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Hussain R, Graham U, Elder A, Nedergaard M. Air pollution, glymphatic impairment, and Alzheimer's disease. Trends Neurosci 2023; 46:901-911. [PMID: 37777345 DOI: 10.1016/j.tins.2023.08.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Revised: 07/12/2023] [Accepted: 08/29/2023] [Indexed: 10/02/2023]
Abstract
Epidemiological evidence demonstrates a link between air pollution exposure and the onset and progression of cognitive impairment and Alzheimer's disease (AD). However, current understanding of the underlying pathophysiological mechanisms is limited. This opinion article examines the hypothesis that air pollution-induced impairment of glymphatic clearance represents a crucial etiological event in the development of AD. Exposure to airborne particulate matter (PM) leads to systemic inflammation and neuroinflammation, increased metal load, respiratory and cardiovascular dysfunction, and sleep abnormalities. All these factors are known to reduce the efficiency of glymphatic clearance. Rescuing glymphatic function by restricting the impact of causative agents, and improving sleep and cardiovascular system health, may increase the efficiency of waste metabolite clearance and subsequently slow the progression of AD. In sum, we introduce air pollution-mediated glymphatic impairment as an important mechanistic factor to be considered when interpreting the etiology and progression of AD as well as its responsiveness to therapeutic interventions.
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Affiliation(s)
- Rashad Hussain
- Center for Translational Neuromedicine, University of Rochester, Rochester, NY 14642, USA.
| | | | - Alison Elder
- Department of Environmental Medicine, University of Rochester, Rochester, NY 14642, USA
| | - Maiken Nedergaard
- Center for Translational Neuromedicine, University of Rochester, Rochester, NY 14642, USA; Center for Translational Neuroscience, University of Copenhagen, 2200 Copenhagen, Denmark.
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Shim JI, Byun G, Lee JTT. Long-term exposure to particulate matter and risk of Alzheimer's disease and vascular dementia in Korea: a national population-based Cohort Study. Environ Health 2023; 22:35. [PMID: 37060077 PMCID: PMC10105439 DOI: 10.1186/s12940-023-00986-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Accepted: 03/29/2023] [Indexed: 05/04/2023]
Abstract
BACKGROUND The prevalence of age-related neurodegenerative diseases has risen in conjunction with an increase in life expectancy. Although there is emerging evidence that air pollution might accelerate or worsen dementia progression, studies on Asian regions remains limited. This study aimed to investigate the relationship between long-term exposure to PM10 and the risk of developing Alzheimer's disease and vascular dementia in the elderly population in South Korea. METHODS The baseline population was 1.4 million people aged 65 years and above who participated in at least one national health checkup program from the National Health Insurance Service between 2008 and 2009. A nationwide retrospective cohort study was designed, and patients were followed from the date of cohort entry (January 1, 2008) to the date of dementia occurrence, death, moving residence, or the end of the study period (December 31, 2019), whichever came first. Long-term average PM10 exposure variable was constructed from national monitoring data considering time-dependent exposure. Extended Cox proportional hazard models with time-varying exposure were used to estimate hazard ratios (HR) for Alzheimer's disease and vascular dementia. RESULTS A total of 1,436,361 participants were selected, of whom 167,988 were newly diagnosed with dementia (134,811 with Alzheimer's disease and 12,215 with vascular dementia). The results show that for every 10 µg/m3 increase in PM10, the HR was 0.99 (95% CI 0.98-1.00) for Alzheimer's disease and 1.05 (95% CI 1.02-1.08) for vascular dementia. Stratified analysis according to sex and age group showed that the risk of vascular dementia was higher in men and in those under 75 years of age. CONCLUSION The results found that long-term PM10 exposure was significantly associated with the risk of developing vascular dementia but not with Alzheimer's disease. These findings suggest that the mechanism behind the PM10-dementia relationship could be linked to vascular damage.
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Affiliation(s)
- Jung-Im Shim
- College of Health Science, Korea University, Seoul, 02841, Republic of Korea.
- Division of Healthcare Technology Assessment Research, National Evidence-based Healthcare Collaborating Agency, Seoul, 04933, Republic of Korea.
| | - Garam Byun
- Interdisciplinary Program in Precision Public Health, Korea University, Seoul, 02841, Korea
| | - Jong-Tae T Lee
- College of Health Science, Korea University, Seoul, 02841, Republic of Korea.
- Interdisciplinary Program in Precision Public Health, Korea University, Seoul, 02841, Korea.
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Wilker EH, Osman M, Weisskopf MG. Ambient air pollution and clinical dementia: systematic review and meta-analysis. BMJ 2023; 381:e071620. [PMID: 37019461 PMCID: PMC10498344 DOI: 10.1136/bmj-2022-071620] [Citation(s) in RCA: 18] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/28/2023] [Indexed: 04/07/2023]
Abstract
OBJECTIVE To investigate the role of air pollutants in risk of dementia, considering differences by study factors that could influence findings. DESIGN Systematic review and meta-analysis. DATA SOURCES EMBASE, PubMed, Web of Science, Psycinfo, and OVID Medline from database inception through July 2022. ELIGIBILITY CRITERIA FOR SELECTING STUDIES Studies that included adults (≥18 years), a longitudinal follow-up, considered US Environmental Protection Agency criteria air pollutants and proxies of traffic pollution, averaged exposure over a year or more, and reported associations between ambient pollutants and clinical dementia. Two authors independently extracted data using a predefined data extraction form and assessed risk of bias using the Risk of Bias In Non-randomised Studies of Exposures (ROBINS-E) tool. A meta-analysis with Knapp-Hartung standard errors was done when at least three studies for a given pollutant used comparable approaches. RESULTS 2080 records identified 51 studies for inclusion. Most studies were at high risk of bias, although in many cases bias was towards the null. 14 studies could be meta-analysed for particulate matter <2.5 µm in diameter (PM2.5). The overall hazard ratio per 2 μg/m3 PM2.5 was 1.04 (95% confidence interval 0.99 to 1.09). The hazard ratio among seven studies that used active case ascertainment was 1.42 (1.00 to 2.02) and among seven studies that used passive case ascertainment was 1.03 (0.98 to 1.07). The overall hazard ratio per 10 μg/m3 nitrogen dioxide was 1.02 ((0.98 to 1.06); nine studies) and per 10 μg/m3 nitrogen oxide was 1.05 ((0.98 to 1.13); five studies). Ozone had no clear association with dementia (hazard ratio per 5 μg/m3 was 1.00 (0.98 to 1.05); four studies). CONCLUSION PM2.5 might be a risk factor for dementia, as well as nitrogen dioxide and nitrogen oxide, although with more limited data. The meta-analysed hazard ratios are subject to limitations that require interpretation with caution. Outcome ascertainment approaches differ across studies and each exposure assessment approach likely is only a proxy for causally relevant exposure in relation to clinical dementia outcomes. Studies that evaluate critical periods of exposure and pollutants other than PM2.5, and studies that actively assess all participants for outcomes are needed. Nonetheless, our results can provide current best estimates for use in burden of disease and regulatory setting efforts. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42021277083.
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Affiliation(s)
- Elissa H Wilker
- Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, MA, USA
- Department of Environmental Heath, Harvard TH Chan School of Public Health, Boston, MA, USA
| | - Marwa Osman
- Department of Environmental Heath, Harvard TH Chan School of Public Health, Boston, MA, USA
| | - Marc G Weisskopf
- Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, MA, USA
- Department of Environmental Heath, Harvard TH Chan School of Public Health, Boston, MA, USA
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Semmens EO, Leary CS, Fitzpatrick AL, Ilango SD, Park C, Adam CE, DeKosky ST, Lopez O, Hajat A, Kaufman JD. Air pollution and dementia in older adults in the Ginkgo Evaluation of Memory Study. Alzheimers Dement 2023; 19:549-559. [PMID: 35436383 PMCID: PMC9576823 DOI: 10.1002/alz.12654] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Revised: 02/13/2022] [Accepted: 02/17/2022] [Indexed: 12/13/2022]
Abstract
INTRODUCTION Growing evidence implicates air pollution as a risk factor for dementia, but prior work is limited by challenges in diagnostic accuracy and assessing exposures in the decades prior to disease development. We evaluated the impact of long-term fine particulate matter (PM2.5 ) exposures on incident dementia (all-cause, Alzheimer's disease [AD], and vascular dementia [VaD]) in older adults. METHODS A panel of neurologists adjudicated dementia cases based on extensive neuropsychological testing and magnetic resonance imaging. We applied validated fine-scale air pollutant models to reconstructed residential histories to assess exposures. RESULTS An interquartile range increase in 20-year PM2.5 was associated with a 20% higher risk of dementia (95% confidence interval [CI]: 5%, 37%) and an increased risk of mixed VaD/AD but not AD alone. DISCUSSION Our findings suggest that air pollutant exposures over decades contribute to dementia and that effects of current exposures may be experienced years into the future.
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Affiliation(s)
- Erin O. Semmens
- Center for Population Health Research, School of Public and Community Health Sciences, University of Montana, Missoula, Montana, USA
| | - Cindy S. Leary
- Center for Population Health Research, School of Public and Community Health Sciences, University of Montana, Missoula, Montana, USA
| | - Annette L. Fitzpatrick
- Departments of Family Medicine and Global Health, University of Washington, Seattle, Washington, USA
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, Washington, USA
| | - Sindana D. Ilango
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, Washington, USA
| | - Christina Park
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, Washington, USA
| | - Claire E. Adam
- Center for Population Health Research, School of Public and Community Health Sciences, University of Montana, Missoula, Montana, USA
| | - Steven T. DeKosky
- Department of Neurology and McKnight Brain Institute, University of Florida, Gainesville, Florida, USA
| | - Oscar Lopez
- Department of Neurology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - Anjum Hajat
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, Washington, USA
| | - Joel D. Kaufman
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, Washington, USA
- Departments of Environmental and Occupational Health Sciences and Medicine, School of Public Health, University of Washington, Seattle, Washington, USA
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Abolhasani E, Hachinski V, Ghazaleh N, Azarpazhooh MR, Mokhber N, Martin J. Air Pollution and Incidence of Dementia: A Systematic Review and Meta-analysis. Neurology 2023; 100:e242-e254. [PMID: 36288998 DOI: 10.1212/wnl.0000000000201419] [Citation(s) in RCA: 17] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Accepted: 08/31/2022] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Studies of association between air pollution and incidence of dementia have shown discrepant results. The aim of this study was to evaluate the association between air pollution and dementia. METHODS In this systematic review and meta-analysis, PubMed, MEDLINE, EMBASE, PsycINFO, Scopus, and Web of Science were searched and updated in August 2021. Population-based cohort studies that reported on hazard ratio (HR) of dementia in association with exposure to fine particulate matter (PM2·5), nitrogen oxides (NOX), nitrogen dioxide (NO2), or ozone (O3) in those aged >40 years were included. Data were extracted by 2 independent investigators. The main outcome was the pooled HR for dementia per increment of pollutant, calculated using a random-effects model. Results were reported in accordance with PRISMA guidelines. The protocol was registered in PROSPERO (registration number: CRD42020219036). RESULTS A total of 20 studies were included in the systematic review, and 17 provided data for the meta-analysis. The total included population was 91,391,296, with 5,521,111 (6%) being diagnosed with dementia. A total of 12, 5, 6, and 4 studies were included in the meta-analyses of PM2·5, NOX, NO2, and O3, respectively. The risk of dementia increased by 3% per 1 μg/m3 increment in PM2·5 (HR, 1.03; 95% CI [1.02-1.05]; I2 = 100%). The association between dementia per 10 μg/m3 increment in NOX (HR, 1.05; 95% CI [0.99-1.13]; I2 = 61%), NO2 (HR, 1.03; 95% CI [1.00-1.07]; I2 = 94%), and O3 levels (HR, 1.01; 95% CI [0.91-1.11]; I2 = 82%) was less clear, although a significant association could not be ruled out, and there was high heterogeneity across studies. DISCUSSION Existing evidence suggests a significant association between exposure to PM2·5 and incidence of dementia and nonsignificant association between dementia and NOX, NO2, and O3 exposure. However, results should be interpreted in light of the small number of studies and high heterogeneity of effects across studies.
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Affiliation(s)
- Ehsan Abolhasani
- From the Department of Epidemiology and Biostatistics (E.A., V.H., M.R.A., J.M), Clinical Neurological Sciences (V.H., M.R.A.), and Neuroscience Program (N.G.), Schulich School of Medicine and Dentistry, Western University, London, ON; Department of Psychiatry (N.M.), Schulich School of Medicine and Dentistry, University of Western Ontario, London; and Department of Anesthesia and Perioperative Medicine (J.M.), MEDICI Centre, Western University, London, ON, Canada
| | - Vladimir Hachinski
- From the Department of Epidemiology and Biostatistics (E.A., V.H., M.R.A., J.M), Clinical Neurological Sciences (V.H., M.R.A.), and Neuroscience Program (N.G.), Schulich School of Medicine and Dentistry, Western University, London, ON; Department of Psychiatry (N.M.), Schulich School of Medicine and Dentistry, University of Western Ontario, London; and Department of Anesthesia and Perioperative Medicine (J.M.), MEDICI Centre, Western University, London, ON, Canada
| | - Nargess Ghazaleh
- From the Department of Epidemiology and Biostatistics (E.A., V.H., M.R.A., J.M), Clinical Neurological Sciences (V.H., M.R.A.), and Neuroscience Program (N.G.), Schulich School of Medicine and Dentistry, Western University, London, ON; Department of Psychiatry (N.M.), Schulich School of Medicine and Dentistry, University of Western Ontario, London; and Department of Anesthesia and Perioperative Medicine (J.M.), MEDICI Centre, Western University, London, ON, Canada
| | - Mahmoud Reza Azarpazhooh
- From the Department of Epidemiology and Biostatistics (E.A., V.H., M.R.A., J.M), Clinical Neurological Sciences (V.H., M.R.A.), and Neuroscience Program (N.G.), Schulich School of Medicine and Dentistry, Western University, London, ON; Department of Psychiatry (N.M.), Schulich School of Medicine and Dentistry, University of Western Ontario, London; and Department of Anesthesia and Perioperative Medicine (J.M.), MEDICI Centre, Western University, London, ON, Canada
| | - Naghmeh Mokhber
- From the Department of Epidemiology and Biostatistics (E.A., V.H., M.R.A., J.M), Clinical Neurological Sciences (V.H., M.R.A.), and Neuroscience Program (N.G.), Schulich School of Medicine and Dentistry, Western University, London, ON; Department of Psychiatry (N.M.), Schulich School of Medicine and Dentistry, University of Western Ontario, London; and Department of Anesthesia and Perioperative Medicine (J.M.), MEDICI Centre, Western University, London, ON, Canada
| | - Janet Martin
- From the Department of Epidemiology and Biostatistics (E.A., V.H., M.R.A., J.M), Clinical Neurological Sciences (V.H., M.R.A.), and Neuroscience Program (N.G.), Schulich School of Medicine and Dentistry, Western University, London, ON; Department of Psychiatry (N.M.), Schulich School of Medicine and Dentistry, University of Western Ontario, London; and Department of Anesthesia and Perioperative Medicine (J.M.), MEDICI Centre, Western University, London, ON, Canada.
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Wood D, Evangelopoulos D, Beevers S, Kitwiroon N, Katsouyanni K. Exposure to Ambient Air Pollution and the Incidence of Dementia in the Elderly of England: The ELSA Cohort. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15889. [PMID: 36497970 PMCID: PMC9736331 DOI: 10.3390/ijerph192315889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 11/24/2022] [Accepted: 11/26/2022] [Indexed: 06/17/2023]
Abstract
Increasing evidence suggests an adverse association between ambient air pollution and the incidence of dementia in adult populations, although results at present are mixed and further work is required. The present study investigated the relationships between NO2, PM10, PM2.5 and ozone on dementia incidence in a cohort of English residents, aged 50 years and older, followed up between 2004 and 2017 (English Longitudinal Study of Ageing; n = 8525). Cox proportional hazards models were applied to investigate the association between time to incident dementia and exposure to pollutants at baseline. Hazard ratios (HRs) were calculated per 10 μg/m3. Models were adjusted for age, gender, physical activity, smoking status and level of education (the latter as a sensitivity analysis). A total of 389 dementia cases were identified during follow-up. An increased risk of developing dementia was suggested with increasing exposure to PM2.5 (HR: 1.10; 95% confidence interval (CI): 0.88, 1.37), whilst NO2, PM10 and ozone exhibited no discernible relationships. Hazard ratios were 0.97 (CI: 0.89, 1.05) for NO2; 0.98 (CI: 0.89, 1.08) for PM10; 1.01 (CI: 0.94, 1.09) for ozone. In the London sub-sample (39 dementia cases), a 10 μg/m3 increase in PM10 was found to be associated with increased risk of dementia by 16%, although not statistically significant (HR: 1.16; CI: 0.90, 1.48), and the magnitude of effect for PM2.5 increased, whilst NO2 and ozone exhibited similar associations as observed in the England-wide study. Further work is required to fully elucidate the potentially adverse associations between air pollution exposure and dementia incidence.
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Affiliation(s)
- Dylan Wood
- Environmental Research Group, School of Public Health, Imperial College, London W12 0BZ, UK
- MRC Centre for Environment and Health, Imperial College, London W12 0BZ, UK
- NIHR HPRU in Environmental Exposures and Health, Imperial College, London W12 0BZ, UK
| | - Dimitris Evangelopoulos
- Environmental Research Group, School of Public Health, Imperial College, London W12 0BZ, UK
- MRC Centre for Environment and Health, Imperial College, London W12 0BZ, UK
- NIHR HPRU in Environmental Exposures and Health, Imperial College, London W12 0BZ, UK
| | - Sean Beevers
- Environmental Research Group, School of Public Health, Imperial College, London W12 0BZ, UK
- MRC Centre for Environment and Health, Imperial College, London W12 0BZ, UK
- NIHR HPRU in Environmental Exposures and Health, Imperial College, London W12 0BZ, UK
| | - Nutthida Kitwiroon
- Environmental Research Group, School of Public Health, Imperial College, London W12 0BZ, UK
- MRC Centre for Environment and Health, Imperial College, London W12 0BZ, UK
- NIHR HPRU in Environmental Exposures and Health, Imperial College, London W12 0BZ, UK
| | - Klea Katsouyanni
- Environmental Research Group, School of Public Health, Imperial College, London W12 0BZ, UK
- MRC Centre for Environment and Health, Imperial College, London W12 0BZ, UK
- NIHR HPRU in Environmental Exposures and Health, Imperial College, London W12 0BZ, UK
- Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
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Long-term particulate matter 2.5 exposure and dementia: a systematic review and meta-analysis. Public Health 2022; 212:33-41. [DOI: 10.1016/j.puhe.2022.08.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 07/26/2022] [Accepted: 08/16/2022] [Indexed: 11/11/2022]
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Comparison of the Concentrations of Heavy Metals in PM2.5 Analyzed in Three Different Global Research Institutions Using X-ray Fluorescence. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12094572] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This inter-lab study aimed to evaluate the comparability of heavy metal concentrations in the same samples using three X-ray fluorescence spectrometers (XRFs) in three different global re-search institutions, namely a collaboration lab between Soonchunhyang University (Asan, Korea). and PAN (a branch of Malvern PANalytical, Seoul, Korea), RTI (Research Triangle Institute, NC, U.S.A), and Aerosol laboratory in Harvard University, Boston, U.S.A. Indoor air filter samples were collected from 8 homes using 3 filters in each household (n = 24) of individuals with asthma, and the same filter samples were sequentially analyzed separately in the collaboration lab Soonchunhyang-PAN, Harvard University, and RTI. Results showed the detection rates of most heavy metals (n = 25 metals) across the three institutions to be approximately 90%. Of the 25 metals, 16 showed coefficient of determination (R²) 0.7 or higher (10 components had 0.9 or higher) implying high correlation among institutions. Therefore, this study demonstrated XRF as a useful device, ensuring reproducibility and compatibility in the measurement of heavy metals in PM2.5, collected from indoor air filters of asthmatics’ residents.
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PM2.5 composition and disease aggravation in amyotrophic lateral sclerosis. Environ Epidemiol 2022; 6:e204. [PMID: 35434459 PMCID: PMC9005248 DOI: 10.1097/ee9.0000000000000204] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Accepted: 03/01/2022] [Indexed: 01/18/2023] Open
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Guzmán P, Tarín-Carrasco P, Morales-Suárez-Varela M, Jiménez-Guerrero P. Effects of air pollution on dementia over Europe for present and future climate change scenarios. ENVIRONMENTAL RESEARCH 2022; 204:112012. [PMID: 34529970 DOI: 10.1016/j.envres.2021.112012] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 08/03/2021] [Accepted: 09/02/2021] [Indexed: 05/28/2023]
Abstract
The scientific literature is scarce when referring to the influence of atmospheric pollutants on neurodegenerative diseases for present and future climate change scenarios. In this sense, this contribution evaluates the incidence of dementia (Alzheimer's disease, AD, and dementia from unspecified cause, DU) occurring in Europe associated with the exposure to air pollution (essentially NO2 and PM2.5) for the present climatic period (1991-2010) and for a future climate change scenario (RCP8.5, 2031-2050). The GEMM methodology has been applied to air pollution simulations using the chemistry/climate regional model WRF-Chem. Present population data were obtained from NASA's Center for Socioeconomic Data and Applications (SEDAC); while future population projections for the year 2050 were derived from the United Nations (UN) Department of Economic and Social Affairs-Population Dynamics. Overall, the estimated incidence rate (cases per year) of AD and DU associated with exposure to air pollution over Europe is 498,000 [95% confidence interval (95% CI) 348,600-647,400] and 314,000 (95% CI 257,500-401,900), respectively. An important increase in the future incidence rate is projected (around 72% for both types of dementia) when considering the effect of climate change together with the foreseen changes in the future population, because of the expected aging of European population. The climate penalty (impacts of future climate change alone on air quality) has a limited effect on the total changes of dementia (approx. 0.5%), because the large increase in the incidence rate over southern Europe is offset by its decrease over more northern countries, favored by an improvement of air pollution caused by the projected enhancement of rainfall.
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Affiliation(s)
- Patricia Guzmán
- Department of Physics, Regional Campus of International Excellence Campus Mare Nostrum, University of Murcia, Spain
| | - Patricia Tarín-Carrasco
- Department of Physics, Regional Campus of International Excellence Campus Mare Nostrum, University of Murcia, Spain
| | - María Morales-Suárez-Varela
- Unit of Public Health and Environmental Care, Department of Preventive Medicine, University of Valencia, Valencia, Spain; CIBER Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Pedro Jiménez-Guerrero
- Department of Physics, Regional Campus of International Excellence Campus Mare Nostrum, University of Murcia, Spain; Biomedical Research Institute of Murcia (IMIB-Arrixaca), Murcia, Spain.
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Chandra M, Rai CB, Kumari N, Sandhu VK, Chandra K, Krishna M, Kota SH, Anand KS, Oudin A. Air Pollution and Cognitive Impairment across the Life Course in Humans: A Systematic Review with Specific Focus on Income Level of Study Area. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031405. [PMID: 35162428 PMCID: PMC8835599 DOI: 10.3390/ijerph19031405] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Revised: 12/23/2021] [Accepted: 12/25/2021] [Indexed: 02/01/2023]
Abstract
Cognitive function is a crucial determinant of human capital. The Lancet Commission (2020) has recognized air pollution as a risk factor for dementia. However, the scientific evidence on the impact of air pollution on cognitive outcomes across the life course and across different income settings, with varying levels of air pollution, needs further exploration. A systematic review was conducted, using Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) Guidelines to assess the association between air pollution and cognitive outcomes across the life course with a plan to analyze findings as per the income status of the study population. The PubMed search included keywords related to cognition and to pollution (in their titles) to identify studies on human participants published in English until 10 July 2020. The search yielded 84 relevant studies that described associations between exposure to air pollutants and an increased risk of lower cognitive function among children and adolescents, cognitive impairment and decline among adults, and dementia among older adults with supportive evidence of neuroimaging and inflammatory biomarkers. No study from low- and middle-income countries (LMICs)was identified despite high levels of air pollutants and high rates of dementia. To conclude, air pollution may impair cognitive function across the life-course, but a paucity of studies from reLMICs is a major lacuna in research.
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Affiliation(s)
- Mina Chandra
- Department of Psychiatry, Centre of Excellence in Mental Health, Atal Bihari Vajpayee Institute of Medical Sciences (formerly PGIMER) and Dr. Ram Manohar Lohia Hospital, New Delhi 110001, India; (C.B.R.); (N.K.); (V.K.S.)
- Correspondence: ; Tel.: +91-98-1183-1902
| | - Chandra Bhushan Rai
- Department of Psychiatry, Centre of Excellence in Mental Health, Atal Bihari Vajpayee Institute of Medical Sciences (formerly PGIMER) and Dr. Ram Manohar Lohia Hospital, New Delhi 110001, India; (C.B.R.); (N.K.); (V.K.S.)
| | - Neelam Kumari
- Department of Psychiatry, Centre of Excellence in Mental Health, Atal Bihari Vajpayee Institute of Medical Sciences (formerly PGIMER) and Dr. Ram Manohar Lohia Hospital, New Delhi 110001, India; (C.B.R.); (N.K.); (V.K.S.)
| | - Vipindeep Kaur Sandhu
- Department of Psychiatry, Centre of Excellence in Mental Health, Atal Bihari Vajpayee Institute of Medical Sciences (formerly PGIMER) and Dr. Ram Manohar Lohia Hospital, New Delhi 110001, India; (C.B.R.); (N.K.); (V.K.S.)
| | - Kalpana Chandra
- Delhi Jal Board, Government of National Capital Territory of Delhi, New Delhi 110094, India;
| | - Murali Krishna
- JSS Academy of Higher Education & Research, Mysore 570015, Karnataka, India;
| | - Sri Harsha Kota
- Department of Civil Engineering, Indian Institute of Technology Delhi, New Delhi 110016, India;
| | - Kuljeet Singh Anand
- Department of Neurology, Atal Bihari Vajpayee Institute of Medical Sciences (Formerly PGIMER) and Dr. Ram Manohar Lohia Hospital, New Delhi 110001, India;
| | - Anna Oudin
- Department of Public Health and Clinical Medicine, Umeå University, 901 87 Umea, Sweden;
- Department of Laboratory Medicine, Lund University, 901 87 Umea, Sweden
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Wang X, Younan D, Millstein J, Petkus AJ, Garcia E, Beavers DP, Espeland MA, Chui HC, Resnick SM, Gatz M, Kaufman JD, Wellenius GA, Whitsel EA, Manson JE, Rapp SR, Chen JC. Association of improved air quality with lower dementia risk in older women. Proc Natl Acad Sci U S A 2022; 119:e2107833119. [PMID: 34983871 PMCID: PMC8764698 DOI: 10.1073/pnas.2107833119] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/04/2021] [Indexed: 12/24/2022] Open
Abstract
Late-life ambient air pollution is a risk factor for brain aging, but it remains unknown if improved air quality (AQ) lowers dementia risk. We studied a geographically diverse cohort of older women dementia free at baseline in 2008 to 2012 (n = 2,239, aged 74 to 92). Incident dementia was centrally adjudicated annually. Yearly mean concentrations of fine particulate matter (PM2.5) and nitrogen dioxide (NO2) were estimated using regionalized national universal kriging models and averaged over the 3-y period before baseline (recent exposure) and 10 y earlier (remote exposure). Reduction from remote to recent exposures was used as the indicator of improved AQ. Cox proportional hazard ratios (HRs) for dementia risk associated with AQ measures were estimated, adjusting for sociodemographic, lifestyle, and clinical characteristics. We identified 398 dementia cases during follow up (median = 6.1 y). PM2.5 and NO2 reduced significantly over the 10 y before baseline. Larger AQ improvement was associated with reduced dementia risks (HRPM2.5 0.80 per 1.78 μg/m3, 95% CI 0.71-0.91; HRNO2 0.80 per 3.91 parts per billion, 95% CI 0.71-0.90), equivalent to the lower risk observed in women 2.4 y younger at baseline. Higher PM2.5 at baseline was associated with higher dementia risk (HRPM2.5 1.16 per 2.90 μg/m3, 95% CI 0.98-1.38), but the lower dementia risk associated with improved AQ remained after further adjusting for recent exposure. The observed associations did not substantially differ by age, education, geographic region, Apolipoprotein E e4 genotypes, or cardiovascular risk factors. Long-term AQ improvement in late life was associated with lower dementia risk in older women.
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Affiliation(s)
- Xinhui Wang
- Department of Neurology, University of Southern California, Los Angeles, CA 90033
| | - Diana Younan
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA 90032;
| | - Joshua Millstein
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA 90032
| | - Andrew J Petkus
- Department of Neurology, University of Southern California, Los Angeles, CA 90033
| | - Erika Garcia
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA 90032
| | - Daniel P Beavers
- Department of Biostatistics and Data Sciences, Wake Forest School of Medicine, Winston-Salem, NC 27157
| | - Mark A Espeland
- Department of Biostatistics and Data Sciences, Wake Forest School of Medicine, Winston-Salem, NC 27157
| | - Helena C Chui
- Department of Neurology, University of Southern California, Los Angeles, CA 90033
| | - Susan M Resnick
- Laboratory of Behavioral Neuroscience, National Institute on Aging, Baltimore, MD 21224
| | - Margaret Gatz
- Center for Economic and Social Research, University of Southern California, Los Angeles, CA 90089
| | - Joel D Kaufman
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA 98195
- Department of Medicine, University of Washington, Seattle, WA 98195
- Department of Epidemiology, University of Washington, Seattle, WA 98195
| | | | - Eric A Whitsel
- Department of Epidemiology, UNC Gillings School of Global Public Health, Chapel Hill, NC 27599
- Department of Medicine, UNC School of Medicine, Chapel Hill, NC 27516
| | - JoAnn E Manson
- Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115
| | - Stephen R Rapp
- Department of Psychiatry and Behavioral Medicine, Wake Forest School of Medicine, Winston-Salem, NC 27157
- Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem, NC 27157
| | - Jiu-Chiuan Chen
- Department of Neurology, University of Southern California, Los Angeles, CA 90033;
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA 90032
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Li J, Wang Y, Steenland K, Liu P, van Donkelaar A, Martin RV, Chang HH, Caudle WM, Schwartz J, Koutrakis P, Shi L. Long-term effects of PM2.5 components on incident dementia in the Northeastern United States. Innovation (N Y) 2022; 3:100208. [PMID: 35199078 PMCID: PMC8844282 DOI: 10.1016/j.xinn.2022.100208] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Accepted: 01/13/2022] [Indexed: 11/26/2022] Open
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14
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A national cohort study (2000-2018) of long-term air pollution exposure and incident dementia in older adults in the United States. Nat Commun 2021; 12:6754. [PMID: 34799599 PMCID: PMC8604909 DOI: 10.1038/s41467-021-27049-2] [Citation(s) in RCA: 79] [Impact Index Per Article: 26.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Accepted: 11/01/2021] [Indexed: 12/17/2022] Open
Abstract
Air pollution may increase risk of Alzheimer’s disease and related dementias (ADRD) in the U.S., but the extent of this relationship is unclear. Here, we constructed two national U.S. population-based cohorts of those aged ≥65 from the Medicare Chronic Conditions Warehouse (2000–2018), combined with high-resolution air pollution datasets, to investigate the association of long-term exposure to ambient fine particulate matter (PM2.5), nitrogen dioxide (NO2), and ozone (O3) with dementia and AD incidence, respectively. We identified ~2.0 million incident dementia cases (N = 12,233,371; dementia cohort) and ~0.8 million incident AD cases (N = 12,456,447; AD cohort). Per interquartile range (IQR) increase in the 5-year average PM2.5 (3.2 µg/m3), NO2 (11.6 ppb), and warm-season O3 (5.3 ppb) over the past 5 years prior to diagnosis, the hazard ratios (HRs) were 1.060 (95% confidence interval [CI]: 1.054, 1.066), 1.019 (95% CI: 1.012, 1.026), and 0.990 (95% CI: 0.987, 0.993) for incident dementias, and 1.078 (95% CI: 1.070, 1.086), 1.031 (95% CI: 1.023, 1.039), and 0.982 (95%CI: 0.977, 0.986) for incident AD, respectively, for the three pollutants. For both outcomes, concentration-response relationships for PM2.5 and NO2 were approximately linear. Our study suggests that exposures to PM2.5 and NO2 are associated with incidence of dementia and AD. Air pollution has been linked to neurodegenerative disease. Here the authors carried out a population-based cohort study to investigate the association between long-term exposure to PM2.5, NO2, and warm-season O3 on dementia and Alzheimer’s disease incidence in the United States.
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15
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Weuve J, Bennett EE, Ranker L, Gianattasio KZ, Pedde M, Adar SD, Yanosky JD, Power MC. Exposure to Air Pollution in Relation to Risk of Dementia and Related Outcomes: An Updated Systematic Review of the Epidemiological Literature. ENVIRONMENTAL HEALTH PERSPECTIVES 2021; 129:96001. [PMID: 34558969 PMCID: PMC8462495 DOI: 10.1289/ehp8716] [Citation(s) in RCA: 81] [Impact Index Per Article: 27.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 08/04/2021] [Accepted: 08/05/2021] [Indexed: 05/02/2023]
Abstract
BACKGROUND Dementia is a devastating neurologic condition that is common in older adults. We previously reviewed the epidemiological evidence examining the hypothesis that long-term exposure to air pollution affects dementia risk. Since then, the evidence base has expanded rapidly. OBJECTIVES With this update, we collectively review new and previously identified epidemiological studies on air pollution and late-life cognitive health, highlighting new developments and critically discussing the merits of the evidence. METHODS Using a registered protocol (PROSPERO 2020 CRD42020152943), we updated our literature review to capture studies published through 31 December 2020, extracted data, and conducted a bias assessment. RESULTS We identified 66 papers (49 new) for inclusion in this review. Cognitive level remained the most commonly considered outcome, and particulate matter (PM) remained the most commonly considered air pollutant. Since our prior review, exposure estimation methods in this research have improved, and more papers have looked at cognitive change, neuroimaging, and incident cognitive impairment/dementia, though methodological concerns remain common. Many studies continue to rely on administrative records to ascertain dementia, have high potential for selection bias, and adjust for putative mediating factors in primary models. A subset of 35 studies met strict quality criteria. Although high-quality studies of fine particulate matter with aerodynamic diameter ≤ 2.5 μ m (PM 2.5 ) and cognitive decline generally supported an adverse association, other findings related to PM 2.5 and findings related to particulate matter with aerodynamic diameter ≤ 10 μ m (PM 10 , NO 2 , and NO x ) were inconclusive, and too few papers reported findings with ozone to comment on the likely direction of association. Notably, only a few findings on dementia were included for consideration on the basis of quality criteria. DISCUSSION Strong conclusions remain elusive, although the weight of the evidence suggests an adverse association between PM 2.5 and cognitive decline. However, we note a continued need to confront methodological challenges in this line of research. https://doi.org/10.1289/EHP8716.
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Affiliation(s)
- Jennifer Weuve
- Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Erin E. Bennett
- Department of Epidemiology, The George Washington University Milken Institute School of Public Health, Washington, DC, USA
| | - Lynsie Ranker
- Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Kan Z. Gianattasio
- Department of Epidemiology, The George Washington University Milken Institute School of Public Health, Washington, DC, USA
| | - Meredith Pedde
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
| | - Sara D. Adar
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
| | - Jeff D. Yanosky
- Department of Public Health Sciences, The Pennsylvania State University College of Medicine, Hershey, Pennsylvania, USA
| | - Melinda C. Power
- Department of Epidemiology, The George Washington University Milken Institute School of Public Health, Washington, DC, USA
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16
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Younan D, Wang X, Gruenewald T, Gatz M, Serre ML, Vizuete W, Braskie MN, Woods NF, Kahe K, Garcia L, Lurmann F, Manson JE, Chui HC, Wallace RB, Espeland MA, Chen JC. Racial/Ethnic Disparities in Alzheimer's Disease Risk: Role of Exposure to Ambient Fine Particles. J Gerontol A Biol Sci Med Sci 2021; 77:977-985. [PMID: 34383042 PMCID: PMC9071399 DOI: 10.1093/gerona/glab231] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Whether racial/ethnic disparities in Alzheimer's disease (AD) risk may be explained by ambient fine particles (PM2.5) has not been studied. METHOD We conducted a prospective, population-based study on a cohort of Black (n = 481) and White (n = 6 004) older women (aged 65-79) without dementia at enrollment (1995-1998). Cox models accounting for competing risk were used to estimate the hazard ratio (HR) for racial/ethnic disparities in AD (1996-2010) defined by Diagnostic and Statistical Manual of Mental Disorders, 4th edition and the association with time-varying annual average PM2.5 (1999-2010) estimated by spatiotemporal model. RESULTS Over an average follow-up of 8.3 (±3.5) years with 158 incident cases (21 in Black women), the racial disparities in AD risk (range of adjusted HRBlack women = 1.85-2.41) observed in various models could not be explained by geographic region, age, socioeconomic characteristics, lifestyle factors, cardiovascular risk factors, and hormone therapy assignment. Estimated PM2.5 exposure was higher in Black (14.38 ± 2.21 µg/m3) than in White (12.55 ± 2.76 µg/m3) women, and further adjustment for the association between PM2.5 and AD (adjusted HRPM2.5 = 1.18-1.28) slightly reduced the racial disparities by 2%-6% (HRBlack women = 1.81-2.26). The observed association between PM2.5 and AD risk was ~2 times greater in Black (HRPM2.5 = 2.10-2.60) than in White (HRPM2.5 = 1.07-1.15) women (range of interaction ps: <.01-.01). We found similar results after further adjusting for social engagement (social strain, social support, social activity, living alone), stressful life events, Women's Health Initiative's clinic sites, and neighborhood socioeconomic characteristics. CONCLUSIONS PM2.5 may contribute to racial/ethnic disparities in AD risk and its associated increase in AD risk was stronger among Black women.
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Affiliation(s)
- Diana Younan
- University of Southern California, Los Angeles, USA
| | - Xinhui Wang
- University of Southern California, Los Angeles, USA
| | | | | | | | | | | | - Nancy F Woods
- University of Washington School of Nursing, Seattle, USA
| | - Ka Kahe
- Columbia University Irving Medical Center, New York, New York, USA
| | | | - Fred Lurmann
- Sonoma Technology, Inc., Petaluma, California, USA
| | - JoAnn E Manson
- Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | | | | | - Mark A Espeland
- Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Jiu-Chiuan Chen
- Address correspondence to: Jiu-Chiuan Chen, MD, ScD, University of Southern California, 2001 N Soto Street, Los Angeles, CA 90032, USA. E-mail:
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17
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Liu M, Saari RK, Zhou G, Li J, Han L, Liu X. Recent trends in premature mortality and health disparities attributable to ambient PM 2.5 exposure in China: 2005-2017. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2021; 279:116882. [PMID: 33756244 DOI: 10.1016/j.envpol.2021.116882] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 03/06/2021] [Accepted: 03/08/2021] [Indexed: 06/12/2023]
Abstract
In the past decade, particulate matter with aerodynamic diameter less than 2.5 μm (PM2.5) has reached unprecedented levels in China and posed a significant threat to public health. Exploring the long-term trajectory of the PM2.5 attributable health burden and corresponding disparities across populations in China yields insights for policymakers regarding the effectiveness of efforts to reduce air pollution exposure. Therefore, we examine how the magnitude and equity of the PM2.5-related public health burden has changed nationally, and between provinces, as economic growth and pollution levels varied during 2005-2017. We derive long-term PM2.5 exposures in China from satellite-based observations and chemical transport models, and estimate attributable premature mortality using the Global Exposure Mortality Model (GEMM). We characterize national and interprovincial inequality in health outcomes using environmental Lorenz curves and Gini coefficients over the study period. PM2.5 exposure is linked to 1.8 (95% CI: 1.6, 2.0) million premature deaths over China in 2017, increasing by 31% from 2005. Approximately 70% of PM2.5 attributable deaths were caused by stroke and IHD (ischemic heart disease), though COPD (chronic obstructive pulmonary disease) and LRI (lower respiratory infection) disproportionately affected poorer provinces. While most economic gains and PM2.5-related deaths were concentrated in a few provinces, both gains and deaths became more equitably distributed across provinces over time. As a nation, however, trends toward equality were more recent and less clear cut across causes of death. The rise in premature mortality is due primarily to population growth and baseline risks of stroke and IHD. This rising health burden could be alleviated through policies to prevent pollution, exposure, and disease. More targeted programs may be warranted for poorer provinces with a disproportionate share of PM2.5-related premature deaths due to COPD and LRI.
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Affiliation(s)
- Ming Liu
- Department of Geography and Environmental Management, University of Waterloo, Waterloo, Ontario, N2L 3G1, Canada; School of Land Engineering, Chang'an University, Xi'an, Shaanxi, 710064, China.
| | - Rebecca K Saari
- Department of Geography and Environmental Management, University of Waterloo, Waterloo, Ontario, N2L 3G1, Canada; Department of Civil and Environmental Engineering, University of Waterloo, Waterloo, Ontario, N2L 3G1, Canada.
| | - Gaoxiang Zhou
- Department of Geography and Environmental Management, University of Waterloo, Waterloo, Ontario, N2L 3G1, Canada; School of Information Engineering, China University of Geosciences, Beijing, 100083, China
| | - Jonathan Li
- Department of Geography and Environmental Management, University of Waterloo, Waterloo, Ontario, N2L 3G1, Canada; Fujian Key Laboratory of Sensing and Computing for Smart Cities, School of Informatics, Xiamen University, Xiamen, FJ, 361005, China
| | - Ling Han
- Shaanxi Key Laboratory of Land Consolidation, School of Land Engineering, Chang'an University, Xi'an, Shaanxi, 710064, China
| | - Xiangnan Liu
- School of Information Engineering, China University of Geosciences, Beijing, 100083, China
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18
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The joint association of physical activity and fine particulate matter exposure with incident dementia in elderly Hong Kong residents. ENVIRONMENT INTERNATIONAL 2021; 156:106645. [PMID: 34015665 DOI: 10.1016/j.envint.2021.106645] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/01/2021] [Revised: 04/13/2021] [Accepted: 05/12/2021] [Indexed: 02/05/2023]
Abstract
OBJECTIVE The evidence for the beneficial effects of physical activity (PA) and potentially detrimental effects of long-term exposure to fine particulate matter (PM2.5) on neurodegeneration diseases is accumulating. However, their joint effects remain unclear. We evaluated joint associations of habitual PA and PM2.5 exposure with incident dementia in a longitudinal elderly cohort in Hong Kong. METHODS A total of 57,775 elderly participants (≥65 years) without dementia were enrolled during 1998-2001 and followed up till 2011. Their information on PA and other relevant covariates were collected at baseline (1998-2001) by a standard self-administered questionnaire, including PA volumes (high, moderate, low, and inactive) and types (aerobic exercise, traditional Chinese exercise, stretching exercise, walking slowly, and no exercise). Their annual mean PM2.5 exposures at the residential address were estimated using a satellite-based spatiotemporal model. We then adopted the Cox proportional hazards model to examine the joint associations with the incidence of all-cause dementia, Alzheimer's diseases, and vascular dementia on additive and multiplicative scales. RESULTS During the follow-up period, we identified 1,157 incident cases of dementia, including 642 cases of Alzheimer's disease and 324 cases of vascular dementia. A higher PA level was associated with a lower risk of incident all-cause dementia (hazard ratio (HR) for the high-PA volume was 0.59 (95% CI, 0.47, 0.75), as compared with the inactive-PA), whereas a high level of PM2.5 was related to the higher risk with an HR of 1.15 (95%CI: 1.00, 1.33) compared with the low-level of PM2.5. No clear evidence was observed of interaction between habitual PA (volume and type) and PM2.5 inhalation to incident dementia on either additive or multiplicative scale. CONCLUSION Habitual PA and long-term PM2.5 exposure were oppositely related to incident dementia in the Hong Kong aged population. The benefits of PA remain in people irrespective of exposure to air pollution.
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Ru M, Brauer M, Lamarque J, Shindell D. Exploration of the Global Burden of Dementia Attributable to PM2.5: What Do We Know Based on Current Evidence? GEOHEALTH 2021; 5:e2020GH000356. [PMID: 34084981 PMCID: PMC8143277 DOI: 10.1029/2020gh000356] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 01/15/2021] [Accepted: 03/11/2021] [Indexed: 05/17/2023]
Abstract
Exposure to ambient PM2.5 pollution has been linked to multiple adverse health effects. Additional effects have been identified in the literature and there is a need to understand its potential role in high prevalence diseases. In response to recent indications of PM2.5 as a risk factor for dementia, we examine the evidence by systematically reviewing the epidemiologic literature, in relation to exposure from ambient air pollution, household air pollution, secondhand smoke, and active smoking. We develop preliminary exposure-response functions, estimate the uncertainty, and discuss sensitivities and model selection. We estimate the likely impact to be 2.1 M (1.4 M, 2.5 M; 5%-95% confidence) global incident dementia cases and 0.6 M (0.4 M, 0.8 M) deaths attributable to ambient PM2.5 pollution in 2015. This implies a combined toll from morbidity and mortality of dementia of 7.3 M (5.0 M, 9.1 M) lost disability-adjusted life years. China, Japan, India, and the United States had the highest estimated total burden, and the per capita burden was highest in developed countries with large elderly populations. Compared to 2000, most countries in Europe, the Americas, and Southern Africa reduced the burden in 2015, while other regions had a net increase. Based on a recent systematic review of cost of illness studies for dementia, our estimates imply economic costs of US$ 26 billion worldwide in 2015. Based on this estimation, ambient PM2.5 pollution may be responsible for 15% of premature deaths and 7% of DALYs associated with dementia. Our estimates also indicate substantial uncertainty in this relationship, and future epidemiological studies at high exposure levels are especially needed.
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Affiliation(s)
- Muye Ru
- Nicholas School of the EnvironmentDuke UniversityDurhamNCUSA
- The Earth InsititueColumbia UniversityNew York CityNYUSA
| | - Michael Brauer
- School of Population and Public HealthUniversity of British ColumbiaVancouverBCCanada
- Institute for Health Metrics and EvaluationUniversity of WashingtonSeattleWAUSA
| | | | - Drew Shindell
- Nicholas School of the EnvironmentDuke UniversityDurhamNCUSA
- Duke Global Health InitiativeDuke UniversityDurhamNCUSA
- Porter School of the Environment and Earth SciencesTel Aviv UniversityTel AvivIsrael
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20
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Herr D, Jew K, Wong C, Kennell A, Gelein R, Chalupa D, Raab A, Oberdörster G, Olschowka J, O'Banion MK, Elder A. Effects of concentrated ambient ultrafine particulate matter on hallmarks of Alzheimer's disease in the 3xTgAD mouse model. Neurotoxicology 2021; 84:172-183. [PMID: 33794265 DOI: 10.1016/j.neuro.2021.03.010] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Revised: 03/22/2021] [Accepted: 03/24/2021] [Indexed: 12/25/2022]
Abstract
BACKGROUND Exposure to air pollution has been identified as a possible environmental contributor to Alzheimer's Disease (AD) risk. As the number of people with AD worldwide continues to rise, it becomes vital to understand the nature of this potential gene-environment interaction. This study assessed the effects of short-term exposures to concentrated ambient ultrafine particulates (UFP, <100 nm) on measurements of amyloid-β, tau, and microglial morphology. METHODS Two cohorts of aged (12.5-14 months) 3xTgAD and NTg mice were exposed to concentrated ambient UFP or filtered air for 2 weeks (4-h/day, 4 days/week). Bronchoalveolar lavage fluid and brain tissue were collected twenty-four hours following the last exposure to evaluate lung inflammation, tau pathology, amyloid-β pathology, and glial cell morphology. RESULTS No exposure- or genotype-related changes were found with any of the measures of lung inflammation or in the hippocampal staining density of astrocyte marker glial fibrillary acidic protein. The microglia marker, ionized calcium binding adaptor molecule 1, and amyloid-β marker, 6E10, exhibited significant genotype by exposure interactions such that levels were lower in the UFP-exposed as compared to filtered air-exposed 3xTgAD mice. When microglia morphology was assessed by Sholl analysis, microglia from both NTg mouse groups were ramified. The 3xTgAD air-exposed mice had the most ameboid microglia, while the 3xTgAD UFP-exposed mice had microglia that were comparatively more ramified. The 3xTgAD air-exposed mice had more plaques per region of interest as measured by Congo red staining as well as more plaque-associated microglia than the 3xTgAD UFP-exposed mice. The number of non-plaque-associated microglia was not affected by genotype or exposure. Levels of soluble and insoluble human amyloid-β42 protein were measured in both 3xTgAD groups and no exposure effect was found. In contrast, UFP-exposure led to significant elevations in phosphorylated tau in 3xTgAD mice as compared to those that were exposed to air, as measured by pT205 staining. CONCLUSIONS Exposure to environmentally relevant levels of ultrafine particulates led to changes in tau phosphorylation and microglial morphology in the absence of overt lung inflammation. Such changes highlight the need to develop greater mechanistic understanding of the link between air pollution exposure and Alzheimer's disease.
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Affiliation(s)
- Denise Herr
- Department of Environmental Medicine, University of Rochester School of Medicine & Dentistry, Rochester, NY, 14642, USA
| | - Katrina Jew
- Department of Environmental Medicine, University of Rochester School of Medicine & Dentistry, Rochester, NY, 14642, USA
| | - Candace Wong
- Department of Environmental Medicine, University of Rochester School of Medicine & Dentistry, Rochester, NY, 14642, USA
| | - Andrea Kennell
- Department of Environmental Medicine, University of Rochester School of Medicine & Dentistry, Rochester, NY, 14642, USA
| | - Robert Gelein
- Department of Environmental Medicine, University of Rochester School of Medicine & Dentistry, Rochester, NY, 14642, USA
| | - David Chalupa
- Department of Environmental Medicine, University of Rochester School of Medicine & Dentistry, Rochester, NY, 14642, USA
| | - Alexandria Raab
- Department of Environmental Medicine, University of Rochester School of Medicine & Dentistry, Rochester, NY, 14642, USA
| | - Günter Oberdörster
- Department of Environmental Medicine, University of Rochester School of Medicine & Dentistry, Rochester, NY, 14642, USA
| | - John Olschowka
- Department of Neuroscience and Del Monte Neuroscience Institute, University of Rochester School of Medicine & Dentistry, Rochester, NY, 14642, USA
| | - M Kerry O'Banion
- Department of Neuroscience and Del Monte Neuroscience Institute, University of Rochester School of Medicine & Dentistry, Rochester, NY, 14642, USA; Department of Neurology, University of Rochester School of Medicine & Dentistry, Rochester, NY, 14642, USA
| | - Alison Elder
- Department of Environmental Medicine, University of Rochester School of Medicine & Dentistry, Rochester, NY, 14642, USA.
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21
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Younan D, Wang X, Casanova R, Barnard R, Gaussoin SA, Saldana S, Petkus AJ, Beavers DP, Resnick SM, Manson JE, Serre ML, Vizuete W, Henderson VW, Sachs BC, Salinas J, Gatz M, Espeland MA, Chui HC, Shumaker SA, Rapp SR, Chen JC. PM 2.5 Associated With Gray Matter Atrophy Reflecting Increased Alzheimer Risk in Older Women. Neurology 2021; 96:e1190-e1201. [PMID: 33208540 PMCID: PMC8055348 DOI: 10.1212/wnl.0000000000011149] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Accepted: 10/20/2020] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To examine whether late-life exposure to PM2.5 (particulate matter with aerodynamic diameters <2.5 µm) contributes to progressive brain atrophy predictive of Alzheimer disease (AD) using a community-dwelling cohort of women (age 70-89 years) with up to 2 brain MRI scans (MRI-1, 2005-2006; MRI-2, 2010-2011). METHODS AD pattern similarity (AD-PS) scores, developed by supervised machine learning and validated with MRI data from the Alzheimer's Disease Neuroimaging Initiative, were used to capture high-dimensional gray matter atrophy in brain areas vulnerable to AD (e.g., amygdala, hippocampus, parahippocampal gyrus, thalamus, inferior temporal lobe areas, and midbrain). Using participants' addresses and air monitoring data, we implemented a spatiotemporal model to estimate 3-year average exposure to PM2.5 preceding MRI-1. General linear models were used to examine the association between PM2.5 and AD-PS scores (baseline and 5-year standardized change), accounting for potential confounders and white matter lesion volumes. RESULTS For 1,365 women 77.9 ± 3.7 years of age in 2005 to 2006, there was no association between PM2.5 and baseline AD-PS score in cross-sectional analyses (β = -0.004; 95% confidence interval [CI] -0.019 to 0.011). Longitudinally, each interquartile range increase of PM2.5 (2.82 µg/m3) was associated with increased AD-PS scores during the follow-up, equivalent to a 24% (hazard ratio 1.24, 95% CI 1.14-1.34) increase in AD risk over 5 years (n = 712, age 77.4 ± 3.5 years). This association remained after adjustment for sociodemographics, intracranial volume, lifestyle, clinical characteristics, and white matter lesions and was present with levels below US regulatory standards (<12 µg/m3). CONCLUSIONS Late-life exposure to PM2.5 is associated with increased neuroanatomic risk of AD, which may not be explained by available indicators of cerebrovascular damage.
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Affiliation(s)
- Diana Younan
- From the Departments of Preventive Medicine (D.Y., J.C.C) and Neurology (X.W., A.J.P., H.C.C., J.-C.C.) and the Center for Economic and Social Research (M.G.), University of Southern California, Los Angeles; Departments of Biostatistics and Data Science (R.C., R.B., S.A.G., S.S., D.P.B., M.A.E.), Psychiatry and Behavioral Medicine (S.R.R.), Social Sciences & Health Policy (S.A.S., S.R.R.), and Neurology (B.C.S.), Wake Forest School of Medicine, Winston-Salem, NC; Laboratory of Behavioral Neuroscience (S.M.R.), National Institute on Aging, Baltimore, MD; Department of Environmental Sciences and Engineering (M.L.S., W.V.), University of North Carolina, Chapel Hill; Departments of Health Research and Policy (Epidemiology) and Neurology and Neurological Sciences (V.W.H.), Stanford University, CA; Department of Medicine (J.E.M.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA; and Center for Cognitive Neurology, Department of Neurology (J.S.), New York University Grossman School of Medicine, New York.
| | - Xinhui Wang
- From the Departments of Preventive Medicine (D.Y., J.C.C) and Neurology (X.W., A.J.P., H.C.C., J.-C.C.) and the Center for Economic and Social Research (M.G.), University of Southern California, Los Angeles; Departments of Biostatistics and Data Science (R.C., R.B., S.A.G., S.S., D.P.B., M.A.E.), Psychiatry and Behavioral Medicine (S.R.R.), Social Sciences & Health Policy (S.A.S., S.R.R.), and Neurology (B.C.S.), Wake Forest School of Medicine, Winston-Salem, NC; Laboratory of Behavioral Neuroscience (S.M.R.), National Institute on Aging, Baltimore, MD; Department of Environmental Sciences and Engineering (M.L.S., W.V.), University of North Carolina, Chapel Hill; Departments of Health Research and Policy (Epidemiology) and Neurology and Neurological Sciences (V.W.H.), Stanford University, CA; Department of Medicine (J.E.M.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA; and Center for Cognitive Neurology, Department of Neurology (J.S.), New York University Grossman School of Medicine, New York
| | - Ramon Casanova
- From the Departments of Preventive Medicine (D.Y., J.C.C) and Neurology (X.W., A.J.P., H.C.C., J.-C.C.) and the Center for Economic and Social Research (M.G.), University of Southern California, Los Angeles; Departments of Biostatistics and Data Science (R.C., R.B., S.A.G., S.S., D.P.B., M.A.E.), Psychiatry and Behavioral Medicine (S.R.R.), Social Sciences & Health Policy (S.A.S., S.R.R.), and Neurology (B.C.S.), Wake Forest School of Medicine, Winston-Salem, NC; Laboratory of Behavioral Neuroscience (S.M.R.), National Institute on Aging, Baltimore, MD; Department of Environmental Sciences and Engineering (M.L.S., W.V.), University of North Carolina, Chapel Hill; Departments of Health Research and Policy (Epidemiology) and Neurology and Neurological Sciences (V.W.H.), Stanford University, CA; Department of Medicine (J.E.M.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA; and Center for Cognitive Neurology, Department of Neurology (J.S.), New York University Grossman School of Medicine, New York
| | - Ryan Barnard
- From the Departments of Preventive Medicine (D.Y., J.C.C) and Neurology (X.W., A.J.P., H.C.C., J.-C.C.) and the Center for Economic and Social Research (M.G.), University of Southern California, Los Angeles; Departments of Biostatistics and Data Science (R.C., R.B., S.A.G., S.S., D.P.B., M.A.E.), Psychiatry and Behavioral Medicine (S.R.R.), Social Sciences & Health Policy (S.A.S., S.R.R.), and Neurology (B.C.S.), Wake Forest School of Medicine, Winston-Salem, NC; Laboratory of Behavioral Neuroscience (S.M.R.), National Institute on Aging, Baltimore, MD; Department of Environmental Sciences and Engineering (M.L.S., W.V.), University of North Carolina, Chapel Hill; Departments of Health Research and Policy (Epidemiology) and Neurology and Neurological Sciences (V.W.H.), Stanford University, CA; Department of Medicine (J.E.M.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA; and Center for Cognitive Neurology, Department of Neurology (J.S.), New York University Grossman School of Medicine, New York
| | - Sarah A Gaussoin
- From the Departments of Preventive Medicine (D.Y., J.C.C) and Neurology (X.W., A.J.P., H.C.C., J.-C.C.) and the Center for Economic and Social Research (M.G.), University of Southern California, Los Angeles; Departments of Biostatistics and Data Science (R.C., R.B., S.A.G., S.S., D.P.B., M.A.E.), Psychiatry and Behavioral Medicine (S.R.R.), Social Sciences & Health Policy (S.A.S., S.R.R.), and Neurology (B.C.S.), Wake Forest School of Medicine, Winston-Salem, NC; Laboratory of Behavioral Neuroscience (S.M.R.), National Institute on Aging, Baltimore, MD; Department of Environmental Sciences and Engineering (M.L.S., W.V.), University of North Carolina, Chapel Hill; Departments of Health Research and Policy (Epidemiology) and Neurology and Neurological Sciences (V.W.H.), Stanford University, CA; Department of Medicine (J.E.M.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA; and Center for Cognitive Neurology, Department of Neurology (J.S.), New York University Grossman School of Medicine, New York
| | - Santiago Saldana
- From the Departments of Preventive Medicine (D.Y., J.C.C) and Neurology (X.W., A.J.P., H.C.C., J.-C.C.) and the Center for Economic and Social Research (M.G.), University of Southern California, Los Angeles; Departments of Biostatistics and Data Science (R.C., R.B., S.A.G., S.S., D.P.B., M.A.E.), Psychiatry and Behavioral Medicine (S.R.R.), Social Sciences & Health Policy (S.A.S., S.R.R.), and Neurology (B.C.S.), Wake Forest School of Medicine, Winston-Salem, NC; Laboratory of Behavioral Neuroscience (S.M.R.), National Institute on Aging, Baltimore, MD; Department of Environmental Sciences and Engineering (M.L.S., W.V.), University of North Carolina, Chapel Hill; Departments of Health Research and Policy (Epidemiology) and Neurology and Neurological Sciences (V.W.H.), Stanford University, CA; Department of Medicine (J.E.M.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA; and Center for Cognitive Neurology, Department of Neurology (J.S.), New York University Grossman School of Medicine, New York
| | - Andrew J Petkus
- From the Departments of Preventive Medicine (D.Y., J.C.C) and Neurology (X.W., A.J.P., H.C.C., J.-C.C.) and the Center for Economic and Social Research (M.G.), University of Southern California, Los Angeles; Departments of Biostatistics and Data Science (R.C., R.B., S.A.G., S.S., D.P.B., M.A.E.), Psychiatry and Behavioral Medicine (S.R.R.), Social Sciences & Health Policy (S.A.S., S.R.R.), and Neurology (B.C.S.), Wake Forest School of Medicine, Winston-Salem, NC; Laboratory of Behavioral Neuroscience (S.M.R.), National Institute on Aging, Baltimore, MD; Department of Environmental Sciences and Engineering (M.L.S., W.V.), University of North Carolina, Chapel Hill; Departments of Health Research and Policy (Epidemiology) and Neurology and Neurological Sciences (V.W.H.), Stanford University, CA; Department of Medicine (J.E.M.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA; and Center for Cognitive Neurology, Department of Neurology (J.S.), New York University Grossman School of Medicine, New York
| | - Daniel P Beavers
- From the Departments of Preventive Medicine (D.Y., J.C.C) and Neurology (X.W., A.J.P., H.C.C., J.-C.C.) and the Center for Economic and Social Research (M.G.), University of Southern California, Los Angeles; Departments of Biostatistics and Data Science (R.C., R.B., S.A.G., S.S., D.P.B., M.A.E.), Psychiatry and Behavioral Medicine (S.R.R.), Social Sciences & Health Policy (S.A.S., S.R.R.), and Neurology (B.C.S.), Wake Forest School of Medicine, Winston-Salem, NC; Laboratory of Behavioral Neuroscience (S.M.R.), National Institute on Aging, Baltimore, MD; Department of Environmental Sciences and Engineering (M.L.S., W.V.), University of North Carolina, Chapel Hill; Departments of Health Research and Policy (Epidemiology) and Neurology and Neurological Sciences (V.W.H.), Stanford University, CA; Department of Medicine (J.E.M.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA; and Center for Cognitive Neurology, Department of Neurology (J.S.), New York University Grossman School of Medicine, New York
| | - Susan M Resnick
- From the Departments of Preventive Medicine (D.Y., J.C.C) and Neurology (X.W., A.J.P., H.C.C., J.-C.C.) and the Center for Economic and Social Research (M.G.), University of Southern California, Los Angeles; Departments of Biostatistics and Data Science (R.C., R.B., S.A.G., S.S., D.P.B., M.A.E.), Psychiatry and Behavioral Medicine (S.R.R.), Social Sciences & Health Policy (S.A.S., S.R.R.), and Neurology (B.C.S.), Wake Forest School of Medicine, Winston-Salem, NC; Laboratory of Behavioral Neuroscience (S.M.R.), National Institute on Aging, Baltimore, MD; Department of Environmental Sciences and Engineering (M.L.S., W.V.), University of North Carolina, Chapel Hill; Departments of Health Research and Policy (Epidemiology) and Neurology and Neurological Sciences (V.W.H.), Stanford University, CA; Department of Medicine (J.E.M.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA; and Center for Cognitive Neurology, Department of Neurology (J.S.), New York University Grossman School of Medicine, New York
| | - JoAnn E Manson
- From the Departments of Preventive Medicine (D.Y., J.C.C) and Neurology (X.W., A.J.P., H.C.C., J.-C.C.) and the Center for Economic and Social Research (M.G.), University of Southern California, Los Angeles; Departments of Biostatistics and Data Science (R.C., R.B., S.A.G., S.S., D.P.B., M.A.E.), Psychiatry and Behavioral Medicine (S.R.R.), Social Sciences & Health Policy (S.A.S., S.R.R.), and Neurology (B.C.S.), Wake Forest School of Medicine, Winston-Salem, NC; Laboratory of Behavioral Neuroscience (S.M.R.), National Institute on Aging, Baltimore, MD; Department of Environmental Sciences and Engineering (M.L.S., W.V.), University of North Carolina, Chapel Hill; Departments of Health Research and Policy (Epidemiology) and Neurology and Neurological Sciences (V.W.H.), Stanford University, CA; Department of Medicine (J.E.M.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA; and Center for Cognitive Neurology, Department of Neurology (J.S.), New York University Grossman School of Medicine, New York
| | - Marc L Serre
- From the Departments of Preventive Medicine (D.Y., J.C.C) and Neurology (X.W., A.J.P., H.C.C., J.-C.C.) and the Center for Economic and Social Research (M.G.), University of Southern California, Los Angeles; Departments of Biostatistics and Data Science (R.C., R.B., S.A.G., S.S., D.P.B., M.A.E.), Psychiatry and Behavioral Medicine (S.R.R.), Social Sciences & Health Policy (S.A.S., S.R.R.), and Neurology (B.C.S.), Wake Forest School of Medicine, Winston-Salem, NC; Laboratory of Behavioral Neuroscience (S.M.R.), National Institute on Aging, Baltimore, MD; Department of Environmental Sciences and Engineering (M.L.S., W.V.), University of North Carolina, Chapel Hill; Departments of Health Research and Policy (Epidemiology) and Neurology and Neurological Sciences (V.W.H.), Stanford University, CA; Department of Medicine (J.E.M.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA; and Center for Cognitive Neurology, Department of Neurology (J.S.), New York University Grossman School of Medicine, New York
| | - William Vizuete
- From the Departments of Preventive Medicine (D.Y., J.C.C) and Neurology (X.W., A.J.P., H.C.C., J.-C.C.) and the Center for Economic and Social Research (M.G.), University of Southern California, Los Angeles; Departments of Biostatistics and Data Science (R.C., R.B., S.A.G., S.S., D.P.B., M.A.E.), Psychiatry and Behavioral Medicine (S.R.R.), Social Sciences & Health Policy (S.A.S., S.R.R.), and Neurology (B.C.S.), Wake Forest School of Medicine, Winston-Salem, NC; Laboratory of Behavioral Neuroscience (S.M.R.), National Institute on Aging, Baltimore, MD; Department of Environmental Sciences and Engineering (M.L.S., W.V.), University of North Carolina, Chapel Hill; Departments of Health Research and Policy (Epidemiology) and Neurology and Neurological Sciences (V.W.H.), Stanford University, CA; Department of Medicine (J.E.M.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA; and Center for Cognitive Neurology, Department of Neurology (J.S.), New York University Grossman School of Medicine, New York
| | - Victor W Henderson
- From the Departments of Preventive Medicine (D.Y., J.C.C) and Neurology (X.W., A.J.P., H.C.C., J.-C.C.) and the Center for Economic and Social Research (M.G.), University of Southern California, Los Angeles; Departments of Biostatistics and Data Science (R.C., R.B., S.A.G., S.S., D.P.B., M.A.E.), Psychiatry and Behavioral Medicine (S.R.R.), Social Sciences & Health Policy (S.A.S., S.R.R.), and Neurology (B.C.S.), Wake Forest School of Medicine, Winston-Salem, NC; Laboratory of Behavioral Neuroscience (S.M.R.), National Institute on Aging, Baltimore, MD; Department of Environmental Sciences and Engineering (M.L.S., W.V.), University of North Carolina, Chapel Hill; Departments of Health Research and Policy (Epidemiology) and Neurology and Neurological Sciences (V.W.H.), Stanford University, CA; Department of Medicine (J.E.M.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA; and Center for Cognitive Neurology, Department of Neurology (J.S.), New York University Grossman School of Medicine, New York
| | - Bonnie C Sachs
- From the Departments of Preventive Medicine (D.Y., J.C.C) and Neurology (X.W., A.J.P., H.C.C., J.-C.C.) and the Center for Economic and Social Research (M.G.), University of Southern California, Los Angeles; Departments of Biostatistics and Data Science (R.C., R.B., S.A.G., S.S., D.P.B., M.A.E.), Psychiatry and Behavioral Medicine (S.R.R.), Social Sciences & Health Policy (S.A.S., S.R.R.), and Neurology (B.C.S.), Wake Forest School of Medicine, Winston-Salem, NC; Laboratory of Behavioral Neuroscience (S.M.R.), National Institute on Aging, Baltimore, MD; Department of Environmental Sciences and Engineering (M.L.S., W.V.), University of North Carolina, Chapel Hill; Departments of Health Research and Policy (Epidemiology) and Neurology and Neurological Sciences (V.W.H.), Stanford University, CA; Department of Medicine (J.E.M.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA; and Center for Cognitive Neurology, Department of Neurology (J.S.), New York University Grossman School of Medicine, New York
| | - Joel Salinas
- From the Departments of Preventive Medicine (D.Y., J.C.C) and Neurology (X.W., A.J.P., H.C.C., J.-C.C.) and the Center for Economic and Social Research (M.G.), University of Southern California, Los Angeles; Departments of Biostatistics and Data Science (R.C., R.B., S.A.G., S.S., D.P.B., M.A.E.), Psychiatry and Behavioral Medicine (S.R.R.), Social Sciences & Health Policy (S.A.S., S.R.R.), and Neurology (B.C.S.), Wake Forest School of Medicine, Winston-Salem, NC; Laboratory of Behavioral Neuroscience (S.M.R.), National Institute on Aging, Baltimore, MD; Department of Environmental Sciences and Engineering (M.L.S., W.V.), University of North Carolina, Chapel Hill; Departments of Health Research and Policy (Epidemiology) and Neurology and Neurological Sciences (V.W.H.), Stanford University, CA; Department of Medicine (J.E.M.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA; and Center for Cognitive Neurology, Department of Neurology (J.S.), New York University Grossman School of Medicine, New York
| | - Margaret Gatz
- From the Departments of Preventive Medicine (D.Y., J.C.C) and Neurology (X.W., A.J.P., H.C.C., J.-C.C.) and the Center for Economic and Social Research (M.G.), University of Southern California, Los Angeles; Departments of Biostatistics and Data Science (R.C., R.B., S.A.G., S.S., D.P.B., M.A.E.), Psychiatry and Behavioral Medicine (S.R.R.), Social Sciences & Health Policy (S.A.S., S.R.R.), and Neurology (B.C.S.), Wake Forest School of Medicine, Winston-Salem, NC; Laboratory of Behavioral Neuroscience (S.M.R.), National Institute on Aging, Baltimore, MD; Department of Environmental Sciences and Engineering (M.L.S., W.V.), University of North Carolina, Chapel Hill; Departments of Health Research and Policy (Epidemiology) and Neurology and Neurological Sciences (V.W.H.), Stanford University, CA; Department of Medicine (J.E.M.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA; and Center for Cognitive Neurology, Department of Neurology (J.S.), New York University Grossman School of Medicine, New York
| | - Mark A Espeland
- From the Departments of Preventive Medicine (D.Y., J.C.C) and Neurology (X.W., A.J.P., H.C.C., J.-C.C.) and the Center for Economic and Social Research (M.G.), University of Southern California, Los Angeles; Departments of Biostatistics and Data Science (R.C., R.B., S.A.G., S.S., D.P.B., M.A.E.), Psychiatry and Behavioral Medicine (S.R.R.), Social Sciences & Health Policy (S.A.S., S.R.R.), and Neurology (B.C.S.), Wake Forest School of Medicine, Winston-Salem, NC; Laboratory of Behavioral Neuroscience (S.M.R.), National Institute on Aging, Baltimore, MD; Department of Environmental Sciences and Engineering (M.L.S., W.V.), University of North Carolina, Chapel Hill; Departments of Health Research and Policy (Epidemiology) and Neurology and Neurological Sciences (V.W.H.), Stanford University, CA; Department of Medicine (J.E.M.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA; and Center for Cognitive Neurology, Department of Neurology (J.S.), New York University Grossman School of Medicine, New York
| | - Helena C Chui
- From the Departments of Preventive Medicine (D.Y., J.C.C) and Neurology (X.W., A.J.P., H.C.C., J.-C.C.) and the Center for Economic and Social Research (M.G.), University of Southern California, Los Angeles; Departments of Biostatistics and Data Science (R.C., R.B., S.A.G., S.S., D.P.B., M.A.E.), Psychiatry and Behavioral Medicine (S.R.R.), Social Sciences & Health Policy (S.A.S., S.R.R.), and Neurology (B.C.S.), Wake Forest School of Medicine, Winston-Salem, NC; Laboratory of Behavioral Neuroscience (S.M.R.), National Institute on Aging, Baltimore, MD; Department of Environmental Sciences and Engineering (M.L.S., W.V.), University of North Carolina, Chapel Hill; Departments of Health Research and Policy (Epidemiology) and Neurology and Neurological Sciences (V.W.H.), Stanford University, CA; Department of Medicine (J.E.M.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA; and Center for Cognitive Neurology, Department of Neurology (J.S.), New York University Grossman School of Medicine, New York
| | - Sally A Shumaker
- From the Departments of Preventive Medicine (D.Y., J.C.C) and Neurology (X.W., A.J.P., H.C.C., J.-C.C.) and the Center for Economic and Social Research (M.G.), University of Southern California, Los Angeles; Departments of Biostatistics and Data Science (R.C., R.B., S.A.G., S.S., D.P.B., M.A.E.), Psychiatry and Behavioral Medicine (S.R.R.), Social Sciences & Health Policy (S.A.S., S.R.R.), and Neurology (B.C.S.), Wake Forest School of Medicine, Winston-Salem, NC; Laboratory of Behavioral Neuroscience (S.M.R.), National Institute on Aging, Baltimore, MD; Department of Environmental Sciences and Engineering (M.L.S., W.V.), University of North Carolina, Chapel Hill; Departments of Health Research and Policy (Epidemiology) and Neurology and Neurological Sciences (V.W.H.), Stanford University, CA; Department of Medicine (J.E.M.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA; and Center for Cognitive Neurology, Department of Neurology (J.S.), New York University Grossman School of Medicine, New York
| | - Stephen R Rapp
- From the Departments of Preventive Medicine (D.Y., J.C.C) and Neurology (X.W., A.J.P., H.C.C., J.-C.C.) and the Center for Economic and Social Research (M.G.), University of Southern California, Los Angeles; Departments of Biostatistics and Data Science (R.C., R.B., S.A.G., S.S., D.P.B., M.A.E.), Psychiatry and Behavioral Medicine (S.R.R.), Social Sciences & Health Policy (S.A.S., S.R.R.), and Neurology (B.C.S.), Wake Forest School of Medicine, Winston-Salem, NC; Laboratory of Behavioral Neuroscience (S.M.R.), National Institute on Aging, Baltimore, MD; Department of Environmental Sciences and Engineering (M.L.S., W.V.), University of North Carolina, Chapel Hill; Departments of Health Research and Policy (Epidemiology) and Neurology and Neurological Sciences (V.W.H.), Stanford University, CA; Department of Medicine (J.E.M.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA; and Center for Cognitive Neurology, Department of Neurology (J.S.), New York University Grossman School of Medicine, New York
| | - Jiu-Chiuan Chen
- From the Departments of Preventive Medicine (D.Y., J.C.C) and Neurology (X.W., A.J.P., H.C.C., J.-C.C.) and the Center for Economic and Social Research (M.G.), University of Southern California, Los Angeles; Departments of Biostatistics and Data Science (R.C., R.B., S.A.G., S.S., D.P.B., M.A.E.), Psychiatry and Behavioral Medicine (S.R.R.), Social Sciences & Health Policy (S.A.S., S.R.R.), and Neurology (B.C.S.), Wake Forest School of Medicine, Winston-Salem, NC; Laboratory of Behavioral Neuroscience (S.M.R.), National Institute on Aging, Baltimore, MD; Department of Environmental Sciences and Engineering (M.L.S., W.V.), University of North Carolina, Chapel Hill; Departments of Health Research and Policy (Epidemiology) and Neurology and Neurological Sciences (V.W.H.), Stanford University, CA; Department of Medicine (J.E.M.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA; and Center for Cognitive Neurology, Department of Neurology (J.S.), New York University Grossman School of Medicine, New York
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22
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Ran J, Schooling CM, Han L, Sun S, Zhao S, Zhang X, Chan KP, Guo F, Lee RSY, Qiu Y, Tian L. Long-term exposure to fine particulate matter and dementia incidence: A cohort study in Hong Kong. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2021; 271:116303. [PMID: 33370610 DOI: 10.1016/j.envpol.2020.116303] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Revised: 11/20/2020] [Accepted: 12/12/2020] [Indexed: 05/07/2023]
Abstract
Recent studies suggested that long-term exposure to fine particulate matter (PM2.5) was related to a higher risk of dementia incidence or hospitalizations in western populations, but the evidence is limited in Asian cities. Here we explored the link between long-term PM2.5 exposure and dementia incidence in the Hong Kong population and whether it varied by population sub-group. We utilized a Hong Kong Chinese cohort of 66,820 people aged ≥65 years who were voluntarily enrolled during 1998-2001 and were followed up to 2011. Prevalent dementia cases were excluded based on the face-to-face interview at baseline. We ascertained the first occurrence of hospitalization for all-cause dementia and major subtypes during the follow-up period. We assessed PM2.5 concentrations using a satellite data-based model with a 1 × 1 km2 resolution on the residential address. Cox proportional hazards models were adopted to estimate associations of annual mean PM2.5 exposure with dementia incidence, adjusting for potential confounders. We identified 1183 incident cases of all-cause dementia during the follow-up period, of which 655 (55.4%) were cases of Alzheimer's disease, and 334 (28.2%) were those of vascular dementia. We found a positive association between annual mean PM2.5 exposure and all-cause dementia incidence in the fully adjusted model. The estimated hazard ratio was 1.06 (95% confidence interval (CI): 1.00, 1.13) per every 3.8 μg/m3 increase in annual mean PM2.5 exposure. And the estimated HRs for Alzheimer's disease and vascular dementia were 1.03 (95% CI: 0.94, 1.12) and 1.09 (95% CI: 0.98, 1.22), respectively. We did not find effect modifications by age, sex, BMI, hypertension, diabetes, or heart disease on the associations. Results suggest that long-term exposure to PM2.5 is associated with a higher risk of dementia incidence in the Asian population.
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Affiliation(s)
- Jinjun Ran
- School of Public Health, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong, China; School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
| | - C Mary Schooling
- School of Public Health, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong, China; City University of New York, School of Public Health and Health Policy, New York, NY, USA
| | - Lefei Han
- School of Nursing, Hong Kong Polytechnic University, Hong Kong, China
| | - Shengzhi Sun
- Department of Environmental Health, Boston University School of Public Health, Boston, MA, USA
| | - Shi Zhao
- School of Nursing, Hong Kong Polytechnic University, Hong Kong, China
| | - Xiaohong Zhang
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - King-Pan Chan
- School of Public Health, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong, China
| | - Fang Guo
- School of Public Health, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong, China
| | | | - Yulan Qiu
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Linwei Tian
- School of Public Health, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong, China
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23
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Nunez Y, Boehme AK, Weisskopf MG, Re DB, Navas-Acien A, van Donkelaar A, Martin RV, Kioumourtzoglou MA. Fine Particle Exposure and Clinical Aggravation in Neurodegenerative Diseases in New York State. ENVIRONMENTAL HEALTH PERSPECTIVES 2021; 129:27003. [PMID: 33555200 PMCID: PMC7869948 DOI: 10.1289/ehp7425] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 01/18/2021] [Accepted: 01/20/2021] [Indexed: 05/23/2023]
Abstract
BACKGROUND Adult-onset neurodegenerative diseases affect millions and negatively impact health care systems worldwide. Evidence suggests that air pollution may contribute to aggravation of neurodegeneration, but studies have been limited. OBJECTIVE We examined the potential association between long-term exposure to particulate matter ≤ 2.5 μ m in aerodynamic diameter [fine particulate matter (PM 2.5 )] and disease aggravation in Alzheimer's (AD) and Parkinson's (PD) diseases and amyotrophic lateral sclerosis (ALS), using first hospitalization as a surrogate of clinical aggravation. METHODS We used data from the New York Department of Health Statewide Planning and Research Cooperative System (SPARCS 2000-2014) to construct annual county counts of first hospitalizations with a diagnosis of AD, PD, or ALS (total, urbanicity-, sex-, and age-stratified). We used annual PM 2.5 concentrations estimated by a prediction model at a 1 -km 2 resolution, which we aggregated to population-weighted county averages to assign exposure to cases based on county of residence. We used outcome-specific mixed quasi-Poisson models with county-specific random intercepts to estimate rate ratios (RRs) for a 1-y PM 2.5 exposure. We allowed for nonlinear exposure-outcome relationships using penalized splines and accounted for potential confounders. RESULTS We found a positive nonlinear PM 2.5 - PD association that plateaued above 11 μ g / m 3 (RR = 1.09 , 95% CI: 1.04, 1.14 for a PM 2.5 increase from 8.1 to 10.4 μ g / m 3 ). We also found a linear PM 2.5 - ALS positive association (RR = 1.05 , 95% CI: 1.01, 1.09 per 1 - μ g / m 3 PM 2.5 increase), and suggestive evidence of an association with AD. We found effect modification by age for PD and ALS with a stronger positive association in patients < 70 years of age but found insufficient evidence of effect modification by sex or urbanization level for any of the outcomes. CONCLUSION Our findings suggest that annual increase in county-level PM 2.5 concentrations may contribute to clinical aggravation of PD and ALS. Importantly, the average annual PM 2.5 concentration in our study was 8.1 μ g / m 3 , below the current American national standards, suggesting the standards may not adequately protect the aging population. https://doi.org/10.1289/EHP7425.
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Affiliation(s)
- Yanelli Nunez
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, New York, USA
| | - Amelia K. Boehme
- Department of Epidemiology and Neurology, Columbia University, New York, New York, USA
| | - Marc G. Weisskopf
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Diane B. Re
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, New York, USA
| | - Ana Navas-Acien
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, New York, USA
| | - Aaron van Donkelaar
- Department of Energy, Environmental and Chemical Engineering, Washington University in St. Louis, St. Louis, Missouri, USA
- Department of Physics and Atmospheric Science, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Randall V. Martin
- Department of Energy, Environmental and Chemical Engineering, Washington University in St. Louis, St. Louis, Missouri, USA
- Department of Physics and Atmospheric Science, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Marianthi-Anna Kioumourtzoglou
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, New York, USA
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24
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Petkus AJ, Younan D, Wang X, Beavers DP, Espeland MA, Gatz M, Gruenewald T, Kaufman JD, Chui HC, Millstein J, Rapp SR, Manson JE, Resnick SM, Wellenius GA, Whitsel EA, Widaman K, Chen JC. Associations Between Air Pollution Exposure and Empirically Derived Profiles of Cognitive Performance in Older Women. J Alzheimers Dis 2021; 84:1691-1707. [PMID: 34744078 PMCID: PMC9057084 DOI: 10.3233/jad-210518] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Elucidating associations between exposures to ambient air pollutants and profiles of cognitive performance may provide insight into neurotoxic effects on the aging brain. OBJECTIVE We examined associations between empirically derived profiles of cognitive performance and residential concentrations of particulate matter of aerodynamic diameter < 2.5 (PM2.5) and nitrogen dioxide (NO2) in older women. METHOD Women (N = 2,142) from the Women's Health Initiative Study of Cognitive Aging completed a neuropsychological assessment measuring attention, visuospatial, language, and episodic memory abilities. Average yearly concentrations of PM2.5 and NO2 were estimated at the participant's addresses for the 3 years prior to the assessment. Latent profile structural equation models identified subgroups of women exhibiting similar profiles across tests. Multinomial regressions examined associations between exposures and latent profile classification, controlling for covariates. RESULT Five latent profiles were identified: low performance across multiple domains (poor multi-domain; n = 282;13%), relatively poor verbal episodic memory (poor memory; n = 216; 10%), average performance across all domains (average multi-domain; n = 974; 45%), superior memory (n = 381; 18%), and superior attention (n = 332; 15%). Using women with average cognitive ability as the referent, higher PM2.5 (per interquartile range [IQR] = 3.64μg/m3) was associated with greater odds of being classified in the poor memory (OR = 1.29; 95% Confidence Interval [CI] = 1.10-1.52) or superior attention (OR = 1.30; 95% CI = 1.10-1.53) profiles. NO2 (per IQR = 9.86 ppb) was associated with higher odds of being classified in the poor memory (OR = 1.38; 95% CI = 1.17-1.63) and lower odds of being classified with superior memory (OR = 0.81; 95% CI = 0.67-0.97). CONCLUSION Exposure to PM2.5 and NO2 are associated with patterns of cognitive performance characterized by worse verbal episodic memory relative to performance in other domains.
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Affiliation(s)
- Andrew J. Petkus
- University of Southern California, Department of Neurology, Los Angeles, CA, USA
| | - Diana Younan
- University of Southern California, Department of Population and Public Health Sciences, Los Angeles, CA, USA
| | - Xinhui Wang
- University of Southern California, Department of Neurology, Los Angeles, CA, USA
| | - Daniel P. Beavers
- Wake Forest School of Medicine, Department of Biostatistics, Winston-Salem, NC, USA
| | - Mark A. Espeland
- Wake Forest School of Medicine, Department of Biostatistics, Winston-Salem, NC, USA
| | - Margaret Gatz
- University of Southern California, Center for Economic and Social Research, Los Angeles, CA, USA
| | - Tara Gruenewald
- Chapman University, Department of Psychology, Orange, CA, USA
| | - Joel D. Kaufman
- University of Washington, Department of Environmental and Occupational Health Sciences, Seattle, WA, USA
| | - Helena C. Chui
- University of Southern California, Department of Neurology, Los Angeles, CA, USA
| | - Joshua Millstein
- University of Southern California, Department of Population and Public Health Sciences, Los Angeles, CA, USA
| | - Stephen R. Rapp
- Wake Forest School of Medicine, Department of Psychiatry and Behavioral Medicine, Winston-Salem, NC, USA
| | - JoAnn E. Manson
- Harvard Medical School, Department of Medicine, Brigham and Women’s Hospital, Boston, MA, USA
| | - Susan M. Resnick
- National Institute on Aging, Laboratory of Behavioral Neuroscience, Baltimore, MD, USA
| | | | - Eric A. Whitsel
- University of North Carolina, Departments of Epidemiology and Medicine, Chapel Hill, NC, USA
| | - Keith Widaman
- University of California, Riverside, Graduate School of Education, Riverside, CA, USA
| | - Jiu-Chiuan Chen
- University of Southern California, Department of Neurology, Los Angeles, CA, USA
- University of Southern California, Department of Population and Public Health Sciences, Los Angeles, CA, USA
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25
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Tham R, Schikowski T. The Role of Traffic-Related Air Pollution on Neurodegenerative Diseases in Older People: An Epidemiological Perspective. J Alzheimers Dis 2020; 79:949-959. [PMID: 33361591 DOI: 10.3233/jad-200813] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Traffic-related air pollution is ubiquitous and almost impossible to avoid. It is important to understand the role that traffic-related air pollution may play in neurodegenerative diseases, such as dementia, Alzheimer's disease, and Parkinson's disease, particularly among older populations and at-risk groups. There is a growing interest in this area among the environmental epidemiology literature and the body of evidence identifying this role is emerging and strengthening. This review focuses on the principal components of traffic-related air pollutants (particulate matter and nitrogen oxides) and the epidemiological evidence of their contribution to common neurodegenerative diseases. All studies reported are currently observational in nature and there are mixed findings depending on the study design, assessment of traffic-related air pollutant levels, assessment of the neurodegenerative disease outcome, time period of assessment, and the role of confounding environmental factors and at-risk genetic characteristics. All current studies have been conducted in income-rich countries where traffic-related air pollution levels are relatively low. Additional longer-term studies are needed to confirm the levels of risk, consider other contributing environmental factors and to be conducted in settings where air pollution exposures are higher and at-risk populations reside and work. Better understanding of these relationships will help inform the development of preventive measures and reduce chronic cognitive and physical health burdens (cost, quality of life) at personal and societal levels.
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Affiliation(s)
- Rachel Tham
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia
| | - Tamara Schikowski
- IUF-Leibniz Institute for Environmental Medicine, Duesseldorf, Germany
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26
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Dimakakou E, Johnston HJ, Streftaris G, Cherrie JW. Is Environmental and Occupational Particulate Air Pollution Exposure Related to Type-2 Diabetes and Dementia? A Cross-Sectional Analysis of the UK Biobank. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17249581. [PMID: 33371391 PMCID: PMC7767456 DOI: 10.3390/ijerph17249581] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 12/16/2020] [Accepted: 12/17/2020] [Indexed: 01/02/2023]
Abstract
Human exposure to particulate air pollution (e.g., PM2.5) can lead to adverse health effects, with compelling evidence that it can increase morbidity and mortality from respiratory and cardiovascular disease. More recently, there has also been evidence that long-term environmental exposure to particulate air pollution is associated with type-2 diabetes mellitus (T2DM) and dementia. There are many occupations that may expose workers to airborne particles and that some exposures in the workplace are very similar to environmental particulate pollution. We conducted a cross-sectional analysis of the UK Biobank cohort to verify the association between environmental particulate air pollution (PM2.5) exposure and T2DM and dementia, and to investigate if occupational exposure to particulates that are similar to those found in environmental air pollution could increase the odds of developing these diseases. The UK Biobank dataset comprises of over 500,000 participants from all over the UK. Environmental exposure variables were used from the UK Biobank. To estimate occupational exposure both the UK Biobank’s data and information from a job exposure matrix, specifically developed for UK Biobank (Airborne Chemical Exposure–Job Exposure Matrix (ACE JEM)), were used. The outcome measures were participants with T2DM and dementia. In appropriately adjusted models, environmental exposure to PM2.5 was associated with an odds ratio (OR) of 1.02 (95% CI 1.00 to 1.03) per unit exposure for developing T2DM, while PM2.5 was associated with an odds ratio of 1.06 (95% CI 0.96 to 1.16) per unit exposure for developing dementia. These environmental results align with existing findings in the published literature. Five occupational exposures (dust, fumes, diesel, mineral, and biological dust in the most recent job estimated with the ACE JEM) were investigated and the risks for most exposures for T2DM and for all the exposures for dementia were not significantly increased in the adjusted models. This was confirmed in a subgroup of participants where a full occupational history was available allowed an estimate of workplace exposures. However, when not adjusting for gender, some of the associations become significant, which suggests that there might be a bias between the occupational assessments for men and women. The results of the present study do not provide clear evidence of an association between occupational exposure to particulate matter and T2DM or dementia.
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Affiliation(s)
- Eirini Dimakakou
- School of Engineering and Physical Sciences, Institute of Biological Chemistry, Biophysics and Bioengineering, Heriot-Watt University, Riccarton, Edinburgh EH14-4AS, UK; (H.J.J.); (J.W.C.)
- Correspondence:
| | - Helinor J. Johnston
- School of Engineering and Physical Sciences, Institute of Biological Chemistry, Biophysics and Bioengineering, Heriot-Watt University, Riccarton, Edinburgh EH14-4AS, UK; (H.J.J.); (J.W.C.)
| | - George Streftaris
- Maxwell Institute for Mathematical Sciences, School of Mathematical and Computer Sciences, Heriot-Watt University, Edinburgh EH14-4AS, UK;
| | - John W. Cherrie
- School of Engineering and Physical Sciences, Institute of Biological Chemistry, Biophysics and Bioengineering, Heriot-Watt University, Riccarton, Edinburgh EH14-4AS, UK; (H.J.J.); (J.W.C.)
- Institute of Occupational Medicine (IOM), Riccarton, Edinburgh EH14-4AP, UK
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27
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Ho HC, Fong KNK, Chan TC, Shi Y. The associations between social, built and geophysical environment and age-specific dementia mortality among older adults in a high-density Asian city. Int J Health Geogr 2020; 19:53. [PMID: 33276778 PMCID: PMC7716506 DOI: 10.1186/s12942-020-00252-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Accepted: 11/25/2020] [Indexed: 12/26/2022] Open
Abstract
Background Although socio-environmental factors which may affect dementia have widely been studied, the mortality of dementia and socio-environmental relationships among older adults have seldom been discussed. Method A retrospective, observational study based on territory-wide register-based data was conducted to evaluate the relationships of four individual-level social measures, two community-level social measures, six short-term (temporally varying) environmental measures, and four long-term (spatially varying) environmental measures with dementia mortality among older adults in a high-density Asian city (Hong Kong), for the following decedents: (1) all deaths: age >= 65, (2) “old-old”: age > = 85, (3) “mid-old”: aged 75–84, and (4) “young-old”: aged 65–74. Results This study identified 5438 deaths (3771 old-old; 1439 mid-old; 228 young-old) from dementia out of 228,600 all-cause deaths among older adults in Hong Kong between 2007 and 2014. Generally, regional air pollution, being unmarried or female, older age, and daily O3 were associated with higher dementia mortality, while more urban compactness and greenness were linked to lower dementia mortality among older adults. Specifically, being unmarried and the age effect were associated with higher dementia mortality among the “old-old”, “mid-old” and “young-old”. Regional air pollution was linked to increased dementia mortality, while urban compactness and greenness were associated with lower dementia mortality among the “old-old” and “mid-old”. Higher daily O3 had higher dementia mortality, while districts with a greater percentage of residents whose native language is not Cantonese were linked to lower dementia mortality among the “old-old”. Economic inactivity was associated with increased dementia mortality among the “young-old”. Gender effect varied by age. Conclusion The difference in strengths of association of various factors with dementia mortality among different age groups implies the need for a comprehensive framework for community health planning. In particular, strategies for air quality control, usage of greenspace and social space, and activity engagement to reduce vulnerability at all ages are warranted.
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Affiliation(s)
- Hung Chak Ho
- Department of Urban Planning and Design, The University of Hong Kong, Hong Kong, China.
| | - Kenneth N K Fong
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China
| | - Ta-Chien Chan
- Research Center for Humanities and Social Sciences, Academia Sinica, Taipei, Taiwan.
| | - Yuan Shi
- Institute of Future Cities, The Chinese University of Hong Kong, Hong Kong, China
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28
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Shi L, Wu X, Danesh Yazdi M, Braun D, Abu Awad Y, Wei Y, Liu P, Di Q, Wang Y, Schwartz J, Dominici F, Kioumourtzoglou MA, Zanobetti A. Long-term effects of PM 2·5 on neurological disorders in the American Medicare population: a longitudinal cohort study. Lancet Planet Health 2020; 4:e557-e565. [PMID: 33091388 PMCID: PMC7720425 DOI: 10.1016/s2542-5196(20)30227-8] [Citation(s) in RCA: 120] [Impact Index Per Article: 30.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Revised: 09/04/2020] [Accepted: 09/07/2020] [Indexed: 05/18/2023]
Abstract
BACKGROUND Accumulating evidence links fine particulate matter (PM2·5) to premature mortality, cardiovascular disease, and respiratory disease. However, less is known about the influence of PM2·5 on neurological disorders. We aimed to investigate the effect of long-term PM2·5 exposure on development of Parkinson's disease or Alzheimer's disease and related dementias. METHODS We did a longitudinal cohort study in which we constructed a population-based nationwide open cohort including all fee-for-service Medicare beneficiaries (aged ≥65 years) in the contiguous United States (2000-16) with no exclusions. We assigned PM2·5 postal code (ie, ZIP code) concentrations based on mean annual predictions from a high-resolution model. To accommodate our very large dataset, we applied Cox-equivalent Poisson models with parallel computing to estimate hazard ratios (HRs) for first hospital admission for Parkinson's disease or Alzheimer's disease and related dementias, adjusting for potential confounders in the health models. FINDINGS Between Jan 1, 2000, and Dec 31, 2016, of 63 038 019 individuals who were aged 65 years or older during the study period, we identified 1·0 million cases of Parkinson's disease and 3·4 million cases of Alzheimer's disease and related dementias based on primary and secondary diagnosis billing codes. For each 5 μg/m3 increase in annual PM2·5 concentrations, the HR was 1·13 (95% CI 1·12-1·14) for first hospital admission for Parkinson's disease and 1·13 (1·12-1·14) for first hospital admission for Alzheimer's disease and related dementias. For both outcomes, there was strong evidence of linearity at PM2·5 concentrations less than 16 μg/m3 (95th percentile of the PM2·5 distribution), followed by a plateaued association with increasingly larger confidence bands. INTERPRETATION We provide evidence that exposure to annual mean PM2·5 in the USA is significantly associated with an increased hazard of first hospital admission with Parkinson's disease and Alzheimer's disease and related dementias. For the ageing American population, improving air quality to reduce PM2·5 concentrations to less than current national standards could yield substantial health benefits by reducing the burden of neurological disorders. FUNDING The Health Effects Institute, The National Institute of Environmental Health Sciences, The National Institute on Aging, and the HERCULES Center.
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Affiliation(s)
- Liuhua Shi
- Department of Environmental Health, Harvard T H Chan School of Public Health, Boston, MA, USA; Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Xiao Wu
- Department of Biostatistics, Harvard T H Chan School of Public Health, Boston, MA, USA
| | - Mahdieh Danesh Yazdi
- Department of Environmental Health, Harvard T H Chan School of Public Health, Boston, MA, USA
| | - Danielle Braun
- Department of Biostatistics, Harvard T H Chan School of Public Health, Boston, MA, USA; Department of Data Sciences, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Yara Abu Awad
- Department of Psychology, Concordia University, Montreal, QC, Canada
| | - Yaguang Wei
- Department of Environmental Health, Harvard T H Chan School of Public Health, Boston, MA, USA
| | - Pengfei Liu
- School of Earth and Atmospheric Sciences, Georgia Institute of Technology, Atlanta, GA, USA
| | - Qian Di
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Yun Wang
- Department of Biostatistics, Harvard T H Chan School of Public Health, Boston, MA, USA
| | - Joel Schwartz
- Department of Environmental Health, Harvard T H Chan School of Public Health, Boston, MA, USA
| | - Francesca Dominici
- Department of Biostatistics, Harvard T H Chan School of Public Health, Boston, MA, USA
| | | | - Antonella Zanobetti
- Department of Environmental Health, Harvard T H Chan School of Public Health, Boston, MA, USA.
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29
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Cui Y, Chen G, Yang Z. Mitochondrial superoxide mediates PM 2.5-induced cytotoxicity in human pulmonary lymphatic endothelial cells. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2020; 263:114423. [PMID: 32222623 DOI: 10.1016/j.envpol.2020.114423] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Revised: 02/29/2020] [Accepted: 03/19/2020] [Indexed: 06/10/2023]
Abstract
Exposure to airborne fine particulate matter (PM2.5) is associated with a variety of respiratory health effects and contributes to premature mortality. Lymphatic vessels are instrumental in facilitating the transport of toxic materials away from the lung to maintain alveolar clearance and have been shown to play important roles in lung injury and repair. Despite intense research efforts in delineating the effects of PM2.5 on blood vascular endothelial cells, the impacts of PM2.5 on lymphatic endothelial cells (LECs), a specialized subset of endothelial cells that comprise lymphatic vessels, remain enigmatic. Here, we conducted MTT assay and show that treatment of human pulmonary LECs with PM2.5 suppresses cell viability in a time- and dose-dependent manner. We subsequently performed Annexin V/propidium iodide labeling and demonstrate that PM2.5 induces LECs apoptosis and necrosis. Furthermore, we found that manganese superoxide dismutase (SOD2) expression and mitochondrial SOD activity were profoundly reduced following PM2.5 exposure. Mechanistically, we provide compelling evidence that PM2.5 reduces SOD2 expression through activation of Akt pathway, which leads to a disruption of mitochondrial redox homeostasis characterized by increased accumulation of mitochondrial superoxide. Conversely, mitochondria-targeted SOD mimetic (MitoTEMPO) corrects the disturbed oxidative milieu in PM2.5-treated LECs. Additionally, MitoTEMPO ameliorates the deleterious impacts of PM2.5 on mitochondrial DNA integrity and preserves the viability of LECs. Taken together, these novel data support a critical role for mitochondrial superoxide in the pathogenesis of PM2.5-induced LECs injury and identity mitochondrial-targeted antioxidants as promising therapeutic options to treat environmental lung diseases. Our findings are limited to experimental studies with primary LECs, and future investigations in animal models are warranted to shed light on the precise pathophysiology of lymphatic system in response to PM exposure.
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Affiliation(s)
- Ye Cui
- Department of Immunology, School of Basic Medical Sciences, Capital Medical University, Beijing 100069, People's Republic of China.
| | - Guang Chen
- Interventional Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, People's Republic of China
| | - Zeran Yang
- Interventional Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, People's Republic of China
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