variable was cognitive function decline or cognitive disorders, and the exposure measure was solid fuels use. The final search date of August 31, 2023. The effect size of odds ratio (OR), regression coefficient (β), and 95% confidence interval (CI) were pooled. Heterogeneity and the possibility of publication bias were assessed by using the Q-statistic and Begg's test, respectively. RESULT Among the 17 included papers, the study participants were ≥45 years old. Eleven studies assessed the relationship between solid fuels use and cognitive function decline [number of studies (n) = 11, β = -0.144; I2 = 97.7%]. Five studies assessed the relationship between solid fuels use and cognitive disorders (n = 5, OR = 1.229; I2 = 41.1%). Switching from using solid fuels to clean fuels could reduce the risk of cognitive function decline as compared to those who remained on using solid fuels (n = 2; β = 0.710; I2 = 82.4%). Among participants using solid fuels, who cooked without on ventilated stoves were correlated with an enhanced risk of cognitive disorders as compared to participants who cooked with ventilated stoves (n = 2; OR = 1.358; I2 = 44.7%). CONCLUSION Our meta-analysis showed a negative relationship between solid fuels use with cognitive function, and a positive relationship with cognitive disorders. Cleaner fuels, using ventilation, improved cookstoves can reduce the adverse health hazards of solid fuels use.
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Affiliation(s)
- Rui Yang
- School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, China
| | - Jie He
- School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, China
| | - Kang-Kang Zhong
- School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, China
| | - Ming-Xuan Fan
- School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, China
| | - Teng Bao
- Second School of Clinical Medicine, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, China
| | - Xue-Chun Liu
- Department of Neurology, The Second People's Hospital of Hefei, Hefei Hospital Afliated to Anhui Medical University, Hefei, Anhui, China.
| | - Qi Zhong
- School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, China.
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Zhang X, Ding L, Yang F, Qiao G, Gao X, Xiong Z, Zhu X. Association between indoor air pollution and depression: a systematic review and meta-analysis of cohort studies. BMJ Open 2024; 14:e075105. [PMID: 38719299 PMCID: PMC11086541 DOI: 10.1136/bmjopen-2023-075105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 04/18/2024] [Indexed: 05/12/2024] Open
Abstract
OBJECTIVES Incomplete combustion of solid fuel and exposure to secondhand smoke (SHS) are the primary causes of indoor air pollution (IAP), potentially leading to detrimental effects on individual mental health. However, current evidence regarding the association between IAP and depression remains inconclusive. This study aims to systematically investigate the evidence regarding the association between IAP and the risk of depression. DESIGN Systematic review and meta-analysis of cohort studies. DATA SOURCES Two independent reviewers searched PubMed, the Cochrane Library, Web of Science and EMBASE for available studies published up to 13 January 2024. ELIGIBILITY CRITERIA We included all cohort studies published in English that aimed to explore the relationship between IAP from solid fuel use and SHS exposure and the risk of depression. DATA EXTRACTION AND SYNTHESIS Two independent reviewers extracted data and assessed the risk of bias. The association between IAP and depression was calculated using pooled relative risk (RR) with 95% CIs. Heterogeneity was assessed using the I2 value, and the effect estimates were pooled using fixed-effects or random-effects models depending on the results of homogeneity analysis. RESULTS We included 12 articles with data from 61 217 participants. The overall findings demonstrated a significant association between IAP exposure and depression (RR=1.22, 95% CI: 1.13 to 1.31), although with substantial heterogeneity (I2=75%). Subgroup analyses based on pollutant type revealed that IAP from solid fuel use was associated with a higher risk of depression (RR=1.20, 95% CI: 1.13 to 1.26; I2=62%; 5 studies, 36 768 participants) than that from SHS exposure (RR=1.11, 95% CI: 0.87 to 1.41; I2=80%; 7 studies, 24 449 participants). In terms of fuel use, the use of solid fuel for cooking (RR: 1.23, 95% CI: 1.16 to 1.31; I2=58%; 4 studies, 34 044 participants) and heating (RR 1.15, 95% CI: 1.04 to 1.27; I2=65%; 3 studies, 24 874 participants) was associated with increased depression risk. CONCLUSIONS The findings from this systematic review and meta-analysis of cohort studies indicated an association between exposure to IAP and depression. PROSPERO REGISTRATION NUMBER CRD42022383285.
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Affiliation(s)
| | - Linlin Ding
- School of Nursing, Hubei University of Chinese Medicine, Wuhan, China
| | - Fen Yang
- School of Nursing, Hubei University of Chinese Medicine, Wuhan, China
| | - Guiyuan Qiao
- School of Nursing, Hubei University of Chinese Medicine, Wuhan, China
| | - Xiaolian Gao
- School of Nursing, Hubei University of Chinese Medicine, Wuhan, China
| | - Zhenfang Xiong
- School of Nursing and Health Management, Wuhan Donghu University, Wuhan, China
| | - Xinhong Zhu
- School of Nursing, Hubei University of Chinese Medicine, Wuhan, China
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Wang Y, Dou L, Wang N, Zhao Y, Nie Y. An analysis of factors influencing cognitive dysfunction among older adults in Northwest China based on logistic regression and decision tree modelling. BMC Geriatr 2024; 24:405. [PMID: 38714934 PMCID: PMC11077840 DOI: 10.1186/s12877-024-05024-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Accepted: 04/29/2024] [Indexed: 05/12/2024] Open
Abstract
BACKGROUND Cognitive dysfunction is one of the leading causes of disability and dependence in older adults and is a major economic burden on the public health system. The aim of this study was to investigate the risk factors for cognitive dysfunction and their predictive value in older adults in Northwest China. METHODS A cross-sectional study was conducted using a multistage sampling method. The questionnaires were distributed through the Elderly Disability Monitoring Platform to older adults aged 60 years and above in Northwest China, who were divided into cognitive dysfunction and normal cognitive function groups. In addition to univariate analyses, logistic regression and decision tree modelling were used to construct a model to identify factors that can predict the occurrence of cognitive dysfunction in older adults. RESULTS A total of 12,494 valid questionnaires were collected, including 2617 from participants in the cognitive dysfunction group and 9877 from participants in the normal cognitive function group. Univariate analysis revealed that ethnicity, BMI, age, educational attainment, marital status, type of residence, residency status, current work status, main economic source, type of chronic disease, long-term use of medication, alcohol consumption, participation in social activities, exercise status, social support, total scores on the Balanced Test Assessment, total scores on the Gait Speed Assessment total score, and activities of daily living (ADL) were significantly different between the two groups (all P < 0.05). According to logistic regression analyses, ethnicity, BMI, educational attainment, marital status, residency, main source of income, chronic diseases, annual medical examination, alcohol consumption, exercise status, total scores on the Balanced Test Assessment, and activities of daily living (ADLs) were found to influence cognitive dysfunction in older adults (all P < 0.05). In the decision tree model, the ability to perform activities of daily living was the root node, followed by total scores on the Balanced Test Assessment, marital status, educational attainment, age, annual medical examination, and ethnicity. CONCLUSIONS Traditional risk factors (including BMI, literacy, and alcohol consumption) and potentially modifiable risk factors (including balance function, ability to care for oneself in daily life, and widowhood) have a significant impact on the increased risk of cognitive dysfunction in older adults in Northwest China. The use of decision tree models can help health care workers better assess cognitive function in older adults and develop personalized interventions. Further research could help to gain insight into the mechanisms of cognitive dysfunction and provide new avenues for prevention and intervention.
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Affiliation(s)
- Yu Wang
- Zhejiang Provincial People's Hospital, No.158 Shangtang Road, Hangzhou City, Zhejiang Province, 310014, People's Republic of China
| | - Li Dou
- The Second Affiliated Hospital of Xinjiang Medical University, No. 38, North 2nd Lane, Nanhu East Road, Shuimogou District, Urumqi City, Xinjiang Uygur Autonomous Region, 830063, People's Republic of China
| | - Ni Wang
- School of Nursing, Xinjiang Medical University, No.567 Shangde North Road, Urumqi City, Xinjiang Uygur Autonomous Region, 830000, People's Republic of China
| | - Yanjie Zhao
- School of Nursing, Xinjiang Medical University, No.567 Shangde North Road, Urumqi City, Xinjiang Uygur Autonomous Region, 830000, People's Republic of China
| | - Yuqin Nie
- The Second Affiliated Hospital of Xinjiang Medical University, No. 38, North 2nd Lane, Nanhu East Road, Shuimogou District, Urumqi City, Xinjiang Uygur Autonomous Region, 830063, People's Republic of China.
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Chen C, Ou Y, Cai A, Huang Y, Feng Y, Nie Z. Household use of solid fuel and sarcopenia among middle-aged and older adults: The China Health and Retirement Longitudinal Study. Maturitas 2024; 182:107925. [PMID: 38325137 DOI: 10.1016/j.maturitas.2024.107925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Revised: 12/25/2023] [Accepted: 01/24/2024] [Indexed: 02/09/2024]
Abstract
OBJECTIVE Few studies have examined the effects of air pollution on the risk of sarcopenia, especially pollution in indoor settings. We explored the cross-sectional and longitudinal associations of household use of solid fuel for cooking and heating, separately and simultaneously, with risk of sarcopenia. METHODS Cross-sectional and follow-up data from the China Health and Retirement Longitudinal Study were used. Multivariable-adjusted generalized linear models and Cox proportional hazards regression models were performed to estimate the odds ratio and hazard ratio for sarcopenia, respectively. RESULTS 11,494 (median age: 57.0 years; 47.4 % males) and 7483 (median age: 57.0 years; 46.9 % males) participants were included in the cross-sectional and longitudinal study, respectively. After fully adjusting for covariates, including outdoor concentration of particulate matter (PM2.5), both the use of solid fuels for cooking and use for heating were positively associated with incident sarcopenia in the longitudinal analyses, with hazard ratios (95 % confidence interval) of 1.56 (1.28-1.89) and 1.26 (1.04-1.52), respectively. Moreover, significant multiplicative and/or additive interactions were observed between age, smoking and cooking with solid fuel and risk of sarcopenia (all P for interaction <0.05). Similar results were found in the cross-sectional analyses. CONCLUSIONS Household use of solid fuel was significantly associated with a higher risk of sarcopenia, while ageing and smoking had synergetic effects with burning solid fuels on the risk of sarcopenia. Our results highlight the importance of taking multi-pronged measures with respect to both air pollution and healthy lifestyle to prevent sarcopenia and promote healthy ageing.
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Affiliation(s)
- Chaolei Chen
- Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou 510080, China
| | - Yanqiu Ou
- Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou 510080, China
| | - Anping Cai
- Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou 510080, China
| | - Yuqing Huang
- Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou 510080, China
| | - Yingqing Feng
- Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou 510080, China.
| | - Zhiqiang Nie
- Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou 510080, China; Global Health Research Center, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou 510080, China.
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Chen Q, Zhou T, Zhang C, Zhong X. Exploring relevant factors of cognitive impairment in the elderly Chinese population using Lasso regression and Bayesian networks. Heliyon 2024; 10:e27069. [PMID: 38449590 PMCID: PMC10915566 DOI: 10.1016/j.heliyon.2024.e27069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 02/12/2024] [Accepted: 02/23/2024] [Indexed: 03/08/2024] Open
Abstract
Older adults are highly susceptible to developing cognitive impairment(CI). Various factors contribute to the prevalence of CI, but the potential relationships among these factors remain unclear. This study aims to explore the relevant factors associated with CI in Chinese older adults and analyze the potential relationships between CI and these factors.We analyzed the data on 6886 older adults aged≥60 from the China Health and Retirement Longitudinal Study (CHARLS) 2018. Lasso regression was initially used to screening variables. Bayesian Networks(BNs) were used to identify the correlates of CI and potential associations between factors. After screening with Lasso regression, 11 variables were finally included in the BNs. The BNs, by establishing a complex network relationship, revealed that age, education, and indoor air pollution were the direct correlates affecting the occurrence of CI in older adults. It also indicated that marital status indirectly influenced CI through age, and residence indirectly linked to CI through two pathways: indoor air pollution and education.Our findings underscore the effectiveness of BNs in unveiling the intricate network linkages among CI and its associated factors, holding promising applications. It can serve as a reference for public health departments to address the prevention of CI in the elderly.
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Affiliation(s)
- Qiao Chen
- College of Public Health, Chongqing Medical University, Chongqing, 400016, China
- Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing, China
| | - Tianyi Zhou
- College of Public Health, Chongqing Medical University, Chongqing, 400016, China
| | - Cong Zhang
- College of Public Health, Chongqing Medical University, Chongqing, 400016, China
| | - Xiaoni Zhong
- College of Public Health, Chongqing Medical University, Chongqing, 400016, China
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Peng H, Wang M, Wang Y, Niu Z, Suo F, Liu J, Zhou T, Yao S. The association between indoor air pollution from solid fuels and cognitive impairment: a systematic review and meta-analysis. REVIEWS ON ENVIRONMENTAL HEALTH 2024:reveh-2023-0158. [PMID: 38413202 DOI: 10.1515/reveh-2023-0158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 11/05/2023] [Accepted: 01/26/2024] [Indexed: 02/29/2024]
Abstract
This study aimed to comprehensively and methodically evaluate the correlation between cognitive impairment and indoor air pollution from solid fuel used for cooking/heating. PubMed, Web of Science, EMBASE, and Cochrane Library databases were searched up to December January 2023. 13 studies from three countries with a total of 277,001 participants were enrolled. A negative correlation was discovered between solid fuel usage for cooking and total cognitive score (β=-0.73, 95 % CI: -0.90 to -0.55) and episodic memory score (β=-0.23, 95 % CI: -0.30 to -0.17). Household solid fuel usage for cooking was considerably associated with a raised risk of cognitive impairment (HR=1.31, 95 % CI: 1.09-1.57) and cognitive decline (HR=1.24, 95 % CI: 1.18-1.30). Compared to continuous solid fuel use for cooking, sustained use of clean fuel and switching from solid fuel to clean fuel were associated with a lower risk of cognitive decline (OR=0.55, 95 % CI: 0.42-0.73; OR=0.81, 95 % CI: 0.71-0.93). A negative association was found between solid fuel usage for heating and total cognitive score (β=-0.43, 95 % CI: -0.59 to -0.26) and episodic memory score (β=-0.22, 95 % CI: -0.34 to -0.10). Our research provided evidence that exposure to indoor air pollution from solid fuel is a potential cause of cognitive impairment and cognitive decline. Making the switch from solid fuels to cleaner fuels could be an important step in preventing cognitive impairment in the elderly.
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Affiliation(s)
- Hongye Peng
- 47839 Beijing University of Chinese Medicine , Beijing, China
| | - Miyuan Wang
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Beijing, China
| | - Yichong Wang
- Digestive Disease Center, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, P.R. China
| | - Zuohu Niu
- Department of Infections, 12517 Beijing Hospital of Traditional Chinese Medicine, Capital Medical University , Beijing, China
| | - Feiya Suo
- Department of Traditional Chinese Medicine, 532949 Dongguan People's Hospital , Guangzhou, China
| | - Jixiang Liu
- 47839 Beijing University of Chinese Medicine , Beijing, China
| | - Tianhui Zhou
- 47839 Beijing University of Chinese Medicine , Beijing, China
| | - Shukun Yao
- Department of Gastroenterology, 36635 China-Japan Friendship Hospital , Beijing, China
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Shen J, Shi H, Zhang J, Meng X, Zhang C, Kang Y. Household polluting cooking fuels and intrinsic capacity among older population: A harmonized nationwide analysis in India and China. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 912:169031. [PMID: 38042204 DOI: 10.1016/j.scitotenv.2023.169031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/17/2023] [Revised: 11/29/2023] [Accepted: 11/29/2023] [Indexed: 12/04/2023]
Abstract
BACKGROUNDS Household polluting cooking fuels, as an important changeable behavior, are related to various detrimental health effects among the elderly. There is limited research on the association between polluting cooking fuel use and intrinsic capacity (IC) as an indicator of healthy aging. This study aimed to evaluate the above-mentioned association in India and China, where polluting cooking fuel use is common. METHODS We enrolled 33,803 participants aged ≥60 years from two nationally representative studies: the Longitudinal Aging Study in India and the China Health and Retirement Longitudinal Study. Polluting cooking fuel use was defined as a self-report of using wood, coal, kerosene, crop residue, or dung. IC was measured by five aspects, including locomotion, cognition, vitality, sensory, and psychological capacity. The random-effects mixed linear regression and logistic regression with population weighting were performed. Multivariable-adjusted model and propensity score were used to adjust for potential confounders. RESULTS A total of 47.54 % and 59.32 % of elderly adults reported primary cooking using polluting fuels in India and China, respectively. Using polluting cooking fuels was consistently associated with IC decline; particularly, cognitive capacity was the most susceptible domain. In India, participants using polluting fuels had a 1.062 (95 % confidence interval [CI]: 1.047-1.078) times risk for IC deficits, whereas more prominent results were observed in China (odds ratio [OR]: 2.040, 95 % CI: 1.642-2.533). Such harmful effects might be alleviated by transferring from polluting to clean fuels. Additionally, the duration of polluting fuel use was also positively associated with IC deficits. CONCLUSION This study provided substantial public implications on healthy aging for the elderly population at a global scale, strengthening the importance of health education and policy efforts to accelerate the transition from polluting to clean fuels.
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Affiliation(s)
- Ji Shen
- Department of Geriatric Medicine, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, No. 1, Dahua Road, Dongdan, Dongcheng District, Beijing 100730, PR China
| | - Hong Shi
- Department of Geriatric Medicine, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, No. 1, Dahua Road, Dongdan, Dongcheng District, Beijing 100730, PR China
| | - Jie Zhang
- Department of Geriatric Medicine, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, No. 1, Dahua Road, Dongdan, Dongcheng District, Beijing 100730, PR China
| | - Xue Meng
- Office of National Clinical Research for Geriatrics, Department of Scientific Research, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, No. 1, Dahua Road, Dongdan, Dongcheng District, Beijing 100730, PR China
| | - Chi Zhang
- The Key Laboratory of Geriatrics, Beijing Institute of Geriatrics, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing Hospital/National Center of Gerontology of National Health Commission, No. 1, Dahua Road, Dongdan, Dongcheng District, Beijing 100730, PR China
| | - Yuting Kang
- Office of National Clinical Research for Geriatrics, Department of Scientific Research, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, No. 1, Dahua Road, Dongdan, Dongcheng District, Beijing 100730, PR China.
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Li M, Ma C, Wu C. Association between solid cooking fuel use and dementia in older Chinese adults: the mediating effect of depression. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2024; 34:779-791. [PMID: 36682058 DOI: 10.1080/09603123.2023.2167950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Accepted: 01/09/2023] [Indexed: 06/17/2023]
Abstract
This study aimed to explore the association between household solid cooking fuel use and dementia prevalence and the mediating effect of depression on this association. A total of 3404 (2018) and 1379 (2015 to 2018) older participants (≥65) from the China Health and Retirement Longitudinal Study (CHARLS) were enrolled in the cross-sectional and retrospective longitudinal analyses, respectively. The results showed that solid cooking fuel use was associated with an increased dementia prevalence (adjusted OR = 1.44) from 2015 to 2018. The indirect effect of depression on this association explained 7.14% and 13.11% variances in the cross-sectional and longitudinal mediating model, respectively. Thus, household solid cooking fuel use is a risk factor for the development of dementia, and depressive symptoms partially accounted for this association. The use of improved cookstoves and clean fuel in households and air cleaners and early intervention in depression may reduce the incidence of dementia.
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Affiliation(s)
- Mengyuan Li
- School of Nursing, Peking University, Beijing, China
| | - Chifen Ma
- School of Nursing, Peking University, Beijing, China
- College of Health Services and Management, Xuzhou Kindergarten Teachers College, Xuzhou, China
| | - Chao Wu
- School of Nursing, Peking University, Beijing, China
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Agyekum MW, Afrifa-Anane GF, Kyei-Arthur F. Prevalence and correlates of disability in older adults, Ghana: evidence from the Ghana 2021 Population and Housing Census. BMC Geriatr 2024; 24:52. [PMID: 38212686 PMCID: PMC10785330 DOI: 10.1186/s12877-023-04587-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 12/11/2023] [Indexed: 01/13/2024] Open
Abstract
BACKGROUND Although there are studies on disabilities in older persons, most of these studies have been carried out in developed countries. Hence, there are limited studies on disability in older adults in sub-Saharan Africa, including Ghana. The few studies that have examined the prevalence and correlates of disability in older adults used survey data for their analyses. To contribute to addressing this knowledge gap that has arisen, this study used a national census, the 2021 Ghana Population and Housing Census, to examine the prevalence and correlates of disability in older adults in Ghana. METHODS The 2021 Ghana Population and Housing Census data was used for this study. A sample size of 197,057 Ghanaians aged 60 years and above was used for this study. The Washington Group questions on disability were used to measure disability by asking older adults about their difficulties in performing the six domains of disability (physical, sight, intellectual, hearing, self-care, and speech). A multinomial logistic regression housed in STATA was used to analyse the correlates of disability in older adults in Ghana. A p-value less than 0.05 was used for statistical significance. RESULTS The results show that slightly more than one-third (38.4%) of the older adults were disabled. In terms of the number of disabilities in older adults, 16.9% had one disability condition, while 2.4% had six disability conditions. Also, 9.4% had two disability conditions. Older adults who were females, aged 70-79 years and 80 years and above, resided in rural areas, with primary, JHS/Middle, SHS, unaffiliated with religion, ever married and never married, unemployed, and belonged to the middle and rich households were more likely to have a disability condition. Also, older adults residing in the Middle and Northern zones, having no health insurance, and using clean cooking fuel were less likely to have a disability condition. CONCLUSIONS The results show that socio-demographic and household factors were associated with disability in older adults in Ghana. Hence, policymakers and researchers should target these factors when designing appropriate policies, programmes, and interventions to improve the wellbeing of older adults.
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Affiliation(s)
- Martin Wiredu Agyekum
- Institute for Educational Research and Innovation Studies, University of Education Winneba, Winneba, Ghana.
| | - Grace Frempong Afrifa-Anane
- Department of Environment and Public Health, University of Environment and Sustainable Development, Somanya, Ghana
| | - Frank Kyei-Arthur
- Department of Environment and Public Health, University of Environment and Sustainable Development, Somanya, Ghana
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Pan W, Wang M, Hu Y, Lian Z, Cheng H, Qin JJ, Wan J. The association between outdoor air pollution and body mass index, central obesity, and visceral adiposity index among middle-aged and elderly adults: a nationwide study in China. Front Endocrinol (Lausanne) 2023; 14:1221325. [PMID: 37876545 PMCID: PMC10593432 DOI: 10.3389/fendo.2023.1221325] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Accepted: 08/22/2023] [Indexed: 10/26/2023] Open
Abstract
Background Previous animal studies have suggested that air pollution (AP) exposure may be a potential risk factor for obesity; however, there is limited epidemiological evidence available to describe the association of obesity with AP exposure. Methods A retrospective cross-sectional study was conducted on 11,766 participants across mainland China in 2015. Obesity was assessed using body mass index (BMI), waist circumference (WC), and visceral adiposity index (VAI). The space-time extremely randomized tree (STET) model was used to estimate the concentration of air pollutants, including SO2, NO2, O3, PM1, PM2.5, and PM10, matched to participants' residential addresses. Logistic regression models were employed to estimate the associations of obesity with outdoor AP exposure. Further stratified analysis was conducted to evaluate whether sociodemographics or lifestyles modified the effects. Results Increased AP exposure was statistically associated with increased odds of obesity. The odds ratio (ORs) and 95% confidence interval (CI) of BMI-defined obesity were 1.21 (1.17, 1.26) for SO2, 1.33 (1.26, 1.40) for NO2, 1.15 (1.10, 1.21) for O3, 1.38 (1.29, 1.48) for PM1, 1.19 (1.15, 1.22) for PM2.5, and 1.11 (1.09, 1.13) for PM10 per 10 μg/m3 increase in concentration. Similar results were found for central obesity. Stratified analyses suggested that elderly participants experienced more adverse effects from all 6 air pollutants than middle-aged participants. Furthermore, notable multiplicative interactions were found between O3 exposure and females as well as second-hand smokers in BMI-defined obesity. Conclusions This study suggested that outdoor AP exposure had a significant association with the risk of obesity in the middle-aged and elderly Chinese population. Elderly individuals and women may be more vulnerable to AP exposure.
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Affiliation(s)
- Wei Pan
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, China
- Cardiovascular Research Institute, Wuhan University, Wuhan, China
- Hubei Key Laboratory of Cardiology, Wuhan, China
| | - Menglong Wang
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, China
- Cardiovascular Research Institute, Wuhan University, Wuhan, China
- Hubei Key Laboratory of Cardiology, Wuhan, China
| | - Yingying Hu
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, China
| | - Zhengqi Lian
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, China
- Cardiovascular Research Institute, Wuhan University, Wuhan, China
| | - Haonan Cheng
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, China
- Cardiovascular Research Institute, Wuhan University, Wuhan, China
| | - Juan-Juan Qin
- Department of Geriatrics, Zhongnan Hospital of Wuhan University, Wuhan, China
- Center for Healthy Aging, Wuhan University School of Nursing, Wuhan, China
| | - Jun Wan
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, China
- Cardiovascular Research Institute, Wuhan University, Wuhan, China
- Hubei Key Laboratory of Cardiology, Wuhan, China
- Dong Fureng Institute of Economic and Social Development, Wuhan University, Wuhan, China
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Hu Z, Tian Y, Song X, Zeng F, Yang A. Associations between indoor air pollution for cooking and heating with muscle and sarcopenia in Chinese older population. J Cachexia Sarcopenia Muscle 2023; 14:2029-2043. [PMID: 37448255 PMCID: PMC10570078 DOI: 10.1002/jcsm.13281] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 03/21/2023] [Accepted: 06/11/2023] [Indexed: 07/15/2023] Open
Abstract
BACKGROUND Exposure to air pollution brings the advent effect for various diseases, but study about the relationship between air pollution and ageing is scant. We aimed to determine the associations between household air pollution for cooking and heating with muscle and sarcopenia in Chinese older population by a nationally representative study. METHODS This cross-sectional study included individuals aged 60 and above from the China Health and Retirement Longitudinal Study between 2011 and 2015. The diagnosis of sarcopenia was defined by low muscle mass with low muscle strength and/or reduced physical performance. Generalized additive analyses and dose-dependent analyses with three models were used to assess the effects of different pattern of cooking and heating on muscle and sarcopenia. RESULTS A total of 8126 Chinese older individuals with predominant male (53.7%) and mean age of 67.3 ± 6.0 years were included in our study. Solid fuel use in cooking showed significant declines in muscle strength (β = -0.424, 95% CI: -0.767, -0.082, P = 0.01 in model 3) and mass (β = -0.034, 95% CI: -0.051, -0.017, P < 0.01 in model 3), when compared with clean fuel use in cooking, respectively. Solid fuel for heating was correlated with lower muscle strength (β = -0.637, 95% CI: -1.033, -0.241, P < 0.01 in model 3) than clean fuel for heating. The joint use of solid fuel for cooking and heating was associated with reduced muscle strength (β = -0.835, 95% CI: -1.306, -0.365, P < 0.01 in model 3) and mass (β = -0.038, 95% CI: -0.061, -0.015, P < 0.01 in model 3) than clean fuel for cooking and heating. Solid fuel for cooking was associated with significantly increased risk of low muscle strength (adjusted OR = 1.29, 95% CI: 1.11, 1.50, P < 0.01 in model 3) and mass (adjusted OR = 1.35, 95% CI: 1.11, 1.61, P < 0.01 in model 3), possible sarcopenia (adjusted OR = 1.33, 95% CI: 1.19, 1.48, P < 0.01 in model 3) and sarcopenia (adjusted OR = 1.44, 95% CI: 1.21, 1.72, P < 0.01 in model 3) compared with clean fuel for cooking. Solid fuel for heating had a significant correlation with low muscle strength (adjusted OR = 1.30, 95% CI: 1.09, 1.56, P < 0.01 in model 3) and possible sarcopenia (adjusted OR = 1.49, 95% CI: 1.31, 1.70, P < 0.01 in model 3). Dose-dependent manner was shown in the associations between the number of solid fuel with low muscle strength and possible sarcopenia. Clean fuel for cooking and solid fuel for heating was positively associated with the prevalence of possible sarcopenia than clean fuel for cooking and heating (adjusted OR = 1.34, 95% CI: 1.14, 1.57, P < 0.01 in model 3). CONCLUSIONS Our findings suggested that solid fuel for cooking and the number of solid fuel use potentially facilitates the onset and progression of muscle loss and sarcopenia.
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Affiliation(s)
- Zhigang Hu
- Department of Respiratory and Critical Care Medicine, The First College of Clinical Medicine ScienceChina Three Gorges UniversityYichangPeople's Republic of China
- Department of Respiratory and Critical Care MedicineYichang Central People's Hospital at ZhijiangZhijiangPeople's Republic of China
- Department of Respiratory and Critical Care MedicineYichang Central People's HospitalYichangPeople's Republic of China
| | - Yufeng Tian
- Department of Academic Management, Clinical Research CenterChina Three Gorges UniversityYichangPeople's Republic of China
| | - Xinyu Song
- Department of Respiratory and Critical Care Medicine, The First College of Clinical Medicine ScienceChina Three Gorges UniversityYichangPeople's Republic of China
- Department of Respiratory and Critical Care MedicineYichang Central People's HospitalYichangPeople's Republic of China
| | - Fanjun Zeng
- Department of Respiratory and Critical Care Medicine, The First College of Clinical Medicine ScienceChina Three Gorges UniversityYichangPeople's Republic of China
- Department of Respiratory and Critical Care MedicineYichang Central People's HospitalYichangPeople's Republic of China
| | - Ailan Yang
- Department of Respiratory and Critical Care MedicineYichang Central People's Hospital at ZhijiangZhijiangPeople's Republic of China
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Jiang Q, Wang S, Zhang H, Guo Y, Lou Y, Huang S, You Q, Cao S. The Association Between Solid Fuel Use and Visual Impairment Among Middle-Aged and Older Chinese Adults: Nationwide Population-Based Cohort Study. JMIR Public Health Surveill 2023; 9:e43914. [PMID: 37494091 PMCID: PMC10413239 DOI: 10.2196/43914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Revised: 05/13/2023] [Accepted: 06/21/2023] [Indexed: 07/27/2023] Open
Abstract
BACKGROUND Indoor air pollution has been reported to have adverse effects on the eye; however, the health effects of exposure to cooking with solid fuels on visual impairment remain unclear in China. OBJECTIVE We aimed to examine the association between cooking with solid fuels and visual impairment, including distance visual impairment (DVI) and near visual impairment (NVI). METHODS Data were obtained from the China Health and Retirement Longitudinal Study, a nationwide survey of adults aged over 45 years who were enrolled in 2011 (Wave 1) and followed up in Wave 2 (2013), Wave 3 (2015), and Wave 4 (2018). We used Cox proportional hazards models to determine the association between solid fuels use and visual impairment. Additionally, the impact of switching cooking fuel types on vision function were examined through wave-specific data analysis (Wave 1 and Wave 4). Interaction and subgroup analyses were performed to explore the potential effect modifiers. Data were collected using the stratified multistage random sampling method and further analyzed using SPSS 27.0 and R 4.2.1 statistical software packages. RESULTS A total of 9559 middle-aged and older Chinese adults without visual impairment at baseline were included in the study, with 51.2% (n=4914) of the participants reporting that they cooked with solid fuels. During the follow-up period, 2644 (27.5%) and 3130 (32.6%) participants developed DVI and NVI, respectively. Compared with the clean fuel users, participants who cooked with solid fuels had a higher risk of DVI (hazards ratio [HR] 1.38, 95% CI 1.28-1.50) and NVI (HR 1.18, 95% CI 1.10-1.27). In addition, switching the cooking fuel type from clean to solid fuels was associated with an elevated risk of DVI (HR 1.51, 95% CI 1.15-1.98) and NVI (HR 1.39, 95% CI 1.06-1.82) compared to persistently using clean fuels during the follow-up period, although no protective effect of switching from solid to clean fuels on NVI was found (P=.52). In subgroup analysis, we found that cooking with solid fuels increased the risk of DVI in participants younger than 65 years (HR 1.41, 95% CI 1.28-1.55), men (HR 1.45, 95% CI 1.28-1.65), urban residents (HR 1.41, 95% CI 1.08-1.75), and smokers (HR 1.43, 95% CI 1.25-1.64). By contrast, negative effects of cooking with solid fuels on NVI were found in nonsmokers (HR 1.21, 95% CI 1.11-1.33) and urban residents (HR 1.20, 95% CI 1.10-1.37). CONCLUSIONS Cooking with solid fuels was associated with an increased risk of visual impairment among middle-aged and older Chinese adults. These findings indicate that promoting the utilization of clean fuels is conducive to reducing the burden of visual impairment for the public.
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Affiliation(s)
- Qingqing Jiang
- School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Shiqi Wang
- School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Hao Zhang
- School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yan Guo
- School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yiling Lou
- School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Shen Huang
- School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Qiqi You
- School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Shiyi Cao
- School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Liu Y, Zang B, Shao J, Ning N, He L, Ma Y. Predictor of cognitive impairment: metabolic syndrome or circadian syndrome. BMC Geriatr 2023; 23:408. [PMID: 37403015 DOI: 10.1186/s12877-023-03996-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Accepted: 04/24/2023] [Indexed: 07/06/2023] Open
Abstract
BACKGROUND It was reported that metabolic syndrome increases the risk for cognitive impairment and circadian rhythm may influence cognition behavior. Identifying the potential risk factors is essential to screen individuals with neuronal dysfunction, neuronal loss, and cognitive decline and prevent cognitive impairment and dementia development. METHODS We clarified participants by the presence of metabolic syndrome (MetS) and circadian syndrome (CircS) and employed three multivariable Generalized Estimating Equation (GEE) models to control the potential confounding factors and estimate the β values for cognitive function using as referents those had neither MetS nor CircS at baseline. The cognitive function consists of episodic memory and executive function was estimated via the modified Telephone Interview for Cognitive Status (TICS) every two years until 2015. RESULTS The mean age of the participants was 58.80 (8.93) years and 49.92% (male). The prevalence of MetS and CircS was 42.98% and 36.43%, respectively. 1,075 (11.00%) and 435 (4.45%) participants had either MetS or CircS alone and 3,124 (31.98%) had both CircS and MetS. Participants with both MetS and CircS compared with normal had a significantly decreased cognitive function score during the 4-years cohort (β = -0.32, 95% CI: -0.63, -0.01) with the complete model, as well as among participants who suffered from CircS alone (β = -0.82, 95% CI: -1.47, -0.16), while not among participants with MetS alone (β = 0.13, 95% CI: -0.27, 0.53). Specifically, compared with the normal population a significantly lower score was discovered in the episodic memory (β = -0.51, 95% CI: -0.95, -0.07), while slightly lower in executive function (β = -0.33, 95% CI: -0.68, -0.01) among individuals with CircS alone. CONCLUSIONS Individuals with CircS alone or both MetS and CircS have a high risk of cognitive impairment. The association was even stronger in participants with CircS alone than those with both MetS and CircS, suggesting CircS probably have a stronger association with cognitive functioning than MetS and could be a better predictor for cognitive impairment.
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Affiliation(s)
- Yang Liu
- Department of Biostatistics and Epidemiology, School of Public Health, China Medical University, No.77 Puhe Road, Shenyang North New Area, Shenyang, 110122, Liaoning Province, China
| | - Boying Zang
- Department of Preventive Medicine, School of Public Heath, North China University of Science and Technology, Tangshan, Hebei, China
| | - Jinang Shao
- Department of Biostatistics and Epidemiology, School of Public Health, China Medical University, No.77 Puhe Road, Shenyang North New Area, Shenyang, 110122, Liaoning Province, China
| | - Ning Ning
- Department of Biostatistics and Epidemiology, School of Public Health, China Medical University, No.77 Puhe Road, Shenyang North New Area, Shenyang, 110122, Liaoning Province, China
| | - Lixia He
- Division of Molecular and Cellular Oncology, Brigham and Women's Hospital, Dana-Farber Cancer Institute, Harvard Medical School, Boston, 02215, USA.
| | - Yanan Ma
- Department of Biostatistics and Epidemiology, School of Public Health, China Medical University, No.77 Puhe Road, Shenyang North New Area, Shenyang, 110122, Liaoning Province, China.
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Zhang F, Chen J, Han A, Li D, Zhu W. The effects of fine particulate matter, solid fuel use and greenness on the risks of diabetes in middle-aged and older Chinese. JOURNAL OF EXPOSURE SCIENCE & ENVIRONMENTAL EPIDEMIOLOGY 2023:10.1038/s41370-023-00551-z. [PMID: 37169800 DOI: 10.1038/s41370-023-00551-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/24/2022] [Revised: 04/17/2023] [Accepted: 04/18/2023] [Indexed: 05/13/2023]
Abstract
BACKGROUND Previous studies provided clues that environmental factors were closely related to diabetes incidence. However, the evidence from high-quality and large cohort studies about the effects of PM2.5, solid fuel use and greenness on the development of diabetes among middle-aged and older adults in China was scarce. OBJECTIVE To separately investigate the independent effects of PM2.5, solid fuel use and greenness on the development of diabetes among middle-aged and older adults. METHODS A total of 9242 participants were involved in this study extracted from the China Health and Retirement Longitudinal Study. Time-varying Cox regression was applied to detect the association of diabetes with PM2.5, solid fuel use and greenness, separately. The potential interactive effect of air pollution and greenness were explored using the relative excess risk due to interaction (RERI). RESULTS Per 10 μg/m3 increases in PM2.5 were associated with 6.0% (95% CI: 1.9, 10.2) increasing risks of diabetes incidence. Females seemed to be more susceptible to PM2.5. However, the effects of solid fuel use only existed in older and lower BMI populations, with hazard ratios (HRs) of 1.404 (1.116, 1.766) and 1.346 (1.057, 1.715), respectively. In addition, exposure to high-level greenness might reduce the risks of developing diabetes [HR = 0.801 (0.687, 0.934)]. Weak evidence of the interaction effect of PM2.5/solid fuel use and greenness on diabetes was found. SIGNIFICANCE Both PM2.5 and solid fuel use were associated with the increasing incidence of diabetes. In addition, high-level greenness might be a beneficial environmental factor for reducing the risks of developing diabetes. All in all, our findings might provide valuable references for public health apartments to formulate very fruitful policies to reduce the burden of diabetes. IMPACT STATEMENT Both PM2.5 and solid fuel use were associated with the increasing incidence of diabetes while high-level greenness was not, which might provide valuable references for public health apartments to make policies.
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Affiliation(s)
- Faxue Zhang
- Department of Occupational and Environmental Health, School of Public Health, Wuhan University, Wuhan, 430071, China
| | - Jiahao Chen
- Department of Public Health, School of Public Health, Wuhan University, Wuhan, 430071, China
| | - Aojing Han
- Department of Occupational and Environmental Health, School of Public Health, Wuhan University, Wuhan, 430071, China
| | - Dejia Li
- Department of Occupational and Environmental Health, School of Public Health, Wuhan University, Wuhan, 430071, China.
| | - Wei Zhu
- Department of Occupational and Environmental Health, School of Public Health, Wuhan University, Wuhan, 430071, China.
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20
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Li X, Duan C, Chen Q, Xiao J, Jim Zhang J. Associations between cooking fuels and hypertension prevalence in Chinese adults: A prospective cohort analysis focusing on fuel transitioning. ENVIRONMENT INTERNATIONAL 2023; 175:107953. [PMID: 37156055 DOI: 10.1016/j.envint.2023.107953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 04/02/2023] [Accepted: 04/25/2023] [Indexed: 05/10/2023]
Abstract
BACKGROUND Using polluting cooking fuels is a suggested risk factor for hypertension. Transitioning to clean cooking fuels has occurred widely in China in the past 30 years. This provides an opportunity to examine whether the transition could reduce hypertension risk and to ascertain the inconsistent literature on the relationship between cooking fuels and hypertension prevalence. METHODS Initiated in 1989, the China Health and Nutrition Survey (CHNS) enrolled participants from 12 provinces in China. By 2015, nine waves of follow-up have been conducted. Based on self-reported cooking fuels, participants were classified into persistent clean fuel users, persistent polluting fuel users and those who transitioned from polluting fuels to clean fuels. Hypertension was defined as having systolic blood pressure (SBP) ≥ 140 mmHg, diastolic blood pressure (DBP) ≥ 90 mmHg, or self-reported current use of antihypertension medication. FINDINGS Among 12,668 participants, 3963 (31.28%) were persistent polluting fuel users; 4299 (33.94%) transitioned to clean fuels; and 4406 (34.78%) were persistent clean fuel users. During the period of follow-up (7.8 ± 6.1 years), hypertension was diagnosed in 4428 participants. Compared to persistent clean fuel users, persistent polluting fuel users had a higher risk for hypertension (hazard ratio [HR] 1.69, 95%CI 1.55-1.85), while those transitioned to clean fuels did not. The effects were consistent by gender and urbanicity, respectively. The HRs for hypertension were 1.99 (95%CI 1.75-2.25), 1.55 (95%CI 1.32-1.81) and 1.36 (95%CI 1.13-1.65) among those persistent polluting fuel users aged 18-44, 45-59 and ≥60 years old, respectively. INTERPRETATION Transitioning from using polluting fuels to clean fuels prevented an increase in hypertension risk. The finding highlights the importance of promoting the fuel transition as a risk-reduction strategy for reducing the disease burden from hypertension.
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Affiliation(s)
- Xing Li
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, Guangdong Province, China
| | - Chongyang Duan
- Department of Biostatistics, School of Public Health, Southern Medical University, Guangzhou, Guangdong Province, China
| | - Qing Chen
- Department of Epidemiology, School of Public Health and Tropical Medicine, Southern Medical University, Guangzhou, Guangdong Province, China
| | - Jianpeng Xiao
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, Guangdong Province, China.
| | - Junfeng Jim Zhang
- Nicholas School of the Environment & Duke Global Health Institute, Duke University, Durham, NC, USA; Duke Kunshan University, Kunshan, Jiangsu Province, China.
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21
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Yu Y, Wang Y, Dong Y, Shu S, Zhang D, Xu J, Zhang Y, Shi W, Wang SL. Butyl benzyl phthalate as a key component of phthalate ester in relation to cognitive impairment in NHANES elderly individuals and experimental mice. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023; 30:47544-47560. [PMID: 36746855 DOI: 10.1007/s11356-023-25729-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Accepted: 02/01/2023] [Indexed: 06/18/2023]
Abstract
Phthalates are a group of neurotoxicants with cognitive-disrupting potentials. Given the structural diversity of phthalates, the corresponding neurotoxicity is dramatically altered. To identify the potential contributions of different phthalates on the process of cognitive impairment, data of 836 elders from the NHANES 2011-2014 cycles were used. Survey-weighted logistic regression and principal component analysis-weighted quantile sum regression (PCA-WQSR) models were applied to estimate the independent and combined associations of 11 urinary phthalate metabolites with cognitive deficit (assessed by 4 tests: Immediate Recall (IR), Delayed Recall (DR), Animal Fluency (AF), and Digit Symbol Substitution Test (DSST)) and to identify the potential phthalate with high weight. Laboratory mice were further used to examine the effect of phthalates on cognitive function and to explore the potential mechanisms. In logistic regression models, MBzP was the only metabolite positively correlated with four tests, with ORs of 2.53 (quartile 3 (Q3)), 2.26 (Q3), 2.89 (Q4) and 2.45 (Q2), 2.82 (Q4) for IR, DR, AF, and DSST respectively. In PCA-WQSR co-exposure models, low-molecular-weight (LMW) phthalates were the only PC positively linked to DSST deficit (OR: 1.93), which was further validated in WQSR analysis (WQS OR7-phthalates: 1.56 and WQS OR8-phthalates: 1.55); consistent with the results of logistic regression, MBzP was the dominant phthalate. In mice, butyl benzyl phthalate (BBP), the parent phthalate of MBzP, dose-dependently reduced cognitive function and disrupted hippocampal neurons. Additionally, the hippocampal transcriptome analysis identified 431 differential expression genes, among which most were involved in inhibiting the neuroactive ligand-receptor interaction pathway and activating the cytokine-cytokine receptor interaction pathway. Our study indicates the critical role of BBP in the association of phthalates and cognitive deficits among elderly individuals, which might be speculated that BBP could disrupt hippocampal neurons, activate neuroinflammation, and inhibit neuroactive receptors. Our findings provide new insight into the cognitive-disrupting potential of BBP.
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Affiliation(s)
- Yongquan Yu
- Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing, 210009, People's Republic of China
- Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing Medical University, 101 Longmian Avenue, Nanjing, 211166, People's Republic of China
| | - Yucheng Wang
- Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing, 210009, People's Republic of China
| | - Yu Dong
- Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing, 210009, People's Republic of China
| | - Shuge Shu
- Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing, 210009, People's Republic of China
| | - Di Zhang
- Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing Medical University, 101 Longmian Avenue, Nanjing, 211166, People's Republic of China
| | - Jiayi Xu
- Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing Medical University, 101 Longmian Avenue, Nanjing, 211166, People's Republic of China
| | - Ying Zhang
- Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing, 210009, People's Republic of China
| | - Wei Shi
- Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing, 210009, People's Republic of China
| | - Shou-Lin Wang
- Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing Medical University, 101 Longmian Avenue, Nanjing, 211166, People's Republic of China.
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22
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Xu T, Ye X, Lu X, Lan G, Xie M, Huang Z, Wang T, Wu J, Zhan Z, Xie X. Association between solid cooking fuel and cognitive decline: Three nationwide cohort studies in middle-aged and older population. ENVIRONMENT INTERNATIONAL 2023; 173:107803. [PMID: 36805161 DOI: 10.1016/j.envint.2023.107803] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 01/07/2023] [Accepted: 02/02/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Household solid-fuel burning contributes to indoor air pollution and is linked to poor cognitive function, but how solid cooking fuel use leads to cognitive decline over time is not well elaborated. OBJECTIVE We examine the associations of solid cooking fuel with cognitive function among three nationally representative cohorts. METHODS This study uses data from the 2010-2018 China Family Panel Studies (CFPS), the 2011-2018 China Health and Retirement Longitudinal Study (CHARLS) and the 2003-2015 Mexican Health and Aging Study (MHAS) in adults over the age of 50. Time varying Cox model was conducted to measure the association between cooking fuel types and cognitive decline. Mediation analysis was used to estimate the potential mediation effects on the associations of cooking fuel types with cognitive decline risk. RESULTS Respondents in CFPS, CHARLS, and MHAS relied on solid cooking fuel at baseline approximately 56 %, 51 %, and 12 %, respectively. Using solid fuel was consistently associated with higher risk of cognitive decline in three cohorts (CFPS: HR = 1.300 [95 % CI: 1.201, 1.407], CHARLS: HR = 1.179 [95 % CI: 1.059, 1.312], MHAS: HR = 1.237 [95 % CI: 1.123, 1.362]). Compared to those with persistent solid fuel, persistent clean fuel and change from solid fuel to clean fuel were associated with a lower risk of cognitive decline. Hypertension, diabetes, physical activity, dyslipidemia and high-density lipoprotein cholesterol (HDL-C) may partially mediate the cognitive decline caused by solid fuel use. Of the cognitive decline burden, 18.23 % (95 % CI: 12.21 %, 24.73 %) in CFPS, 8.90 % (95 % CI: 2.93 %, 15.52 %) in CHARLS and 2.92 % (95 % CI: 1.52 %, 4.46 %) in MHAS of cognitive decline cases attributable to solid cooking fuel use. CONCLUSION The use of solid cooking fuel is associated with a higher risk of cognitive decline. It is essential to promote the expanded use of clean fuel to protect cognitive health.
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Affiliation(s)
- Tingting Xu
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou, China
| | - Xiaoying Ye
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou, China
| | - Xiaoli Lu
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou, China
| | - Guohui Lan
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou, China
| | - Mengying Xie
- The Second Clinical Medical School, Nanchang University, Nanchang, China
| | - Zelin Huang
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou, China
| | - Tinggui Wang
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou, China
| | - Jieyu Wu
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou, China
| | - Zhiying Zhan
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou, China
| | - Xiaoxu Xie
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou, China; Clinical Research Unit, The Second Affiliated Hospital, Fujian Medical University, Quanzhou, China.
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Jin X, Wang Y, Wu Y, Liang Y, Li Y, Sun X, Yan S, Mei L, Tao J, Song J, Pan R, Yi W, Cheng J, Yang L, Su H. The increased medical burden associated with frailty is partly attributable to household solid fuel: A nationwide prospective study of middle-aged and older people in China. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 858:159829. [PMID: 36374752 DOI: 10.1016/j.scitotenv.2022.159829] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Revised: 10/19/2022] [Accepted: 10/26/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Frail individuals often face a high medical burden, and household solid fuel use is associated with a range of functional declines or diseases, but evidence on the relationship between household solid fuel and frailty and the resulting medical burden is limited. We aim to investigate the effect of household solid fuel on frailty and further quantify how much of the increased medical burden associated with frailty is attributable to household solid fuel. METHODS The prospective data were from the China Health and Retirement Longitudinal Study, 4685 non-frail participants at baseline were included. Inverse probability weighting was used to balance the covariates between groups. The modified Poisson regression was used to analyze the association of household solid fuel (including baseline and switching across three-wave survey) with frailty, and the generalized linear model was used to analyze the association of frailty with the change in medical burden. Further, the increased medical burden associated with frailty attributable to household solid fuel was quantified. RESULTS Using solid fuel for cooking (RR = 1.29, 95%CI, 1.07-1.57), heating (RR = 1.38, 95%CI, 1.09-1.73), or both (RR = 1.40, 95%CI, 1.05-1.86) had a higher risk of frailty than using clean fuel. In addition, the risk of frailty generally increases with the times of solid fuel use across the three-wave survey. Then, frailty participants had a greater increase in the annual number of hospitalizations (β = 0.11, 95%CI, 0.02-0.19) and annual costs of hospitalizations (β = 2953.35, 95%CI, 1149.87-4756.83) than those non-frailty. Heating coal caused the largest frailty-related increase in the annual number of hospitalizations and annual costs of hospitalizations, with 0.04 and 1195.40, respectively. CONCLUSION The increased medical burden associated with frailty was partly attributable to household solid fuel, which suggested that intervention targeting household solid fuels can delay frailty and thus reduce individual medical burden.
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Affiliation(s)
- Xiaoyu Jin
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, China
| | - Yuling Wang
- Department of Pharmacology, School of Basic Medicine, Anhui Medical University, China
| | - Yudong Wu
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, China
| | - Yunfeng Liang
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, China
| | - Yuxuan Li
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, China
| | - Xiaoni Sun
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, China
| | - Shuangshuang Yan
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, China
| | - Lu Mei
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, China
| | - Junwen Tao
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, China
| | - Jian Song
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, China
| | - Rubing Pan
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, China
| | - Weizhuo Yi
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, China
| | - Jian Cheng
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, China
| | - Linsheng Yang
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, China
| | - Hong Su
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, China.
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Pu F, Hu Y, Li C, Cao X, Yang Z, Liu Y, Zhang J, Li X, Yang Y, Wang W, Liu X, Hu K, Ma Y, Liu Z. Association of solid fuel use with a risk score capturing dementia risk among middle-aged and older adults: A prospective cohort study. ENVIRONMENTAL RESEARCH 2023; 218:115022. [PMID: 36502898 DOI: 10.1016/j.envres.2022.115022] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 11/17/2022] [Accepted: 12/07/2022] [Indexed: 06/17/2023]
Abstract
OBJECTIVES Whether household air pollution is associated with dementia risk remains unknown. This study examined the associations between solid fuel use for cooking and heating (the main source of household air pollution) and dementia risk. METHODS This analysis included data on 11,352 participants (aged 45+ years) from the 2011 wave of China Health and Retirement Longitudinal Study, with follow-up to 2018. Dementia risk was assessed by a risk score using the Rotterdam Study Basic Dementia Risk Model (BDRM), which was subsequently standardized for analysis. Household fuel types of cooking and heating were categorized as solid (e.g., coal and crop residue) and clean (e.g., central heating and solar). Multivariable analyses were performed using generalized estimating equations. Moreover, we examined the joint associations of solid fuel use for cooking and heating with the BDRM score. RESULTS After adjusting for potential confounders, we found an independent and significant association of solid (vs. clean) fuel use for cooking and heating with a higher BDRM score (e.g., β = 0.17 for solid fuel for cooking; 95% confidence interval [CI]: 0.15-0.19). Participants who used solid (vs. clean) fuel for both cooking and heating had the highest BDRM score (β = 0.32; 95% CI: 0.29-0.36). Subgroup analysis suggested stronger associations in participants living in rural areas. CONCLUSIONS Solid fuel use for cooking and heating was independently associated with increased dementia risk in Chinese middle-aged and older adults, particularly among those living in rural areas. Our findings call for more efforts to facilitate universal access to clean energy for dementia prevention.
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Affiliation(s)
- Fan Pu
- Department of Big Data in Health Science School of Public Health and Center for Clinical Big Data and Analytics of the Second Affiliated Hospital, The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Zhejiang University School of Medicine, Zhejiang University School of Medicine, Hangzhou, 310058, Zhejiang, China
| | - Yingying Hu
- School of Public Affairs, Zhejiang University, Hangzhou, 310058, Zhejiang, China
| | - Chenxi Li
- Department of Big Data in Health Science School of Public Health and Center for Clinical Big Data and Analytics of the Second Affiliated Hospital, The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Zhejiang University School of Medicine, Zhejiang University School of Medicine, Hangzhou, 310058, Zhejiang, China
| | - Xingqi Cao
- Department of Big Data in Health Science School of Public Health and Center for Clinical Big Data and Analytics of the Second Affiliated Hospital, The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Zhejiang University School of Medicine, Zhejiang University School of Medicine, Hangzhou, 310058, Zhejiang, China
| | - Zhenqing Yang
- Department of Big Data in Health Science School of Public Health and Center for Clinical Big Data and Analytics of the Second Affiliated Hospital, The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Zhejiang University School of Medicine, Zhejiang University School of Medicine, Hangzhou, 310058, Zhejiang, China
| | - Yi Liu
- Department of Big Data in Health Science School of Public Health, Zhejiang University School of Medicine, Hangzhou, 310058, Zhejiang, China
| | - Jingyun Zhang
- Department of Big Data in Health Science School of Public Health and Center for Clinical Big Data and Analytics of the Second Affiliated Hospital, The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Zhejiang University School of Medicine, Zhejiang University School of Medicine, Hangzhou, 310058, Zhejiang, China
| | - Xueqin Li
- Department of Big Data in Health Science School of Public Health and Center for Clinical Big Data and Analytics of the Second Affiliated Hospital, The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Zhejiang University School of Medicine, Zhejiang University School of Medicine, Hangzhou, 310058, Zhejiang, China
| | - Yongli Yang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, 450001, Henan, China
| | - Wei Wang
- Department of Occupational Health and Occupational Disease, College of Public Health, Zhengzhou University, Zhengzhou, 450001, Henan, China
| | - Xiaoting Liu
- School of Public Affairs, Zhejiang University, Hangzhou, 310058, Zhejiang, China; Institute of Wenzhou, Zhejiang University, Hangzhou, Zhejiang, China
| | - Kejia Hu
- Department of Big Data in Health Science School of Public Health, Zhejiang University School of Medicine, Hangzhou, 310058, Zhejiang, China
| | - Yanan Ma
- Department of Biostatistics and Epidemiology, School of Public Health, China Medical University, Shenyang, Liaoning, China
| | - Zuyun Liu
- Department of Big Data in Health Science School of Public Health and Center for Clinical Big Data and Analytics of the Second Affiliated Hospital, The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Zhejiang University School of Medicine, Zhejiang University School of Medicine, Hangzhou, 310058, Zhejiang, China.
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Chen W, Wang X, Chen J, You C, Ma L, Zhang W, Li D. Household air pollution, adherence to a healthy lifestyle, and risk of cardiometabolic multimorbidity: Results from the China health and retirement longitudinal study. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 855:158896. [PMID: 36150596 DOI: 10.1016/j.scitotenv.2022.158896] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/05/2022] [Revised: 09/15/2022] [Accepted: 09/17/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND The adverse health effects of household air pollution have been widely explored, but few studies have evaluated the effects of household air pollution on the risk of cardiometabolic multimorbidity (CMM), a pressing public health concern worldwide. Thus, we aimed to investigate whether exposure to household use of polluting fuels is associated with morbid CMM and, if so, whether a healthy lifestyle could mitigate this association. METHODS In this prospective, nationwide representative cohort of the China Health and Retirement Longitudinal Study (CHARLS), participants free of CMM (defined as the coexistence of 2 or more of the following: heart disease, stroke, and diabetes or high blood sugar) were included in 2011-2012 and followed for CMM incidence until 2018. Household air pollution was measured as the use of solid fuels for cooking and heating. The healthy lifestyle score was determined by six factors, physical activity, smoking, body mass index, total cholesterol, blood glucose, and blood pressure, and categorized into three groups (unhealthy, 0-1 factors; intermediate, 2-4; and healthy, 5-6). Cox proportional hazards models investigated associations between household air pollution and incident CMM. The potential modifier effect of a healthy lifestyle score was tested through stratified analyses. RESULTS Among 7125 eligible participants, 239 incident cases of CMM were identified over a median follow-up of 7.0 years. After adjustment for potential confounders, the use of solid household fuels for heating was associated with more significant hazards of CMM (adjusted hazard ratio [HR] 1.71, 95 % confidence interval [CI] 1.28 to 2.28), while use for cooking (HR, 1.14; 95 % CI, 0.85 to 1.52) was not. Compared with participants in the unhealthy group, those in the healthy and intermediate groups had considerably lower CMM risk, with adjusted HRs (95 % CI) of 0.17 (0.09 to 0.31) and 0.39 (0.29 to 0.53), respectively, regardless of the household air pollution category. Importantly, when participants adhered to a healthy lifestyle, exposure to household air pollution was no longer significantly associated with a higher risk of CMM (adjusted HR 1.77, 95 % CI 0.51 to 6.12; P = 0.369). CONCLUSIONS Household usage of polluting fuels was significantly associated with a higher risk of CMM, and adherence to a healthy lifestyle may mitigate this adverse effect. From a broader perspective, our findings underscore the importance of public health policies and interventions targeting multiple exposures (air pollution, physical activity, smoking, etc.) in enhancing the prevention of detrimental cardiometabolic health effect.
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Affiliation(s)
- Wei Chen
- Department of Neurosurgery, West China Hospital of Sichuan University, Chengdu, China; West China Biomedical Big Data Center, West China Hospital of Sichuan University, Chengdu, China; Med-X Center for Informatics, Sichuan University, Chengdu, China
| | - Xiaoyu Wang
- Department of Neurosurgery, West China Hospital of Sichuan University, Chengdu, China
| | - Jing Chen
- Department of Neurosurgery, West China Hospital of Sichuan University, Chengdu, China
| | - Chao You
- Department of Neurosurgery, West China Hospital of Sichuan University, Chengdu, China
| | - Lu Ma
- Department of Neurosurgery, West China Hospital of Sichuan University, Chengdu, China
| | - Wei Zhang
- West China Biomedical Big Data Center, West China Hospital of Sichuan University, Chengdu, China; Med-X Center for Informatics, Sichuan University, Chengdu, China.
| | - Dong Li
- Division of Hospital Medicine, Emory University School of Medicine, Atlanta, GA 30322, USA.
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Wu T, Zhang Y, Zhou Y, Zhang Z, Cheng Y, Liu X, Xu X. Solid Fuel Use and the Progression of Multimorbidity in Middle-Aged Chinese Participants: A Prospective Cohort Study. Int J Public Health 2023; 67:1605206. [PMID: 36713464 PMCID: PMC9880982 DOI: 10.3389/ijph.2022.1605206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Accepted: 12/13/2022] [Indexed: 01/11/2023] Open
Abstract
Objectives: This study aimed to examine the association of solid fuel use for cooking and heating with the progression of multimorbidity. Methods: A total of 5,437 participants from the China Health and Retirement Longitudinal Study were included. Multivariate logistic regression models were used to estimate the odds ratios (ORs) and 95% confidence intervals (CIs) for the associations of the independent and joint effects of solid fuel use for cooking and heating with the progression of multimorbidity. Results: The proportion of participants reporting solid fuel use for both cooking and heating was 59.0% at baseline. Solid fuel use for both cooking and heating was associated with the progression of multimorbidity (adjusted OR: 1.42, 95% CI: 1.19-1.70), compared with clean fuel use for both. Conclusion: Solid fuel use for cooking and heating play an important role in the progression of multimorbidity. Therefore, solid fuel reduction should be considered in developing multimorbidity control and prevention programmes.
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Affiliation(s)
- Tingting Wu
- School of Public Health The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Yue Zhang
- School of Public Health The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Yaguan Zhou
- School of Public Health The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Zifan Zhang
- School of Public Health The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Yangyang Cheng
- School of Public Health The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Xiangtong Liu
- School of Public Health, Capital Medicine University, Beijing, China
| | - Xiaolin Xu
- School of Public Health The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China,*Correspondence: Xiaolin Xu,
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Ming X, Guo R, Liu M, He X, Guo F, Gao S. Associations of Household Solid Fuel Use With Falls and Fall-Related Injuries in Middle-Aged and Older Population in China: A Cohort Study. Int J Public Health 2023; 67:1605425. [PMID: 36686388 PMCID: PMC9852047 DOI: 10.3389/ijph.2022.1605425] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Accepted: 12/22/2022] [Indexed: 01/09/2023] Open
Abstract
Objective: This study evaluated the associations of solid fuels with incidence of falls and fall-related injuries. Methods: Data were taken from wave 1∼4 of the China Health and Retirement Longitudinal Study, including 15,651 participants aged 45 years and older. Modified Poisson regression was used to examine the associations of solid fuels with falls and fall-related injuries. Results: Modified Poisson regression analysis showed that solid fuels users for cooking had an increasing incidence of falls and fall-related injuries, with RR of 1.211 (95% CI: 1.124, 1.305) and 1.248 (95% CI: 1.107, 1.408); for heating had an incidence, with RR of 1.178 (95% CI: 1.062, 1.306) and 1.134 (95% CI: 0.963, 1.335); combined for cooking and heating, with RR of 1.247 (95% CI: 1.105, 1.408) and 1.185 (95% CI: 0.982, 1.431). Conclusion: Our study suggests that solid fuel use is associated with a higher incidence of falls and fall-related injuries among adults aged 45 years and older in China. It is necessary to restrict solid fuel use to reduce household air pollution and make stronger environmental protection policies to improve household environment.
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Affiliation(s)
- Xing Ming
- Pathophysiology Department, School of Basic Medicine, Qingdao University, Qingdao, China
| | - Ruixiao Guo
- Pathophysiology Department, School of Basic Medicine, Qingdao University, Qingdao, China
| | - Mengli Liu
- Department of Epidemiology and Health Statistics, Public Health College, Qingdao University, Qingdao, China
| | - Xiaoman He
- Pathophysiology Department, School of Basic Medicine, Qingdao University, Qingdao, China
| | - Feifei Guo
- Pathophysiology Department, School of Basic Medicine, Qingdao University, Qingdao, China,*Correspondence: Feifei Guo, ; Shengli Gao,
| | - Shengli Gao
- Biomedical Center, Qingdao medical College, Qingdao University, Qingdao, China,*Correspondence: Feifei Guo, ; Shengli Gao,
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Zhang H, Zhang L, Chen C, Zhong X. Association between daytime napping and cognitive impairment among Chinese older population: a cross-sectional study. Environ Health Prev Med 2023; 28:72. [PMID: 37989282 PMCID: PMC10685077 DOI: 10.1265/ehpm.23-00031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Accepted: 09/30/2023] [Indexed: 11/23/2023] Open
Abstract
BACKGROUND Both napping and nighttime sleep duration have been reported to be associated with cognitive function in older adults, whereas little is known about the association between daytime napping and cognitive impairment in different nighttime sleep duration subgroups. This study aimed to explore the correlation between daytime napping and cognitive impairment across nighttime sleep duration subgroups. METHODS A cross-sectional study was conducted by using the fourth survey of China Health and Retirement Longitudinal Study (CHARLS). We utilized the Mini-Mental State Examination (MMSE) scale to define cognitive impairment, and the daytime napping and nighttime sleep duration was self-reported by individuals. We applied the Restricted Cubic Spline (RCS) to analysis the dose-response relationships between daytime napping and cognitive impairment. And the multivariate Logistic Regression Model (LRM) was performed to evaluate the association of daytime napping and cognitive impairment. RESULTS A total of 3,052 individuals were included, of which 769 were cognitive impairment. The RCS showed there were non-linear association between daytime napping and cognitive impairment in all participants group and longer nighttime sleep duration subgroup (PNon-linear < 0.05, PDaytime napping < 0.05). The LRM revealed no napping (OR = 1.62, 95%CI 1.14-2.30) and excessive napping (1.64 95%CI 1.09-2.48) were related to cognitive impairment in longer nighttime sleep duration subgroup. CONCLUSIONS Daytime napping had nonlinear association with cognitive impairment in Chinese elderly population. No napping and excessive daytime napping (>90 minutes) were related to cognitive impairment in participants with 7 and more hours nighttime sleep duration.
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Affiliation(s)
- Hong Zhang
- Department of Health Statistics, School of Public Health, Chongqing Medical University, Chongqing 400016, PR China
| | - Lijuan Zhang
- Department of Health Statistics, School of Public Health, Chongqing Medical University, Chongqing 400016, PR China
| | - Chen Chen
- Department of Health Statistics, School of Public Health, Chongqing Medical University, Chongqing 400016, PR China
| | - Xiaoni Zhong
- Department of Health Statistics, School of Public Health, Chongqing Medical University, Chongqing 400016, PR China
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Liu Y, Zeng S, Huang C, Wang C, Zhu J, Peng J, Ding F, Li J, Qin G, Chen J. Indoor Solid Fuel Use and Non-Neoplastic Digestive System Diseases: A Population-Based Cohort Study Among Chinese Middle-Aged and Older Population. Int J Public Health 2022; 67:1605419. [PMID: 36618433 PMCID: PMC9810631 DOI: 10.3389/ijph.2022.1605419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Accepted: 12/12/2022] [Indexed: 12/24/2022] Open
Abstract
Objectives: We tended to explore the association of indoor air pollution (IAP) and non-neoplastic digestive system diseases (NNDSD) among the Chinese middle-aged and older population. Methods: From 2011 to 2018, we included 7884 NNDSD-free adults from the China Health and Retirement Longitudinal Study (CHARLS). Physician-diagnosed NNDSD was obtained by self-reported information at baseline and updated across follow-up surveys. We investigated the associations between baseline exposure of solid fuel use for cooking and/or heating and NNDSD diagnosed during follow-up through Cox proportional hazard models. Furthermore, we examined the relationship between cooking fuel switching and NNDSD diagnosed during follow-up. Results: Solid fuel use for cooking and/or heating was positively associated with NNDSD after adjusting for potential confounders. The risk of NNDSD among subjects who always use solid fuel for cooking (adjusted hazard ratio [aHR]: 1.42; 95% confidence interval [CI]: 1.09, 1.84) was higher than those with always clean fuels. Moreover, we found a lower NNDSD risk among participants who switched from solid to clean cooking fuel (aHR: 0.65; 95% CI: 0.49, 0.87) than those with always solid fuels. Conclusion: Our present study shows that indoor solid fuel use is a dependent risk factor for NNDSD. Moreover, switching to clean fuel may contribute to the prevention of digestive system illnesses.
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Affiliation(s)
- Yahang Liu
- Department of Biostatistics, School of Public Health, The Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China
| | - Silu Zeng
- Department of Biostatistics, School of Public Health, The Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China
| | - Chen Huang
- Department of Biostatistics, School of Public Health, The Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China
| | - Ce Wang
- Department of Biostatistics, School of Public Health, The Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China
| | - Jingjing Zhu
- Clinical Research Unit, Shanghai Ninth People’s Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Jiahuan Peng
- Department of Biostatistics, School of Public Health, The Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China
| | - Fengfei Ding
- Department of Pharmacology, School of Basic Medical Sciences, Fudan University, Shanghai, China
| | - Jiong Li
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark,Department of Clinical Epidemiology, Aarhus University, Aarhus, Denmark
| | - Guoyou Qin
- Department of Biostatistics, School of Public Health, The Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China
| | - Jiaohua Chen
- Department of Health Management, Seventh People’s Hospital of Shanghai University of Traditional Chinese Medicine, Shanghai, China,*Correspondence: Jiaohua Chen,
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Du X, Li X, Qian P, Wu H. Indoor air pollution from solid fuels use, inflammation, depression and cognitive function in middle-aged and older Chinese adults. J Affect Disord 2022; 319:370-376. [PMID: 36167244 DOI: 10.1016/j.jad.2022.09.103] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 08/29/2022] [Accepted: 09/20/2022] [Indexed: 10/14/2022]
Abstract
BACKGROUND Few studies have focused on the influence of indoor air pollution on depression and cognitive impairment; besides, the underlying mechanism is not well-established. OBJECTIVE This study aimed to fill the above gaps by exploring the underlying influence mechanism of solid fuel use, the major cause of indoor air pollution, with the risk of depression and cognitive impairment. METHODS This data came from China Health and Retirement Longitudinal Study (CHARLS) 2015 dataset. Self-reported household cooking fuels were collected and categorized as clean fuels and solid fuels. High-sensitivity C-reactive protein (CRP) and white blood cells (WBC) were used to measure inflammation. Depression and cognitive function were assessed by using standardized questionnaires. RESULTS Respondents had an average Center for Epidemiologic Studies Depression Scale (CESD-10) scores of 7.68 (SD = 6.14) and cognitive function scores of 15.97 (SD = 4.84). In the whole sample, 36.4 % of respondents used solid fuels use, but this proportion was much greater among those living in rural areas (78.38 %). Compared with clean fuel users, solid fuel users had more depression and worse cognitive function. After adjusting for confounders, indoor air pollution was significantly associated with depression and cognitive function respectively (β = -0.444, p < 0.001; β = 0.656, p < 0.001). Indoor air pollution was significantly related to the WBC (β = 0.170, p < 0.01), but not for the CRP. The WBC mediated the association between indoor air pollution and depression (β = 0.026, p < 0.01). CONCLUSION In conclusion, solid fuel use was significantly associated with a higher risk of depression and cognitive impairment. Furthermore, we found that solid fuel use influences depression partly via the inflammatory profile.
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Affiliation(s)
- Xiwang Du
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Xuezhu Li
- School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Pan Qian
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Hong Wu
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China.
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Shi W, Zhang T, Li Y, Huang Y, Luo L. Association between household air pollution from solid fuel use and risk of chronic diseases and their multimorbidity among Chinese adults. ENVIRONMENT INTERNATIONAL 2022; 170:107635. [PMID: 36413929 DOI: 10.1016/j.envint.2022.107635] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/13/2022] [Revised: 10/21/2022] [Accepted: 11/14/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Given the increasing burden of chronic conditions, multimorbidity is now a priority for public health systems worldwide. However, the relationship between household air pollution (HAP) exposure with multimorbidity remains unclear. METHODS We used three waves data (2011, 2013, and 2015) including 19,295 participants aged ≥ 45 years from the China Health and Retirement Longitudinal Study, to investigate the association between HAP exposure from solid fuel use for heating and cooking with the risk of chronic multimorbidity. Multimorbidity was defined as the coexistence of two or more of 15 chronic diseases (hypertension, diabetes, dyslipidemia, heart disease, stroke, cardiovascular disease, chronic lung disease, asthma, kidney disease, liver disease, digestive disease, cancer, psychiatric disease, memory-related disease, and arthritis). Multiple logistic regression investigated the association between solid fuel use for heating and cooking, separately or simultaneously, with the risk of multimorbidity. Poisson regression with quasi-likelihood estimation explored whether solid fuel exposure could increase the number of morbidities. Stratified analyses and sensitivity analyses examined the effect modification and robustness of the association. RESULTS Of the 19,295 participants (mean age: 58.9 years), 40.9 % have multimorbidity. Compared with participants who used clean fuels for heating and cooking, the risk was higher in mixed fuel (adjusted odds ratio, aOR = 1.26, 95 %CI:1.16-1.36) and solid fuel users (aOR = 1.81, 1.67-1.98) separately. HAP from solid fuel use was positively associated with an increased number of morbidities (adjusted β = 0.329, 0.290 to 0.368), after controlling for confounders. Those living in a one-story building, with poor household cleanliness have a higher risk of multimorbidity. No significant modifications of those associations by the socio-demographic and behaviour characteristics was observed. CONCLUSIONS HAP from solid fuel use is associated with a high risk of chronic multimorbidity in Chinese adults. Our findings provide important implications for reducing chronic disease burden by restricting solid fuel use.
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Affiliation(s)
- Wenming Shi
- School of Public Health, Fudan University, Shanghai 200032, China.
| | - Tiantian Zhang
- School of Social Development and Public Policy, Fudan University, Shanghai 200433, China
| | - Yongzhen Li
- Children's Hospital of Fudan University, Shanghai 201100, China
| | - Yonggang Huang
- Department of Blood Transfusion, Tongling People's Hospital, Tongling 244000, Anhui, China
| | - Li Luo
- School of Public Health, Fudan University, Shanghai 200032, China; Key Lab of Public Health Safety of the Ministry of Education, NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai 200032, China
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Jin X, He J, Liang Y, Sun X, Yan S, Wu Y, Li Y, Mei L, Song J, Pan R, Yi W, Tao J, Xu Z, Cheng J, Su H. Associations between household solid fuel use and activities of daily living trajectories: A nationwide longitudinal study of middle and older adults in China. ENVIRONMENT INTERNATIONAL 2022; 170:107605. [PMID: 36323064 DOI: 10.1016/j.envint.2022.107605] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 10/13/2022] [Accepted: 10/26/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND More studies focus on reporting the effects of ambient air pollution on physical activity while ignoring the hazards of indoor air pollution caused by household solid fuel use. Moreover, the impact of individual cognitive and depressive status on the health effects of air pollution is often overlooked. OBJECTIVE We examined the association between household solid fuel and activities of daily living (ADL) trajectories, and further examined this association in homogeneous subgroups of cognitive or depressive trajectories. METHODS Participants were from the China Health and Retirement Longitudinal Study, which conducted four waves of surveys from 2011 to 2018. We collected information on participants' household fuel use, then the ADL, cognitive and depressive performances were assessed in each wave. The latent growth mixture model (LGMM) was used to identify the optimal trajectory class for ADL, cognition, and depression. Then, the multinomial logistic regression was used to assess the association between solid fuel use and ADL trajectories in total population, as well as subgroups with different cognitive or depression trajectories. Furthermore, we examined the association between switching household fuel types and ADL trajectories across the four-wave survey. RESULTS The study sample included 7052 participants. We identified three ADL trajectory classes in total population: "Low-stable", "Moderate-anterior rise", and "Moderate-posterior rise". The multinomial logistic regression results showed that solid fuel use was associated with elevated odds for the adverse ADL trajectories, and this association was still shown in homogeneous subgroups of cognitive or depressive trajectories, while some effects were less significant. In addition, the risk of adverse ADL trajectories generally increases with the times of solid fuel use across the four-wave survey. CONCLUSIONS For middle and older adults in China, household solid fuel use was not conducive to physical activity development, which inspires that a further transformation to cleaner fuels is an important intervention.
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Affiliation(s)
- Xiaoyu Jin
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, China
| | - Jun He
- Sanlian Street Community Health Service Center, Shushan District, Hefei City, Anhui Province, China
| | - Yunfeng Liang
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, China
| | - Xiaoni Sun
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, China
| | - Shuangshuang Yan
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, China
| | - Yudong Wu
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, China
| | - Yuxuan Li
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, China
| | - Lu Mei
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, China
| | - Jian Song
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, China
| | - Rubing Pan
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, China
| | - Weizhuo Yi
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, China
| | - Junwen Tao
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, China
| | - Zhiwei Xu
- School of Public Health, Faculty of Medicine, University of Queensland, Brisbane, Australia
| | - Jian Cheng
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, China
| | - Hong Su
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, China.
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Hu Y, Peng W, Ren R, Wang Y, Wang G. Sarcopenia and mild cognitive impairment among elderly adults: The first longitudinal evidence from CHARLS. J Cachexia Sarcopenia Muscle 2022; 13:2944-2952. [PMID: 36058563 PMCID: PMC9745544 DOI: 10.1002/jcsm.13081] [Citation(s) in RCA: 48] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 07/13/2022] [Accepted: 07/27/2022] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND The association between sarcopenia and mild cognitive impairment (MCI) among elderly adults in China remains unclear. The present study aimed to examine the association based on a nationally representative large-scale survey. METHODS The study used two waves of data from China Health and Retirement Longitudinal Study (CHARLS) in 2015 and 2018. All subjects met the inclusion criteria were classified based on Asia Working Group for Sarcopenia 2019 criteria. Aging-associated cognitive decline is used to define MCI, and cognitive function is measured based on four dimensions: orientation, computation, memory, and drawing. OLS and logistic regression model were conducted to analyse the cross-sectional association between sarcopenia and different cognitive functions. Logistic regression model was conducted to analyse the longitudinal association between sarcopenia and MCI. RESULTS Totally, 5715 participants aged over 60 years (43.8% women; mean age 67.3 ± 6.0 years) were enrolled in a cross-sectional association study in 2015, and further 2982 elderly adults were followed up in 2018. During the period, sarcopenia and possible sarcopenia increased from 8.5% to 29.6%. Scores of cognitive and four dimensions (orientation, computation, memory, and drawing) exhibited a decreasing trend from non-sarcopenia to sarcopenia (P < 0.001). In the fully adjusted OLS regression model, scores of four dimensions were lower in possible sarcopenia and sarcopenia groups when compared with the non-sarcopenia group (P < 0.05) respectively. The incidence of MCI was 10.1%, 16.5%, and 24.2% for non-sarcopenia, possible sarcopenia, and sarcopenia groups from 2015 to 2018, with a significantly statistical difference (P < 0.001). Logistic regression model revealed an odds ratio of 1.43 [95% confidence interval (CI): 1.06-1.91, P = 0.017] for the possible sarcopenia group and 1.72 (95% CI: 1.04-2.85, P = 0.035) for sarcopenia group when compared with the non-sarcopenia group. CONCLUSIONS Sarcopenia is associated with worse cognitive impairment, which provided new evidence for a strong association that warrants further research into mechanistic insights.
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Affiliation(s)
- Yisong Hu
- National Survey Research Center, Renmin University of China, Beijing, China
| | - Wenjia Peng
- School of Public Health, Fudan University, Shanghai, China
| | - Rujing Ren
- Department of Neurology and Institute of Neurology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Ying Wang
- School of Public Health, Fudan University, Shanghai, China.,NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, China
| | - Gang Wang
- Department of Neurology and Institute of Neurology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Jin Y, Zhou X, Deng L, Xiong X, Li Y, Wei Q, Dong B, Qiu S. Association between the domestic use of solid cooking fuel and increased prevalence of depression and cognitive impairment in a big developing country: A large-scale population-based study. Front Public Health 2022; 10:1038573. [PMID: 36504928 PMCID: PMC9731231 DOI: 10.3389/fpubh.2022.1038573] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Accepted: 11/04/2022] [Indexed: 11/25/2022] Open
Abstract
Background Previous studies have suggested that air pollution affects physiological and psychological health. Using solid fuel at home is a significant source of indoor air pollution. The associations between solid fuel use and depressive symptoms and cognitive health were unclear among older adults from low- and middle-income countries (LMICs). Methods To evaluate the association of solid fuel use with depressive symptoms and cognitive health among older adults, we obtained data from the Longitudinal Aging Study in India (LASI) and excluded subjects younger than 60 years and without critical data (solid fuel use, depressive symptoms, and cognitive health). The 10-item Center for Epidemiologic Studies Depression Scale (CES-D-10) was used to assess depressive symptoms, with more than ten indicative of depression. Cognitive health was assessed using measures from the Health and Retirement Study (HRS), and subjects with the lowest 10th percentile were considered to have cognitive impairment. The participants' responses defined solid fuel use. Multivariable logistic regression, linear regression, subgroup analysis, and interaction tests were performed to appraise the relationship between solid fuel use and depression and cognitive impairment. Results A total of 29,789 participants over 60 years old were involved in this study. Almost half of the participants (47.5%) reported using solid fuel for home cooking. Compared with clean fuel use, solid fuel use was related to an increased prevalence of depression [odds ratio (OR) 1.09, 95% CI 1.03-1.16] and higher CES-D-10 scores (β 0.23, 95% CI 0.12-0.35) after fully adjusted covariables. Using solid fuel was also related to a higher risk of cognitive impairment (OR 1.21, 95% CI 1.11-1.32) and a lower cognitive score (β -0.63, 95% CI -0.79 to -0.47) compared with those who used clean fuel. In the subgroup analysis, the prevalence of depression increased in females and non-smokers. The association of solid fuel use with depression and cognitive impairment exists in subgroups of BMI, economic status, caste, living area, education, and drinking. Conclusions The use of solid fuel at home was associated with an increased prevalence of depression and cognitive impairment among older adults in India.
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Affiliation(s)
- Yuming Jin
- Department of Urology, National Clinical Research Center for Geriatrics, Institute of Urology, West China Hospital, Sichuan University, Chengdu, China
| | - Xianghong Zhou
- Department of Urology, National Clinical Research Center for Geriatrics, Institute of Urology, West China Hospital, Sichuan University, Chengdu, China
| | - Linghui Deng
- National Clinical Research Center of Geriatrics, The Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, Chengdu, China
| | - Xingyu Xiong
- Department of Urology, National Clinical Research Center for Geriatrics, Institute of Urology, West China Hospital, Sichuan University, Chengdu, China
| | - Yifan Li
- Department of Urology, National Clinical Research Center for Geriatrics, Institute of Urology, West China Hospital, Sichuan University, Chengdu, China
| | - Qiang Wei
- Department of Urology, National Clinical Research Center for Geriatrics, Institute of Urology, West China Hospital, Sichuan University, Chengdu, China
| | - Birong Dong
- National Clinical Research Center of Geriatrics, The Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, Chengdu, China,Birong Dong
| | - Shi Qiu
- Department of Urology, National Clinical Research Center for Geriatrics, Institute of Urology, West China Hospital, Sichuan University, Chengdu, China,Institute of Oncology Research (IOR) and Oncology Institute of Southern Switzerland (IOSI), Bellinzona, Switzerland,*Correspondence: Shi Qiu
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Hu X, Nie Z, Ou Y, Qian Z, McMillin SE, Aaron HE, Zhou Y, Dong G, Dong H. Air quality improvement and cognitive function benefit: Insight from clean air action in China. ENVIRONMENTAL RESEARCH 2022; 214:114200. [PMID: 36030909 DOI: 10.1016/j.envres.2022.114200] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Revised: 08/18/2022] [Accepted: 08/20/2022] [Indexed: 06/15/2023]
Abstract
INTRODUCTION Epidemiological evidence suggests associations between long-term exposure to air pollution and accelerated cognitive decline. China implemented a strict clean air action plan in 2013; however, it is unclear whether the improvement of air quality has alleviated cognitive impairment in the population. METHODS From the China Health and Retirement Longitudinal Study, 8536 Chinese adults were enrolled in 2011 and followed up in 2015. Satellite-based spatiotemporal models were used to estimate exposure to air pollutants (including particles with diameters ≤1.0 μm [PM1], ≤2.5 μm [PM2.5], ≤10 μm [PM10], nitrogen dioxide [NO2], and ozone [O3]). Cognitive function was evaluated using a structured questionnaire in three dimensions: episodic memory, orientation and attention, and visuoconstruction. The associations between changes in the levels of air pollutants and cognitive function were elucidated by a logistic model. The Bayesian Kernel Machine Regression (BKMR) model was applied to evaluate the cumulative effect of air pollutants. RESULTS The mean (standard deviation) age of all participants was 58.6 (8.7) years. The odds ratio (95% confidence interval) between the highest and the lowest quartile of PM1 exposure reduction for cognitive impairment was 0.46 (0.41, 0.53) after adjusting for confounders. Similar protective effects of cognitive function were observed with the decrease in the level of PM2.5 (0.34 [0.30, 0.39]), PM10 (0.54 [0.48, 0.62]), and NO2 (0.59 [0.51, 0.67]), while the reduction in O3 appeared to be less related to changes in cognitive function (OR: 0.97 [0.85, 1.10]). The protective association of PM1 reduction was stronger in males than in females. Decreased in PM2.5 dominate the cognitive function benefit relative to PM1, PM10, NO2. CONCLUSIONS The implementation of the clean air action plan led to a significant reduction in PM1, PM2.5, PM10, and NO2, which could slow the decline of cognitive function, while a reduction in O3 may not.
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Affiliation(s)
- Xiangming Hu
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, China.
| | - Zhiqiang Nie
- Department of Cardiology, Hypertension Research Laboratory, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, China
| | - Yanqiu Ou
- Department of Cardiology, Hypertension Research Laboratory, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, China
| | - Zhengmin Qian
- Department of Epidemiology and Biostatistics, College for Public Health & Social Justice, Saint Louis University, Saint Louis, MO, 63104, USA
| | - Stephen Edward McMillin
- School of Social Work, College for Public Health and Social Justice, Saint Louis University, Saint Louis, MO, 63103, USA
| | - Hannah E Aaron
- Department of Epidemiology and Biostatistics, College for Public Health & Social Justice, Saint Louis University, Saint Louis, MO, 63104, USA
| | - Yingling Zhou
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, China
| | - Guanghui Dong
- Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment, Guangdong Provincial Engineering Technology Research Center of Environmental and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China.
| | - Haojian Dong
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, China.
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Ren Z, Sun W, Shan S, Hou L, Zhu S, Yi Q, Wu Y, Guo C, Liu J, Song P. Risk of functional disability associated with solid fuel use and population impact of reducing indoor air pollution in China: A national cohort study. Front Public Health 2022; 10:976614. [PMID: 36262231 PMCID: PMC9575675 DOI: 10.3389/fpubh.2022.976614] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Accepted: 09/08/2022] [Indexed: 01/25/2023] Open
Abstract
Background In China, numerous people still rely on solid fuel for household use. To date, the association between household solid fuel use and functional disability, and what benefit reducing household solid fuel usage could bring at the population level to China remain unclear. Method Data were from the China Health and Retirement Longitudinal Study. Household fuel was classified as clean or solid for cooking or heating. Functional disability was defined as difficulties in any item of activities of daily living (ADL) or instrumental activities of daily living (IADL). The associations of household fuel use in 2011 and its transitions between 2011 and 2013 with subsequent ADL or IADL disability were assessed with Cox proportional-hazards models. The number of events prevented in a population (NEPP) was generated to estimate how many functionally disabled patients could be prevented by reducing solid fuel usage. Results A total of 6,216 and 9,716 participants without prior ADL or IADL disability in 2011 were included. Solid (vs. clean) fuel users were more likely to develop ADL and IADL disability, with hazard ratios (HRs) and 95% confidence intervals (CIs) of 1.37 (1.28~1.45) and 1.38 (1.31~1.46) for using both solid cooking and heating fuel. Furthermore, participants that switched heating fuel from solid to clean (vs. keep solid) were about 20% less likely to develop functional disability. Cooking fuel use switching from solid to clean (vs. keep solid) was also negatively associated with IADL disability (HR = 0.84, 95% CI 0.74~0.96). Over the next 7 years, raising clean fuel usage to 80% could prevent about 4.9 million ADL disability and 2.6 million IADL disability among Chinese aged 45 and older. Conclusion Household solid fuel use was a risk factor for functional disability. Reducing solid fuel usage could help reduce the burden of functional disability in the current aging society of China.
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Affiliation(s)
- Ziyang Ren
- School of Public Health and Women's Hospital, Zhejiang University School of Medicine, Hangzhou, China,Institute of Reproductive and Child Health/Key Laboratory of Reproductive Health, National Health Commission of the People's Republic of China, Peking University, Beijing, China,Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Weidi Sun
- School of Public Health and Women's Hospital, Zhejiang University School of Medicine, Hangzhou, China,Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Shiyi Shan
- School of Public Health and Women's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Leying Hou
- School of Public Health and Women's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Siyu Zhu
- School of Public Health and Women's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Qian Yi
- School of Public Health and Women's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - You Wu
- School of Medicine, Tsinghua University, Beijing, China,Institute for Hospital Management, Tsinghua University, Shenzhen, China
| | - Chao Guo
- Institute of Population Research, Peking University, Beijing, China,APEC Health Science Academy (HeSAY), Peking University, Beijing, China
| | - Jufen Liu
- Institute of Reproductive and Child Health/Key Laboratory of Reproductive Health, National Health Commission of the People's Republic of China, Peking University, Beijing, China,Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China,Jufen Liu
| | - Peige Song
- School of Public Health and Women's Hospital, Zhejiang University School of Medicine, Hangzhou, China,*Correspondence: Peige Song
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Yang Y, Liu Y, Peng L, Zhang S, Yuan C, Li W, Liu Z, Ma Y. Cooking or heating with solid fuels increased the all-cause mortality risk among mid-aged and elderly People in China. Environ Health 2022; 21:91. [PMID: 36184584 PMCID: PMC9528092 DOI: 10.1186/s12940-022-00903-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Revised: 09/21/2022] [Accepted: 09/22/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Our study aimed to explore the associations between solid fuels burning for either heating or cooking and all-cause mortality based on 2859 participants from the China Health and Retirement Longitudinal Study during 2011-2018. METHODS Logistic regression models were performed to estimate the risk for all-cause mortality between different types of fuels in the current longitudinal study. Furthermore, the combined impacts of applying solid fuels for both cooking and heating and the effect among those who switched types of fuels in cooking or heating during follow-up were also analyzed. Interaction and stratification analysis by covariables was applied further to explore the relationship between fuel burning and all-cause mortality. RESULTS After full-adjustment, usage of solid fuels was associated with higher all-cause mortality (for heating: OR = 1.93, 95% CI = 1.25, 3.00; for cooking: OR = 1.76, 95% CI = 1.10, 2.82). Using solid fuels for both cooking and heating (OR = 2.36; 95% CI, 1.38, 4.03) was associated with a higher risk of all-cause mortality, while using solid fuels with a single purpose was not (OR = 1.52; 95% CI, 0.90, 2.55). Protective tendencies were detected in switching solid to clean fuel for cooking (OR = 0.62; 95% CI, 0.32, 1.17) and heating (OR = 0.62; 95% CI, 0.35, 1.10). CONCLUSION Either cooking or heating with solid fuels increases the risk of all-cause mortality among Chinese mid-aged and aging people in the urban area of China.
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Affiliation(s)
- Yuxiang Yang
- NHC Key Laboratory of Trace Element Nutrition, National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, 100050 Beijing, China
| | - Yang Liu
- Department of Biostatistics and Epidemiology, School of Public Health, China Medical University, No.77 Puhe Road, Shenyang North New Area, 110122 Shenyang, Liaoning China
| | - Luolan Peng
- NHC Key Laboratory of Trace Element Nutrition, National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, 100050 Beijing, China
| | - Shuai Zhang
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, 100021 Beijing, China
| | - Changzheng Yuan
- School of Public Health, Zhejiang University School of Medicine, 866 Yuhangtang Road, 310058 Hangzhou, Zhejiang China
| | - Wenyuan Li
- Department of Big Data in Health Science School of Public Health, Center for Clinical Big Data and Analytics Second Affiliated Hospital, Zhejiang University School of Medicine, 866 Yuhangtang Rd, 310058 Hangzhou, Zhejiang China
| | - Zuyun Liu
- Department of Big Data in Health Science School of Public Health, Center for Clinical Big Data and Analytics Second Affiliated Hospital, Zhejiang University School of Medicine, 866 Yuhangtang Rd, 310058 Hangzhou, Zhejiang China
| | - Yanan Ma
- Department of Biostatistics and Epidemiology, School of Public Health, China Medical University, No.77 Puhe Road, Shenyang North New Area, 110122 Shenyang, Liaoning China
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Niu Z, Zhao F, Wen W, Han D, Zhang K, Zhao X, Han S, Yang F, Duan Z, Qin W. The higher levels of self-reported satisfaction, the lower risk of depressive symptoms: Evidence from a nationwide cross-sectional study in China. Front Med (Lausanne) 2022; 9:844964. [PMID: 36203778 PMCID: PMC9530607 DOI: 10.3389/fmed.2022.844964] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Accepted: 08/26/2022] [Indexed: 11/24/2022] Open
Abstract
Objectives This study aimed to investigate the associations between several dimensions of self-reported satisfaction and the risk of depressive symptoms among Chinese middle-aged and older adults. Methods The China Health and Retirement Longitudinal Study (CHARLS) conducted a nationwide cross-sectional study of middle-aged and older adults. Depressive status was evaluated using the 10-item center for epidemiological studies depression scale (CESD-10), and self-reported life, health, marital status, parent-child relationship, and air quality satisfaction were adopted using Likert 5-point evaluation methods. A generalized linear model (GLM) was applied to explore the association between satisfaction and depression risk. Results A total of 13,978 Chinese people aged over 45 years old were included in this study, and 35.7% of the participants had depressive symptoms. The GLM analysis indicated that all dimensions of satisfaction were negatively associated with the risk of depressive symptoms. For each 1-point increase in life, health, marital status, parent-child relationship, and air quality satisfaction, the incidence of depressive symptoms decreased by 60.8% (odds ratio (OR) = 0.392; 95% confidence interval (CI): 0.370, 0.414), 56.3% (OR = 0.437; 95% CI: 0.418, 0.458), 41.8% (OR = 0.582; 95% CI: 0.555, 0.610), 37.2% (OR = 0.628; 95% CI: 0.596, 0.662), and 25.6% (OR = 0.744; 95% CI: 0.711, 0.778), respectively. Conclusion Higher satisfaction levels with life, health, marital status, parent-child relationship, and air quality are associated with a lower risk of depressive symptoms among middle-aged and older adults. Given the aging society and the increasing mental health problems of middle-aged and older adults in China, our study provides a comprehensive perspective for depression prevention and mental health improvement.
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Affiliation(s)
- Zhiping Niu
- Department of Urology, Xijing Hospital, The Fourth Military Medical University, Xi'an, China
| | - Feng Zhao
- Department of Anesthesiology, Heze Municipal Hospital, Heze, China
| | - Weihong Wen
- Institute of Medical Research, Northwestern Polytechnical University, Xi'an, China
| | - Donghui Han
- Department of Urology, Xijing Hospital, The Fourth Military Medical University, Xi'an, China
| | - Keying Zhang
- Department of Urology, Xijing Hospital, The Fourth Military Medical University, Xi'an, China
| | - Xiaolong Zhao
- Department of Urology, Xijing Hospital, The Fourth Military Medical University, Xi'an, China
| | - Shichao Han
- Department of Urology, Xijing Hospital, The Fourth Military Medical University, Xi'an, China
| | - Fa Yang
- Department of Urology, Xijing Hospital, The Fourth Military Medical University, Xi'an, China
| | - Zhizhou Duan
- Preventive Health Service, Jiangxi Provincial People's Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, China
- *Correspondence: Zhizhou Duan
| | - Weijun Qin
- Department of Urology, Xijing Hospital, The Fourth Military Medical University, Xi'an, China
- Weijun Qin
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Tawiah T, Iddrisu S, Gyaase S, Twumasi M, Asante KP, Jack D. The feasibility and acceptability of clean fuel use among rural households. A pilot study in Central Ghana. J Public Health Afr 2022; 13:2205. [PMID: 36277951 PMCID: PMC9585603 DOI: 10.4081/jphia.2022.2205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Accepted: 07/21/2022] [Indexed: 11/23/2022] Open
Abstract
Background: 76% of the population in Ghana uses solid fuels as their primary source of cooking energy, including 41.3% firewood and 31.5% charcoal. Consequently, household air pollution (HAP) continues to be the leading risk factor for the majority of illness burden in the country. In the past, aggressive LPG distribution and adoption schemes have been implemented to reduce HAP in Ghana. Nevertheless, just 22% of Ghanaian households utilize LPG for cooking. Aims. The purpose of this study was to determine the viability and acceptability of four clean fuels among rural households in central Ghana, both separately and in combination. Methods: Quantitative and qualitative methods were used to conduct this study. The Kintampo Health Demographic Surveillance System was used to randomly pick ten homes who exclusively utilized biomass fuel. For each family (n = 10), we gave four stove and fuel combinations that were both clean. The stoves were utilized for two weeks, and free fuel was supplied. After each two-week trial period, interviews were conducted to gauge stove acceptance, with an emphasis on finding the specific energy requirements that each stove satisfied. Conclusions. LPG and ethanol stoves were the most popular among rural families, according to our data. In comparison to Mimi Moto and electric induction stoves, the two stoves were favoured because they were easier to use and clean, cooked faster, were deemed safer, and enabled a variety of cooking styles. Participants’ stove preferences appear to be primarily influenced by two domains: 1) realizing the benefits of clean stove technology and 2) overcoming early anxiety of clean stove use, particularly LPG.
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40
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Smith L, Pizzol D, López Sánchez GF, Kostev K, Oh H, Jacob L, Veronese N, Underwood BR, Butler L, Barnett Y, Tully MA, Koyanagi A. Association between cooking fuels and mild cognitive impairment among older adults from six low- and middle-income countries. Sci Rep 2022; 12:14055. [PMID: 35982103 PMCID: PMC9388480 DOI: 10.1038/s41598-022-17216-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2022] [Accepted: 07/21/2022] [Indexed: 11/17/2022] Open
Abstract
There is a small body of evidence suggesting that unclean cooking fuel use may be associated with cognitive decline. However, to date, no study has investigated the association between unclean cooking fuel and mild cognitive impairment (MCI). Thus, we investigated the association between cooking fuel type or ventilation type and MCI among adults aged ≥ 65 years using nationally representative datasets from six low- and middle-income countries. Cross-sectional, community-based data from the World Health Organization (WHO) Study on global Ageing and adult health (SAGE) were analyzed. MCI was defined using the National Institute on Aging-Alzheimer's Association criteria. Unclean cooking fuel referred to kerosene/paraffin, coal/charcoal, wood, agriculture/crop, animal dung, and shrubs/grass. Multivariable logistic regression analysis was conducted to assess associations. Data on 13,623 individuals were analyzed [mean (SD) age 72.8 (11.0) years; 45.5% males]. Unclean cooking fuel (vs. clean cooking fuel) was associated with a significant 1.48 (95% CI = 1.08–2.03) times higher odds for MCI. Having no chimney or hood for cooking ventilation was also associated with significantly higher odds for MCI (OR = 1.88; 95% CI = 1.25–2.84). Unclean cooking fuel use and lack of chimney or hood for cooking ventilation were associated with higher odds for MCI. Findings support the implementation of the United Nations Sustainable Goal 7, which advocates affordable, reliable, sustainable, and modern energy for all, as this may also help reduce MCI and ultimately dementia.
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Affiliation(s)
- Lee Smith
- Centre for Health, Performance, and Wellbeing, Anglia Ruskin University, Cambridge, UK
| | - Damiano Pizzol
- Italian Agency for Development Cooperation, Gedaref, Khartoum, Sudan
| | - Guillermo F López Sánchez
- Division of Preventive Medicine and Public Health, Department of Public Health Sciences, School of Medicine, University of Murcia, Murcia, Spain.
| | - Karel Kostev
- University Hospital of Marburg, Marburg, Germany
| | - Hans Oh
- Suzanne Dworak Peck School of Social Work, University of Southern California, Los Angeles, CA, 90007, USA
| | - Louis Jacob
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, ISCIII, 08830, Barcelona, Spain.,Faculty of Medicine, University of Versailles Saint-Quentin-en-Yvelines, 78000, Versailles, France
| | - Nicola Veronese
- Chair for Biomarkers of Chronic Diseases, Biochemistry Department, College of Science King Saud University, Riyadh, 11451, Saudi Arabia.,Department of Internal Medicine, Geriatrics Section, University of Palermo, Palermo, Italy
| | - Benjamin R Underwood
- Cambridgeshire and Peterborough NHS Foundation Trust, The Gnodde Goldman Sachs Translational Neuroscience Unit, University of Cambridge, Cambridge, UK
| | - Laurie Butler
- Centre for Health, Performance, and Wellbeing, Anglia Ruskin University, Cambridge, UK
| | - Yvonne Barnett
- Centre for Health, Performance, and Wellbeing, Anglia Ruskin University, Cambridge, UK
| | - Mark A Tully
- School of Medicine, Ulster University, Belfast, UK
| | - Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, ISCIII, 08830, Barcelona, Spain.,ICREA, Pg. Lluis Companys 23, 08010, Barcelona, Spain
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Peng Y, Wang Y, Wu F, Chen Y. Association of cooking fuel with incident hypertension among adults in China: A population-based cohort study. J Clin Hypertens (Greenwich) 2022; 24:1003-1011. [PMID: 35904176 PMCID: PMC9380161 DOI: 10.1111/jch.14533] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 05/27/2022] [Accepted: 05/30/2022] [Indexed: 12/04/2022]
Abstract
With an increasing prevalence of hypertension, indoor air‐pollution factors began to attract extensive attention. However, the association of cooking fuel with the incidence of hypertension was inconsistent. The aim of this study was to investigate the association of household air‐pollution caused by cooking fuel with the incidence of hypertension. Data were derived from the China Health and Nutrition Survey. Participants aged 18 years or older were eligible. A validated questionnaire was used to collect the information on the type of cooking fuel, including electricity, natural gas, coal, and wood/charcoal. Participants with a systemic blood pressure (SBP) ≥ 140 mmHg or /and a diastolic blood pressure (DBP) ≥ 90 mmHg without use of anti‐hypertensive medications, or participants with an SBP/DBP < 140/90 mmHg but having hypertensive history or currently being taking anti‐hypertensive medication were identified as hypertension. Multilevel Cox regressions were employed to examine the association of cooking fuel with incident hypertension. Compared to participants using electricity, participants using wood/charcoal had a higher incidence of hypertension (HR: 1.581; 95% CI: 1.373‐1.821; and P < .001), which was independent of sex and living areas. Furthermore, this significant association was observed only in the participants aged 18–39 years (HR: 1.443; 95% CI: 1.131‐1.840; and P = .003). Compared to participants using non‐polluting energy, participants using solid fuel were more likely to develop hypertension (HR: 1.309; 95% CI: 1.191‐1.439; and P < .001). In conclusion, household air‐pollution was associated with the incidence of hypertension among Chinese adults. Using wood/charcoal or solid fuel in youth was associated with a higher incidence of hypertension later in life.
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Affiliation(s)
- Yue Peng
- Department of Epidemiology and Statistics, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Yu Wang
- Department of Epidemiology and Statistics, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Fei Wu
- Department of Epidemiology and Statistics, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Yongjie Chen
- Department of Epidemiology and Statistics, School of Public Health, Tianjin Medical University, Tianjin, China.,Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China
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Mediating Factors Explaining the Associations between Solid Fuel Use and Self-Rated Health among Chinese Adults 65 Years and Older: A Structural Equation Modeling Approach. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19116904. [PMID: 35682487 PMCID: PMC9180008 DOI: 10.3390/ijerph19116904] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Revised: 05/28/2022] [Accepted: 06/02/2022] [Indexed: 02/01/2023]
Abstract
Exposure to indoor air pollution from cooking with solid fuel has been linked with the health of elderly people, although the pathway to their association is unclear. This study aimed to investigate the mediating effects between solid fuel use and self-rated health by using structural equation modeling (SEM) with the baseline data from Chinese Longitudinal Healthy Longevity Survey (CLHLS). We conducted a cross-sectional survey among 7831 elderly people aged >65 years from the CLHLS. SEM was used to analyze the pathways underlying solid fuel use and self-rated health. We estimated indirect effects of sleep quality (β = −0.027, SE = 0.006), cognitive abilities (β = −0.006, SE = 0.002), depressive symptoms (β = −0.066, SE = 0.007), systolic blood pressure (β = 0.000, SE = 0.000), and BMI (β = −0.000, SE = 0.000) on the association between solid fuel and the self-rated health using path analysis. Depressive symptoms emerged as the strongest mediator in the relationship between solid fuel use and self-rated health in the elderly. Interventions targeting sleep quality, cognitive abilities, depressive symptoms, systolic blood pressure, and BMI could greatly reduce the negative effects of solid fuel use on the health of the elderly population.
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Xue B, Wang B, Lei R, Li Y, Luo B, Yang A, Zhang K. Indoor solid fuel use and renal function among middle-aged and older adults: A national study in rural China. ENVIRONMENTAL RESEARCH 2022; 206:112588. [PMID: 34951991 DOI: 10.1016/j.envres.2021.112588] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 12/06/2021] [Accepted: 12/15/2021] [Indexed: 05/26/2023]
Abstract
Solid fuel use is the main source of indoor air pollution, especially in rural areas of developing countries. Nevertheless, the evidence linking indoor solid fuel use and renal function is very limited. Therefore, we investigated the association between indoor solid fuel use and renal function among middle-aged and older adults in rural China. Cystatin C (CysC) concentration of each participant was used to calculate the estimated glomerular filtration rate (eGFR). We used the baseline data to investigate the associations between solid fuel use for cooking and heating and eGFR through a linear-mixed effects model. Then, we applied the generalized linear-mixed effects model with binary distribution to examine the relationship between renal function decline and cooking fuel switching from 2011 to 2015. A total of 4959 participants were included at baseline, and 3536 participants were included in the follow-up analysis. Compared to participants who used clean fuel for both cooking and heating, the eGFR was significantly lower among participants who cooked with solid fuel and heated with clean fuel (β: -2.81; 95% CI: -5.53, -0.09). In the follow-up analysis, the risks of renal function decline for participants using solid fuel for cooking were significantly higher in males (OR: 2.74; 95% CI: 1.68, 4.49), smokers (OR: 5.70; 95% CI: 2.82, 11.55), and drinkers (OR: 7.11; 95% CI: 3.15, 16.02) compared to females, non-smokers, and non-drinkers. Moreover, 45-65 years aged participants (OR: 0.54; 95% CI: 0.33, 0.89) and non-drinkers (OR: 0.61; 95% CI: 0.41, 0.92) who switched from solid to clean cooking fuel had a lower risk of renal function decline. In conclusion, our findings show that household solid fuel use is likely to be an important risk factor for renal function decline in rural China. And switching to cleaner fuel may provide significant public health benefits.
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Affiliation(s)
- Baode Xue
- Institute of Occupational Health and Environmental Health, School of Public Health, Lanzhou University, Lanzhou, Gansu, 730000, People's Republic of China
| | - Bo Wang
- Institute of Occupational Health and Environmental Health, School of Public Health, Lanzhou University, Lanzhou, Gansu, 730000, People's Republic of China
| | - Ruoyi Lei
- Institute of Occupational Health and Environmental Health, School of Public Health, Lanzhou University, Lanzhou, Gansu, 730000, People's Republic of China
| | - Yanlin Li
- Institute of Occupational Health and Environmental Health, School of Public Health, Lanzhou University, Lanzhou, Gansu, 730000, People's Republic of China
| | - Bin Luo
- Institute of Occupational Health and Environmental Health, School of Public Health, Lanzhou University, Lanzhou, Gansu, 730000, People's Republic of China.
| | - Aimin Yang
- Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Hong Kong SAR, People's Republic of China.
| | - Kai Zhang
- Department of Environmental Health Sciences, School of Public Health, University at Albany, State University of New York, One University Place, Rensselaer, NY, 12144, USA.
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Tseng TWJ, Carter E, Yan L, Chan Q, Elliott P, Ezzati M, Kelly F, Schauer JJ, Wu Y, Yang X, Zhao L, Baumgartner J. Household air pollution from solid fuel use as a dose-dependent risk factor for cognitive impairment in northern China. Sci Rep 2022; 12:6187. [PMID: 35418188 PMCID: PMC9008006 DOI: 10.1038/s41598-022-10074-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Accepted: 03/15/2022] [Indexed: 11/09/2022] Open
Abstract
The relationship between exposure to household air pollution (HAP) from solid fuel use and cognition remains poorly understood. Among 401 older adults in peri-urban northern China enrolled in the INTERMAP-China Prospective Study, we estimated the associations between exposure to HAP and z-standardized domain-specific and overall cognitive scores from the Montreal Cognitive Assessment. Interquartile range increases in exposures to fine particulate matter (53.2-µg/m3) and black carbon (0.9-µg/m3) were linearly associated with lower overall cognition [- 0.13 (95% confidence interval: - 0.22, - 0.04) and - 0.10 (- 0.19, - 0.01), respectively]. Using solid fuel indoors and greater intensity of its use were also associated with lower overall cognition (range of point estimates: - 0.13 to - 0.03), though confidence intervals included zero. Among individual cognitive domains, attention had the largest associations with most exposure measures. Our findings indicate that exposure to HAP may be a dose-dependent risk factor for cognitive impairment. As exposure to HAP remains pervasive in China and worldwide, reducing exposure through the promotion of less-polluting stoves and fuels may be a population-wide intervention strategy to lessen the burden of cognitive impairment.
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Affiliation(s)
- Tzu-Wei Joy Tseng
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, 1130 Pine Ave W, Montreal, QC, H3A 1A3, Canada
| | - Ellison Carter
- Institute on the Environment, University of Minnesota, Saint Paul, MN, USA
- Department of Civil and Environmental Engineering, Colorado State University, Fort Collins, CO, USA
| | - Li Yan
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
- Environmental Research Group, MRC Centre for Environment and Health, School of Public Health, Imperial College London, London, UK
| | - Queenie Chan
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
- Environmental Research Group, MRC Centre for Environment and Health, School of Public Health, Imperial College London, London, UK
- MRC Centre for Environment and Health, School of Public Health, Imperial College London, London, UK
| | - Paul Elliott
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
- MRC Centre for Environment and Health, School of Public Health, Imperial College London, London, UK
- NIHR Imperial College London Biomedical Research Centre, London, UK
| | - Majid Ezzati
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
- MRC Centre for Environment and Health, School of Public Health, Imperial College London, London, UK
| | - Frank Kelly
- Environmental Research Group, MRC Centre for Environment and Health, School of Public Health, Imperial College London, London, UK
| | - James J Schauer
- Department of Civil and Environmental Engineering, University of Wisconsin, Madison, USA
- Environmental Chemistry & Technology Program, University of Wisconsin, Madison, USA
| | - Yangfeng Wu
- Peking University Clinical Research Institute, Beijing, China
| | - Xudong Yang
- Department of Building Science, School of Architecture, Tsinghua University, Beijing, China
| | - Liancheng Zhao
- National Center for Cardiovascular Disease, Fuwai Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, China
| | - Jill Baumgartner
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, 1130 Pine Ave W, Montreal, QC, H3A 1A3, Canada.
- Institute for Health and Social Policy, McGill University, Montreal, Canada.
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Chen T, Zou C, Yuan Y, Pan J, Zhang B, Qiao L, Li Y, Qian JY, Guo Q, Yuan Y, Ding C. Indoor air pollution from solid fuel on children pneumonia in low- and middle-income countries: a systematic review and meta-analysis. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2022; 29:24574-24588. [PMID: 35066845 DOI: 10.1007/s11356-021-18293-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Accepted: 12/19/2021] [Indexed: 06/14/2023]
Abstract
An updated systematic review was conducted to assessing on the association between indoor air pollution caused by household energy consumption and childhood pneumonia in low- and middle-income countries. We performed a meta-analysis from the electronic databases of PubMed, Cochrane library, Web of Science, EMBASE. Studies were selected when they reported childhood pneumonia or ALRI in relation to indoor air pollution resulted from solid fuel. Studies must provide results on exposure prevalence of children aged below 5 years from Asia or Africa. We devoted ourselves to identifying randomized controlled experiments and observational epidemiological researches, which revealed the relation between household usage of solid fuel and childhood pneumonia. Among 1954 articles, 276 were reviewed thoroughly and 16 conduced to such a meta-analysis. It was found that there is a significant relationship between the solid fuel combustion and increasing risk of childhood pneumonia (OR = 1.66, 95%CI 1.36-2.02). The summary odds ratios from biomass use and mixed fuel use were, respectively, 1.86 (95%CI 1.15-3.02) and 1.58 (95%CI 1.38-1.81), with substantial between study heterogeneity (I2 = 87.2% and 29.2%, respectively). According to the subgroup analysis along with the meta-regression analysis, the risk of using solid fuel in Asian regions is higher than that in African regions. Studies based on non-hospital participates (I2 = 49.5%) may also a source of heterogeneity. We found that indoor air pollution generated by the usage of solid fuel might be a significant risk factor for pneumonia in children and suggested improving the indoor air quality by promoting cleaner fuel will be important in undeveloped countries.
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Affiliation(s)
- Tianming Chen
- School of Environmental Science and Engineering, Yancheng Institute of Technology, P.O.Box NO.211 Jianjun Road, Yancheng, 224051, Jiangsu Province, China
- Jiangsu Province Engineering Research Center of Intelligent Environmental Protection Equipment, Yancheng, 224051, Jiangsu Province, China
| | - Chao Zou
- School of Environmental Science and Engineering, Yancheng Institute of Technology, P.O.Box NO.211 Jianjun Road, Yancheng, 224051, Jiangsu Province, China
- Jiangsu Province Engineering Research Center of Intelligent Environmental Protection Equipment, Yancheng, 224051, Jiangsu Province, China
| | - Yang Yuan
- Yancheng Hospital of Traditional Chinese Medicine, Yancheng, 224001, Jiangsu, China
| | - Jingjing Pan
- School of Environmental Science and Engineering, Yancheng Institute of Technology, P.O.Box NO.211 Jianjun Road, Yancheng, 224051, Jiangsu Province, China
- Jiangsu Province Engineering Research Center of Intelligent Environmental Protection Equipment, Yancheng, 224051, Jiangsu Province, China
| | - Baoping Zhang
- School of Environmental Science and Engineering, Yancheng Institute of Technology, P.O.Box NO.211 Jianjun Road, Yancheng, 224051, Jiangsu Province, China
| | - Liang Qiao
- School of Environmental Science and Engineering, Yancheng Institute of Technology, P.O.Box NO.211 Jianjun Road, Yancheng, 224051, Jiangsu Province, China
- Jiangsu Province Engineering Research Center of Intelligent Environmental Protection Equipment, Yancheng, 224051, Jiangsu Province, China
| | - Yanping Li
- Department of Pharmacy, Jiangsu Vocational College of Medicine, Jiangsu, 224005, China
| | - Jia-Yan Qian
- Nantong Production Quality Supervising & Inspection Institute, Jiangsu, 226005, China
| | - Qingyuan Guo
- School of Environmental Science and Engineering, Yancheng Institute of Technology, P.O.Box NO.211 Jianjun Road, Yancheng, 224051, Jiangsu Province, China
- Jiangsu Province Engineering Research Center of Intelligent Environmental Protection Equipment, Yancheng, 224051, Jiangsu Province, China
| | - Ye Yuan
- School of Environmental Science and Engineering, Yancheng Institute of Technology, P.O.Box NO.211 Jianjun Road, Yancheng, 224051, Jiangsu Province, China.
- Jiangsu Province Engineering Research Center of Intelligent Environmental Protection Equipment, Yancheng, 224051, Jiangsu Province, China.
| | - Cheng Ding
- School of Environmental Science and Engineering, Yancheng Institute of Technology, P.O.Box NO.211 Jianjun Road, Yancheng, 224051, Jiangsu Province, China.
- Jiangsu Province Engineering Research Center of Intelligent Environmental Protection Equipment, Yancheng, 224051, Jiangsu Province, China.
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Cao L, Zhai D, Kuang M, Xia Y. Indoor air pollution and frailty: A cross-sectional and follow-up study among older Chinese adults. ENVIRONMENTAL RESEARCH 2022; 204:112006. [PMID: 34499891 DOI: 10.1016/j.envres.2021.112006] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/27/2021] [Revised: 08/31/2021] [Accepted: 09/01/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Previous studies have suggested that ambient air pollution negatively affects frailty, but whether indoor air pollution exposure affects frailty is unknown. METHOD This study was conducted on 4946 older adults (≥60 years) followed from baseline to 4 years in the Chinese Longitudinal Healthy Longevity Survey. Household fuel types and frailty were assessed with self-rated questionnaires and physical examination. The relationships between indoor air pollution and frailty via phenotypic frailty and a frailty index were explored with logistic regression models and Cox proportional hazard regression models in both a cross-sectional and follow-up design. Additionally, the effects of indoor air pollution on phenotypic frailty together with mild cognitive impairment (MCI) were further investigated. RESULTS In the cross-sectional study, the adjusted ORs (95% CIs) for frailty assessment with the frailty index and phenotypic frailty were 1.28 (1.12, 1.46) and 1.36 (1.18, 1.57), respectively. Solid fuel use was a risk factor in prefrail/frail patients with [OR and 95% CI, 1.88 (1.41, 2.50)], or without MCI [OR and 95% CI, 1.37 (1.17, 1.61)], as compared with the groups with no phenotypic prefrailty/frailty and no MCI. Moreover, solid cooking fuel use was positively associated with the incidence of phenotypic prefrailty and frailty. The adjusted HRs (95% CIs) for phenotypic prefrailty and frailty were 1.26 (1.03, 1.55). CONCLUSIONS Solid cooking fuels can be regarded as a risk factor for frailty. Moreover, our findings suggest that more attention should be paid to solid cooking fuel using as it relates to phenotypic frailty together with MCI.
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Affiliation(s)
- Limin Cao
- The Third Central Hospital of Tianjin, 83 Jintang Road, Hedong District, Tianjin, 300170, China; Tianjin Key Laboratory of Extracorporeal Life Support for Critical Disease, China
| | - Daokuan Zhai
- The Third Central Hospital of Tianjin, 83 Jintang Road, Hedong District, Tianjin, 300170, China; Tianjin Key Laboratory of Extracorporeal Life Support for Critical Disease, China
| | - Mingjie Kuang
- Department of Orthopedics, Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, 250014, China.
| | - Yang Xia
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China.
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Zhang H, Xia Y, Cao L, Chang Q, Zhao Y. Associations between long term exposures to outdoor air pollution and indoor solid fuel use and depression in China. JOURNAL OF ENVIRONMENTAL MANAGEMENT 2022; 302:113982. [PMID: 34700082 DOI: 10.1016/j.jenvman.2021.113982] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Revised: 10/12/2021] [Accepted: 10/18/2021] [Indexed: 06/13/2023]
Abstract
Depression is one of the most common mental disorders. Effects of air pollution from outdoor and indoor on depression were inconsistent. We assessed 30,139 participants from Northeast China to explore the associations between long term exposures of outdoor and indoor solid fuel use and depressive symptoms. Multiple logistic regressions models as well as multiplicative interaction and additive interaction analysis were used. Outdoor exposures to air pollutants of particulate matter (with an aerodynamic diameter <2.5 μm, [PM2.5], odds ratio [OR] = 1.98 per standard deviation [SD], 95% confidence interval [CI]: 1.78, 2.19; with an aerodynamic diameter <10 μm, [PM10], OR = 1.83, 95% CI:1.68, 2.00), sulfur dioxide (SO2, OR = 1.42, 95% CI: 1.33, 1.52), and nitrogen dioxide (NO2, OR = 1.62, 95% CI: 1.49, 1.76) were significantly associated with higher occurrence of depressive symptoms. A significant linear trend for increased occurrence of depressive symptoms was observed in participants using both solid fuels for cooking and heating (P = 0.04). Indoor air pollution exposures from solid fuel use for heating (OR = 1.16, 95%CI: 1.00, 1.35) and high cooking frequency (OR = 1.17, 95%CI: 1.00, 1.37) were significantly associated with increased occurrence of depressive symptoms. We observed significant interactions of indoor solid fuel use and outdoor air pollution exposures on depressive symptoms (indoor fuel use for cooking and SO2, P value = 0.04; solid fuel use for heating and NO2, P value = 0.02). Solid fuel use for cooking weakened the associations between SO2(relative excess risk due to interaction [RERI] = -1.37, 95% CI: -1.88, -0.86) and depressive symptoms. Solid fuel use for heating weakened the associations between NO2 (RERI = -1.91, 95% CI: -2.55, -1.27) and depressive symptoms. Compared with individual associations, antagonistic interactions of outdoor air pollution and indoor solid fuel use on depressive symptoms might exist. Our findings contribute to better understandings for the associations between air pollution and depressive symptoms, which might be useful for developing effective strategies for depression prevention and air pollution control.
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Affiliation(s)
- Hehua Zhang
- Clinical Research Center, Shengjing Hospital of China Medical University, Heping District, Sanhao Street, No. 36, Shenyang City, Liaoning Province, 110004, China
| | - Yang Xia
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Heping District, Sanhao Street, No. 36, Shenyang, Liaoning Province, 110004, China
| | - Limin Cao
- The Third Central Hospital of Tianjin, Hedong District, Jintang Road, No. 83, Tianjin, 300170, China
| | - Qing Chang
- Clinical Research Center, Shengjing Hospital of China Medical University, Heping District, Sanhao Street, No. 36, Shenyang City, Liaoning Province, 110004, China
| | - Yuhong Zhao
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Heping District, Sanhao Street, No. 36, Shenyang, Liaoning Province, 110004, China.
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Zhai D, Cao L, Zhou Y, Liu H, Shi M, Wei Y, Xia Y. The effect of water source on cognitive functioning in Chinese adults: A cross-sectional and follow-up study. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2022; 230:113156. [PMID: 34979313 DOI: 10.1016/j.ecoenv.2021.113156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Revised: 12/17/2021] [Accepted: 12/30/2021] [Indexed: 06/14/2023]
Abstract
The effect of water source on cognitive functioning is poorly understood. The present study explored the associations between water source and cognition in 9921 participants from the China Health and Retirement Longitudinal Study (CHARLS). Cognitive functioning was measured from three aspects: orientation and attention, episodic memory, and visuo-construction. Water sources included tap and non-tap water. Generalized linear models and multiple logistic regression models were conducted to investigate the associations of cognitive scores with water source among the whole population and different subgroups. Results from cross-sectional analysis reported that participants without access to tap water showed a lower cognitive score (β = - 0.57; 95% CI: - 0.74, - 0.39) than those with tap water as a water source; and this phenomenon was pronounced for both sexes and across all residences. During 4-years' follow-up, a greater decline of cognitive score was associated with no tap water use in the lowest quartile of baseline cognitive scores (β = - 0.67; 95% CI: - 1.26, - 0.08). Additionally, the utilization rate of tap water was lower in rural areas compared to urban areas. The lowest utilization rates were observed in urban areas of the Anhui province (0.38 in 2011 and 0.55 in 2015) and in rural areas of Inner Mongolia (0.09 in 2011 and 0.20 in 2015). These findings suggest that having no tap water may be a risk factor for cognition impairment, particularly for those with a low basic cognition score. Additionally, our results support the need to expand tap water use in China.
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Affiliation(s)
- Daokuan Zhai
- The Third Central Hospital of Tianjin, 83 Jintang Road, Hedong District, Tianjin 300170, China
| | - Limin Cao
- The Third Central Hospital of Tianjin, 83 Jintang Road, Hedong District, Tianjin 300170, China
| | - Yuhan Zhou
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Huiyuan Liu
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Mengyuan Shi
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Yingliang Wei
- Department of Orthopedic Surgery, Shengjing Hospital of China Medical University, Shenyang, China.
| | - Yang Xia
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China.
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Gao K, Ma WZ, Huck S, Li BL, Zhang L, Zhu J, Li T, Zhou D. Association Between Sarcopenia and Depressive Symptoms in Chinese Older Adults: Evidence From the China Health and Retirement Longitudinal Study. Front Med (Lausanne) 2021; 8:755705. [PMID: 34869454 PMCID: PMC8635632 DOI: 10.3389/fmed.2021.755705] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Accepted: 10/18/2021] [Indexed: 12/27/2022] Open
Abstract
Background: Little is known about whether sarcopenia predicts incident depressive symptoms in older adults. Using the nationally representative data from the China Health and Retirement Longitudinal Study (CHARLS), we conducted cross-sectional and longitudinal analyses to estimate the association between sarcopenia and depressive symptoms among older adults. Methods: The sample comprised 7,706 participants aged at least 60 years (50.6% women; mean age 68.0 ± 6.5) from the CHARLS 2015. Based on the Asian Working Group for Sarcopenia 2019 (AWGS 2019) criteria, sarcopenia status was classified into three types: no-sarcopenia, possible sarcopenia, and sarcopenia. Depressive symptoms were assessed using the validated 10-items of the Center for Epidemiologic Studies Depression Scale. A cross-sectional analysis was used to examine the relationship between sarcopenia status and depressive symptoms. A total of 4,652 participants without depressive symptoms were recruited from the same cohort in 2015 and were followed up in 2018. Cox proportional hazards regression models were conducted to examine the effect of sarcopenia status on subsequent depressive symptoms with the report of hazard ratio (HR). Results: The prevalence of depressive symptoms in total populations, no-sarcopenia, possible sarcopenia, and sarcopenia individuals were 27.1% (2085/7706), 21.5% (927/4310), 33.6% (882/2627), and 35.9% (276/769), respectively. Both possible sarcopenia (OR: 1.75, 95% CI: 1.46–2.10) and sarcopenia (OR: 1.64, 95% CI: 1.23–2.19) were positively associated with higher odds of depressive symptoms (all p < 0.01). During the 3.7 years of follow-up, 956 cases (20.6%) with incident depressive symptoms were identified. In the longitudinal analysis, individuals with the diagnosed possible sarcopenia (HR: 1.27, 95% CI: 1.01–1.58) and sarcopenia participants (HR: 1.49, 95% CI: 1.06–2.09) were more likely to have new onset depressive symptoms than no-sarcopenia peers. Conclusions: Both possible sarcopenia and sarcopenia, assessed using the AWGS 2019 criteria, were independent predictors for the occurrence of depressive symptoms among Chinese older adults. Our findings provided new evidence supporting the longitudinal connection between sarcopenia and mental health problems, it also provides further justification for timely identification and management of both possible sarcopenia and sarcopenia as part of comprehensive strategies to fight against depressive symptoms.
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Affiliation(s)
- Ke Gao
- Department of Cardiology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Wen-Zhuo Ma
- Department of Biomedical and Pharmaceutical Sciences, College of Pharmacy, University of Rhode Island, South Kingstown, RI, United States.,Department of Pharmacology, School of Basic Medicine Sciences, Xi'an Jiaotong University Health Science Center, Xi'an, China
| | - Scarlett Huck
- Department of Biomedical and Pharmaceutical Sciences, College of Pharmacy, University of Rhode Island, South Kingstown, RI, United States
| | - Bo-Lin Li
- Department of Cardiology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Li Zhang
- Department of Gastroenterology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Jiao Zhu
- Department of Gastroenterology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Tian Li
- School of Basic Medicine, Fourth Military Medical University, Xi'an, China
| | - Dan Zhou
- Department of Gastroenterology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
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50
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Saenz JL, Adar SD, Zhang YS, Wilkens J, Chattopadhyay A, Lee J, Wong R. Household use of polluting cooking fuels and late-life cognitive function: A harmonized analysis of India, Mexico, and China. ENVIRONMENT INTERNATIONAL 2021; 156:106722. [PMID: 34182193 PMCID: PMC8380666 DOI: 10.1016/j.envint.2021.106722] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 06/02/2021] [Accepted: 06/14/2021] [Indexed: 06/13/2023]
Abstract
INTRODUCTION Exposure to high levels of air pollution is associated with poor health, including worse cognitive function. Whereas many studies of cognition have assessed outdoor air pollution, we evaluate how exposure to air pollution from combustion of polluting household fuels relates with cognitive function using harmonized data from India, Mexico, and China. MATERIALS & METHODS We analyze adults age 50+ in three nationally representative studies of aging with common data collection methods: the 2017-2019 Longitudinal Aging Study in India (n = 50,532), 2015 Mexican Health and Aging Study (n = 12,883), and 2013 China Health and Retirement Longitudinal Study (n = 12,913). Use of polluting fuels was assessed by self-report of wood, coal, kerosene, crop residue, or dung for cooking. Cognitive function was measured by performance across several cognitive domains and summarized into a total cognition score. We used linear regression, by country, to test how polluting cooking fuel use relates with cognition adjusting for key demographic and socioeconomic factors. RESULTS Approximately 47%, 12%, and 48% of respondents in India, Mexico, and China, respectively, relied primarily on polluting cooking fuel, which was more common in rural areas. Using polluting cooking fuels was consistently associated with poorer cognitive function in all countries, independent of demographic and socioeconomic characteristics. Adjusted differences in cognitive function between individuals using polluting and clean cooking fuel were equivalent to differences observed between individuals who were 3 years of age apart in Mexico and China and 6 years of age apart in India. Across countries, associations between polluting cooking fuel use and poorer cognition were larger for women. CONCLUSIONS Results suggest that household air pollution from the use of polluting cooking fuel may play an important role in shaping cognitive outcomes of older adults in countries where reliance on polluting fuels for domestic energy needs still prevails. As these countries continue to age, public health efforts should seek to reduce reliance on these fuels.
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Affiliation(s)
- Joseph L Saenz
- Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA, United States.
| | - Sara D Adar
- Department of Epidemiology, University of Michigan, Ann Arbor, MI, United States
| | - Yuan S Zhang
- Carolina Population Center, University of North Carolina, Chapel Hill, NC, United States
| | - Jenny Wilkens
- Center for Economic and Social Research, University of Southern California, Los Angeles, CA, United States
| | - Aparajita Chattopadhyay
- Department of Development Studies, International Institute for Population Sciences, Mumbai, India.
| | - Jinkook Lee
- Center for Economic and Social Research, University of Southern California, Los Angeles, CA, United States; Department of Economics, University of Southern California, Los Angeles, CA, United States
| | - Rebeca Wong
- Sealy Center on Aging, University of Texas Medical Branch, Galveston, TX, United States
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