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Larsen PP, Féart C, Pais de Barros JP, Gayraud L, Delyfer MN, Korobelnik JF, Schweitzer C, Delcourt C. Association of Lipopolysaccharide-Type Endotoxins with Retinal Neurodegeneration: The Alienor Study. OPHTHALMOLOGY SCIENCE 2025; 5:100610. [PMID: 39386054 PMCID: PMC11462263 DOI: 10.1016/j.xops.2024.100610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/28/2024] [Revised: 08/20/2024] [Accepted: 08/21/2024] [Indexed: 10/12/2024]
Abstract
Purpose Lipopolysaccharide (LPS)-type endotoxins are naturally found in the gut microbiota and there is emerging evidence linking gut microbiota and neuroinflammation leading to retinal neurodegeneration. Thinning of the retinal nerve fiber layer (RNFL) is a biomarker of retinal neurodegeneration, and a hallmark of glaucoma, the second leading cause of blindness worldwide. We assessed the association of a blood biomarker of LPS with peripapillary RNFL thickness (RNFLT) and its longitudinal evolution up to 11 years. Design The Alienor study is a single center prospective population-based cohort study. Subjects The studied sample of this study includes 1062 eyes of 548 participants receiving ≥1 gradable RNFL measurement. Methods Plasma esterified 3-hydroxy fatty acids (3-OH FAs) were measured as a proxy of LPS burden. Retinal nerve fiber layer thickness was acquired using spectral-domain OCT imaging every 2 years from 2009 to 2020 (up to 5 visits). Main Outcome Measures Associations of plasma esterified 3-OH FAs with RNFLT were assessed using linear mixed models. Results Mean age of the included 548 participants was 82.4 ± 4.3 years and 62.6% were women. Higher plasma esterified 3-OH FAs was significantly associated with thinner RNFLT at baseline (coefficient beta = -1.42 microns for 1 standard deviation-increase in 3-OH FAs, 95% confidence interval [-2.56; -0.28], P = 0.02). This association remained stable after multivariate adjustment for potential confounders. No statistically significant association was found between 3-OH FAs and longitudinal RNFLT change. Conclusions Higher plasma esterified 3-OH FAs were associated with thinner RNFLT at baseline, indicating an involvement of LPS in the early processes of optic nerve neurodegeneration and highlighting the potential importance of the human microbiota in preserving retinal health. Financial Disclosures Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
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Affiliation(s)
- Petra P. Larsen
- University of Bordeaux, INSERM, BPH, U1219, F-33000 Bordeaux, France
| | - Catherine Féart
- University of Bordeaux, INSERM, BPH, U1219, F-33000 Bordeaux, France
| | | | - Laure Gayraud
- University of Bordeaux, INSERM, BPH, U1219, F-33000 Bordeaux, France
| | - Marie-Noëlle Delyfer
- University of Bordeaux, INSERM, BPH, U1219, F-33000 Bordeaux, France
- CHU de Bordeaux, Service d’Ophtalmologie, F-33000, Bordeaux, France
| | - Jean-François Korobelnik
- University of Bordeaux, INSERM, BPH, U1219, F-33000 Bordeaux, France
- CHU de Bordeaux, Service d’Ophtalmologie, F-33000, Bordeaux, France
| | - Cédric Schweitzer
- University of Bordeaux, INSERM, BPH, U1219, F-33000 Bordeaux, France
- CHU de Bordeaux, Service d’Ophtalmologie, F-33000, Bordeaux, France
| | - Cécile Delcourt
- University of Bordeaux, INSERM, BPH, U1219, F-33000 Bordeaux, France
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Sakaniwa R, Shirai K, Cador D, Saito T, Kondo K, Kawachi I, Steptoe A, Iso H. Socioeconomic Status Transition Throughout Life and Risk of Dementia. JAMA Netw Open 2024; 7:e2412303. [PMID: 38771573 PMCID: PMC11109776 DOI: 10.1001/jamanetworkopen.2024.12303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Accepted: 03/19/2024] [Indexed: 05/22/2024] Open
Abstract
Importance Socioeconomic status (SES) is associated with dementia. However, the role of SES transitions in dementia is less explored; such evidence would be useful to understand whether social mobility is associated with healthy longevity at older ages. Objective To investigate the association of lifetime SES transition with risk of dementia. Design, Setting, and Participants This prospective cohort study, conducted from August 2010 to December 2016, used data from the Japan Gerontological Evaluation Study for participants aged 65 years or older from 31 different areas in Japan. Individuals with missing SES values, loss of follow-up, or new dementia onset 1 year or less from baseline were excluded. Data analysis was performed from April 2022 to April 2023. Exposure Transitions in SES across the life course. Main Outcomes and Measures The main outcome was risk of dementia incidence and corresponding loss or gain of dementia-free periods in a lifespan. The incidence of dementia was identified with a national registry of long-term nursing care services. Results A total of 9186 participants (4703 men [51.2%]) were included. The mean (SD) age at baseline was 74.2 (6.0) years. Six SES transitions were identified: upward, stable-high, upper-middle, lower-middle, downward, and stable-low. During the follow-up period, 800 cases of dementia were identified. Many dementia risk factors, including lifestyle behaviors, comorbidities, and social factors, were associated with SES transition patterns. Compared with lower-middle SES, the lowest risk of dementia was observed for upward transition (hazard ratio [HR], 0.66; 95% CI, 0.57-0.74) followed by stable-high (HR, 0.77; 95% CI, 0.69-0.86), downward (HR, 1.15; 95% CI, 1.09-1.23), and stable-low (HR 1.45; 95% CI, 1.31-1.61) transition (P < .001 for linearity); there was no association of upper-middle transition with risk of dementia (HR, 0.91; 95% CI, 0.79-1.03). The greatest increases in dementia-free years in the lifespan were also associated with upward SES transition (eg, 1.8 years [95% CI, 1.4-2.2 years] at age 65 years), while the downward transition was associated with the largest loss in lifetime dementia-free years at 75 years or older (eg, -1.4 years [95% CI, -2.4 to -0.4 years] at age 85 years). Conclusions and Relevance This cohort study of Japanese older adults identified that upward and downward SES transitions were associated with risk of dementia and the length of dementia-free periods over the lifespan. The results may be useful to understand the association between social mobility and healthy longevity.
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Affiliation(s)
- Ryoto Sakaniwa
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Kokoro Shirai
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
- Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
- Department of Behavioural Science and Health, University College London, London, United Kingdom
| | - Dorina Cador
- Department of Behavioural Science and Health, University College London, London, United Kingdom
- Centre for Dementia Studies, Department of Clinical Neuroscience, Brighton and Sussex Medical School, University of Sussex, Brighton, United Kingdom
| | - Tami Saito
- Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Aichi, Japan
| | - Katsunori Kondo
- Center for Preventive Medical Sciences, Chiba University, Chiba, Japan
| | - Ichiro Kawachi
- Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
| | - Andrew Steptoe
- Department of Behavioural Science and Health, University College London, London, United Kingdom
| | - Hiroyasu Iso
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
- Institute for Global Health Policy Research, Bureau of International Health Cooperation, National Center for Global Health and Medicine, Tokyo, Japan
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Sol K, Morris EP, Lee JH, Zaheed AB, Palms JD, Scambray K, Clarke P, Zahodne LB. Histories of neighborhood socioeconomic status contribute to race differences in later-life cognition. Alzheimers Dement 2024; 20:3342-3351. [PMID: 38552138 PMCID: PMC11095476 DOI: 10.1002/alz.13786] [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: 09/07/2023] [Revised: 02/09/2024] [Accepted: 02/13/2024] [Indexed: 05/16/2024]
Abstract
INTRODUCTION Neighborhood characteristics are increasingly implicated in cognitive health disparities, but no research has investigated how the historical context of neighborhoods shapes these disparities. METHODS Four hundred sixty-four Black (55%) and White older adults (Mage = 63.6) were drawn from the Michigan Cognitive Aging Project, a community-based, prospective study of older adults. Participants' addresses at baseline (2017-2020) were geocoded and linked to 2000-2017 measures of neighborhood socioeconomic status (NSES): disadvantage [NDis] and affluence [NAff]. Latent class growth analysis (LCGA) characterized 18 interpolated year trajectories of NSES across 1344 census tracts. Path analysis examined whether NSES trajectory classes mediated the association between race and a global cognition composite. RESULTS LCGA identified three NDis and two NAff trajectory classes, which were associated with participant race. Only one NDis class was associated with cognition, and it mediated the association between the Black race and cognition. DISCUSSION Disinvestment in neighborhoods may be particularly salient in race disparities in cognitive function. HIGHLIGHTS Race is implicated in the likelihood of living in more disadvantaged neighborhoods. Historical trends in neighborhood disadvantage are associated with cognitive function in older adulthood. Identifying patterns of neighborhood change may inform neighborhood-level interventions.
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Affiliation(s)
- Ketlyne Sol
- Social Environment and Health Program, Institute for Social ResearchUniversity of MichiganAnn ArborMichiganUSA
| | - Emily P. Morris
- Department of PsychologyUniversity of MichiganAnn ArborMichiganUSA
| | - Ji Hyun Lee
- Department of PsychologyUniversity of MichiganAnn ArborMichiganUSA
| | - Afsara B. Zaheed
- Department of PsychologyUniversity of MichiganAnn ArborMichiganUSA
| | - Jordan D. Palms
- Department of PsychologyUniversity of MichiganAnn ArborMichiganUSA
| | - Kiana Scambray
- Department of PsychologyUniversity of MichiganAnn ArborMichiganUSA
| | - Philippa Clarke
- Social Environment and Health Program, Institute for Social ResearchUniversity of MichiganAnn ArborMichiganUSA
| | - Laura B. Zahodne
- Department of PsychologyUniversity of MichiganAnn ArborMichiganUSA
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Gayraud L, Mortamais M, Schweitzer C, de Hoogh K, Cougnard-Grégoire A, Korobelnik JF, Delyfer MN, Rougier MB, Leffondré K, Helmer C, Vienneau D, Berr C, Delcourt C. Association of long-term exposure to ambient air pollution with retinal neurodegeneration: The prospective alienor study. ENVIRONMENTAL RESEARCH 2023:116364. [PMID: 37301495 DOI: 10.1016/j.envres.2023.116364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 05/23/2023] [Accepted: 06/07/2023] [Indexed: 06/12/2023]
Abstract
Chronic exposure to air pollution may have adverse effects on neurodegenerative diseases. Glaucoma, the second leading cause of blindness worldwide, is a neurodegenerative disease of the optic nerve, characterized by progressive thinning of the retinal nerve fiber layer (RNFL). We investigated the relationship of air pollution exposure with longitudinal changes of RNFL thickness in the Alienor study, a population-based cohort of residents of Bordeaux, France, aged 75 years or more. Peripapillary RNFL thickness was measured using optical coherence tomography imaging every 2 years from 2009 to 2020. Measurements were acquired and reviewed by specially trained technicians to control quality. Air pollution exposure (particulate matter ≤2.5 μm (PM2.5), black carbon (BC), nitrogen dioxide (NO2)) was estimated at the participants' geocoded residential address using land-use regression models. For each pollutant, the 10-year average of past exposure at first RNFL thickness measurement was estimated. Associations of air pollution exposure with RNFL thickness longitudinal changes were assessed using linear mixed models adjusted for potential confounders, allowing for intra-eye and intra-individual correlation (repeated measurements). The study included 683 participants with at least one RNFL thickness measurement (62% female, mean age 82 years). The average RNFL was 90 μm (SD:14.4) at baseline. Exposure to higher levels of PM2.5 and BC in the previous 10 years was significantly associated with a faster RNFL thinning during the 11-year follow-up (-0.28 μm/year (95% confidence interval (CI) [-0.44;-0.13]) and -0.26 μm/year (95% CI [-0.40;-0.12]) per interquartile range increment; p < 0.001 for both). The size of the effect was similar to one year of age in the fitted model (-0.36 μm/year). No statistically significant associations were found with NO2 in the main models. This study evidenced a strong association of chronic exposure to fine particulate matter with retinal neurodegeneration, at air pollution levels below the current recommended thresholds in Europe.
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Affiliation(s)
- Laure Gayraud
- Univ. Bordeaux, Inserm, Bordeaux Population Health Research Center, UMR, 1219, F-33000, Bordeaux, France
| | - Marion Mortamais
- Univ. Montpellier, Inserm, Institute for Neurosciences of Montpellier INM, UMR, 1298, 34091, Montpellier, France
| | - Cédric Schweitzer
- Univ. Bordeaux, Inserm, Bordeaux Population Health Research Center, UMR, 1219, F-33000, Bordeaux, France; Centre Hospitalier Universitaire de Bordeaux, Service d'Ophtalmologie, Bordeaux, France
| | - Kees de Hoogh
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
| | - Audrey Cougnard-Grégoire
- Univ. Bordeaux, Inserm, Bordeaux Population Health Research Center, UMR, 1219, F-33000, Bordeaux, France
| | - Jean-François Korobelnik
- Univ. Bordeaux, Inserm, Bordeaux Population Health Research Center, UMR, 1219, F-33000, Bordeaux, France; Centre Hospitalier Universitaire de Bordeaux, Service d'Ophtalmologie, Bordeaux, France
| | - Marie-Noelle Delyfer
- Univ. Bordeaux, Inserm, Bordeaux Population Health Research Center, UMR, 1219, F-33000, Bordeaux, France; Centre Hospitalier Universitaire de Bordeaux, Service d'Ophtalmologie, Bordeaux, France
| | - Marie-Bénédicte Rougier
- Univ. Bordeaux, Inserm, Bordeaux Population Health Research Center, UMR, 1219, F-33000, Bordeaux, France; Centre Hospitalier Universitaire de Bordeaux, Service d'Ophtalmologie, Bordeaux, France
| | - Karen Leffondré
- Univ. Bordeaux, Inserm, Bordeaux Population Health Research Center, UMR, 1219, F-33000, Bordeaux, France
| | - Catherine Helmer
- Univ. Bordeaux, Inserm, Bordeaux Population Health Research Center, UMR, 1219, F-33000, Bordeaux, France
| | - Danielle Vienneau
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
| | - Claudine Berr
- Univ. Montpellier, Inserm, Institute for Neurosciences of Montpellier INM, UMR, 1298, 34091, Montpellier, France
| | - Cécile Delcourt
- Univ. Bordeaux, Inserm, Bordeaux Population Health Research Center, UMR, 1219, F-33000, Bordeaux, France.
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Cornelis MC, Agarwal P, Holland TM, van Dam RM. MIND Dietary Pattern and Its Association with Cognition and Incident Dementia in the UK Biobank. Nutrients 2022; 15:nu15010032. [PMID: 36615690 PMCID: PMC9823700 DOI: 10.3390/nu15010032] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 12/13/2022] [Accepted: 12/19/2022] [Indexed: 12/24/2022] Open
Abstract
A high adherence to the Mediterranean-Dietary Approaches to Stop Hypertension Diet Intervention for Neurodegenerative Delay (MIND) has been associated with better cognition and a lower risk of dementia in some but not all studies. We measured adherence to MIND and its association with cognitive health in the UK Biobank (UKB). A MIND score was derived from 24 h diet recall questionnaires for 120,661 participants who completed at least one of seven self-administered cognitive function tests. In a subset of 78,663 participants aged 55+, diagnosis of dementia was determined by linked hospital and death records. Multivariable regression and Cox proportional hazard ratio (HR) models were used to examine associations of MIND with cognitive ability and incident dementia. Higher adherence to MIND was associated with a small but significant worsening in performance on five of seven cognitive tests (p < 0.002). Associations were strongest among highly educated participants (p < 0.002 for MIND × education interaction). After a mean follow-up time of 10.5 years, 842 participants developed dementia. Overall, MIND adherence was not associated with incident dementia. An inverse association was observed among females (HR = 0.87 per score standard deviation (SD), p = 0.008) but not males (HR = 1.09, p = 0.11) (p = 0.008 for MIND × sex interaction). Similar associations with cognitive ability and dementia were observed for the Alternative Healthy Eating Index-2010 (AHEI-2010) dietary pattern. Associations were not modified by genetic susceptibility. In UKB, the MIND diet was not associated with better cognitive test scores and only with lower dementia risk in women.
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Affiliation(s)
- Marilyn C. Cornelis
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA
- Correspondence:
| | - Puja Agarwal
- Department of Internal Medicine, Rush University Medical Center, Chicago, IL 60612, USA
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, IL 60612, USA
| | - Thomas M. Holland
- Department of Internal Medicine, Rush University Medical Center, Chicago, IL 60612, USA
- Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, IL 60612, USA
| | - Rob M. van Dam
- Department of Exercise and Nutrition Sciences, Milken Institute School of Public Health, The George Washington University, Washington, DC 20052, USA
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Letellier N, Gutierrez LA, Duchesne J, Chen C, Ilango S, Helmer C, Berr C, Mortamais M, Benmarhnia T. Air quality improvement and incident dementia: Effects of observed and hypothetical reductions in air pollutant using parametric g-computation. Alzheimers Dement 2022; 18:2509-2517. [PMID: 35142029 DOI: 10.1002/alz.12606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 11/23/2021] [Accepted: 01/03/2022] [Indexed: 01/31/2023]
Abstract
INTRODUCTION No evidence exists about the impact of air pollution reduction on incidence of dementia. The aim of this study was to quantify how air quality improvement leads to dementia-incidence benefits. METHODS In the French Three-City cohort (12 years of follow-up), we used parametric g-computation to quantify the expected number of prevented dementia cases under different hypothetical interventions with particulate matter measuring <2.5 μm (PM2.5 ) reductions. RESULTS Among 7051 participants, 789 participants developed dementia. The median PM2.5 reduction between 1990 and 2000 was 12.2 (μg/m3 ). Such a reduction reduced the risk of all-cause dementia (hazard ratio [HR], 0.85; 95% confidence interval [CI], 0.76 to 0.95). If all study participants were enjoying a hypothetical reduction of more than 13.10 μg/m3 (median reduction observed in the city of Montpellier), the rate difference was -0.37 (95% CI, -0.57 to -0.17) and the rate ratio was 0.67 (95% CI, 0.50 to 0.84). DISCUSSION These findings highlight the possible substantial benefits of reducing air pollution in the prevention of dementia.
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Affiliation(s)
- Noémie Letellier
- Herbert Wertheim School of Public Health and Human Longevity Science & Scripps Institution of Oceanography, UC San Diego, San Diego, California, USA
| | - Laure-Anne Gutierrez
- Institute for Neurosciences of Montpellier INM, Univ Montpellier, INSERM, Montpellier, France
| | - Jeanne Duchesne
- Institute for Neurosciences of Montpellier INM, Univ Montpellier, INSERM, Montpellier, France
| | - Chen Chen
- Herbert Wertheim School of Public Health and Human Longevity Science & Scripps Institution of Oceanography, UC San Diego, San Diego, California, USA
| | - Sindana Ilango
- Department of Epidemiology, University of Washington School of Public Health, Seattle, USA
| | - Catherine Helmer
- Bordeaux Population Health Research Center, Université de Bordeaux, INSERM, UMR 1219, Bordeaux, France
| | - Claudine Berr
- Institute for Neurosciences of Montpellier INM, Univ Montpellier, INSERM, Montpellier, France.,Memory Research and Resources Center, Department of Neurology, Montpellier University Hospital Gui de Chauliac, Montpellier, France
| | - Marion Mortamais
- Institute for Neurosciences of Montpellier INM, Univ Montpellier, INSERM, Montpellier, France
| | - Tarik Benmarhnia
- Herbert Wertheim School of Public Health and Human Longevity Science & Scripps Institution of Oceanography, UC San Diego, San Diego, California, USA
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Santos CJ, Paciência I, Ribeiro AI. Neighbourhood Socioeconomic Processes and Dynamics and Healthy Ageing: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19116745. [PMID: 35682327 PMCID: PMC9180257 DOI: 10.3390/ijerph19116745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 05/26/2022] [Accepted: 05/30/2022] [Indexed: 02/05/2023]
Abstract
Elderly citizens are concentrated in urban areas and are particularly affected by the immediate residential environment. Cities are unequal and segregated places, where there is an intensification of urban change processes such as gentrification and displacement. We aimed to understand how neighbourhood socioeconomic processes and dynamics influence older people’s health. Three bibliographic databases—PubMed, Web of Science, and Scopus—were used to identify evidence of the influence of neighbourhood socioeconomic deprivation, socio-spatial segregation, urban renewal, and gentrification on healthy ageing. We followed the method of Arksey and O’Malley, Levac and colleagues, the Joanna Briggs Institute, and the PRISMA-ScR. The included studies (n = 122) were published between 2001 and 2021. Most evaluated neighbourhood deprivation (n = 114), followed by gentrification (n = 5), segregation (n = 2), and urban renewal (n = 1). Overall, older people living in deprived neighbourhoods had worse healthy ageing outcomes than their counterparts living in more advantaged neighbourhoods. Older adults pointed out more negative comments than positive ones for gentrification and urban renewal. As to segregation, the direction of the association was not entirely clear. In conclusion, the literature has not extensively analysed the effects of segregation, gentrification, and urban renewal on healthy ageing, and more quantitative and longitudinal studies should be conducted to draw better inferences.
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Affiliation(s)
- Cláudia Jardim Santos
- EPIUnit-Instituto de Saúde Pública, Universidade do Porto, 4050-600 Porto, Portugal;
- Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), 4050-600 Porto, Portugal
- Correspondence: ; Tel.: +351-222-061-820
| | - Inês Paciência
- Center for Environmental and Respiratory Health Research (CERH), University of Oulu, P.O. Box 5000, 90570 Oulu, Finland;
- Biocenter Oulu, University of Oulu, P.O. Box 5000, 90570 Oulu, Finland
| | - Ana Isabel Ribeiro
- EPIUnit-Instituto de Saúde Pública, Universidade do Porto, 4050-600 Porto, Portugal;
- Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), 4050-600 Porto, Portugal
- Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina, Universidade do Porto, 4200-319 Porto, Portugal
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Wong R, Wang Y. Role of Neighborhood Physical Disorder and Social Cohesion on Racial and Ethnic Disparities in Dementia Risk. J Aging Health 2022; 34:1178-1187. [PMID: 35580113 DOI: 10.1177/08982643221101352] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objectives: To analyze how neighborhood physical disorder and social cohesion are associated with racial and ethnic disparities in dementia risk. Methods: Nine years of data (2011-2019) were retrieved from the National Health and Aging Trends Study, a nationally representative U.S. older adult (age 65+) sample. Cox regression analyzed time to dementia diagnosis using composite scores for neighborhood physical disorder and social cohesion. Results: Higher baseline neighborhood physical disorder (Adjusted Hazard Ratio [aHR]=1.11, 95% Confidence Interval [CI]=1.01-1.23) and increased disorder at follow-up (aHR=1.10, 95% CI=1.01-1.19) significantly increased dementia risk. Hispanic older adults with higher physical disorder at baseline (aHR=0.62, 95% CI=0.49-0.79) and follow-up (aHR=0.81, 95% CI=0.67-0.98) had a significantly decreased dementia risk. There were no significant associations for social cohesion. Discussion: Physical but not social neighborhood characteristics are associated with dementia risk. Future research is needed to understand protective mechanisms for dementia among Hispanic older adults in neighborhoods with high physical disorder.
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Affiliation(s)
- Roger Wong
- Department of Public Health and Preventive Medicine, Norton College of Medicine, SUNY Upstate Medical University, Syracuse, NY, USA
| | - Yi Wang
- School of Social Work, University of Iowa, Iowa City, IA, USA
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Holm E, Jacobsen KK, de Lony TB, Lembeck M, Pedersen H, Andersson C, Johannsen P, Jørgensen TSH, Torp‐Pedersen C. Frequency of missed or delayed diagnosis in dementia is associated with neighborhood socioeconomic status. ALZHEIMER'S & DEMENTIA (NEW YORK, N. Y.) 2022; 8:e12271. [PMID: 35356741 PMCID: PMC8943602 DOI: 10.1002/trc2.12271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/21/2021] [Revised: 01/18/2022] [Accepted: 01/23/2022] [Indexed: 11/12/2022]
Abstract
Introduction Underdetection of dementia in areas with low socioeconomic status (SES) may interfere with findings concerning associations between SES and dementia. Methods Using administrative registers we assessed the associations between age- and sex-adjusted dementia incidence and neighborhood socioeconomic status (nSES) in 94 Danish municipalities. Wealth was divided into income quartiles and other nSES variables were dichotomized into high versus low according to the median. Results High population density (odds ratio [OR] 1.21, 95% confidence interval [CI] 1.18-1.24), higher proportion of inhabitants in higher income quartiles (P for trend < .0001), and high educational level (OR 1.19, 95% CI 1.15-1.22) were associated with higher incidence of dementia. High proportion of residents above 65 years was associated with lower age-adjusted dementia incidence (OR 0.86, 95% CI 0.84-0.89). Discussion Low nSES municipalities have a lower age-adjusted incidence of dementia diagnosis. These findings corroborate prior concerns that a large number of dementia diagnoses may be missed in municipalities characterized by low SES.
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Affiliation(s)
- Ellen Holm
- Department of Internal MedicineUniversity Hospital ZealandKøgeDenmark
- Department of Clinical MedicineUniversity of CopenhagenCopenhagenDenmark
| | - Katja Kemp Jacobsen
- Department of TechnologyFaculty of Health and TechnologyUniversity College CopenhagenCopenhagenDenmark
| | - Thea Bang de Lony
- Geriatric SectionDepartment of Internal MedicineNykøbing Falster HospitalNykøbing FalsterDenmark
| | - Maurice Lembeck
- Geriatric SectionDepartment of Internal MedicineNykøbing Falster HospitalNykøbing FalsterDenmark
| | - Hanne Pedersen
- Geriatric SectionDepartment of Internal Medicine in GlostrupAmager Hvidovre HospitalGlostrupDenmark
| | - Charlotte Andersson
- Department of MedicineSection of Cardiovascular MedicineBoston University Medical CenterBostonMassachusettsUSA
| | - Peter Johannsen
- International Medical Vice President, Medical & ScienceClinical Drug DevelopmentNovo NordiskCopenhagenDenmark
| | | | - Christian Torp‐Pedersen
- Department of Cardiology and Clinical ResearchNordsjaellands HospitalHillerødDenmark
- Department of Public HealthUniversity of CopenhagenCopenhagenDenmark
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Duchesne J, Gutierrez LA, Carrière I, Mura T, Chen J, Vienneau D, de Hoogh K, Helmer C, Jacquemin B, Berr C, Mortamais M. Exposure to ambient air pollution and cognitive decline: Results of the prospective Three-City cohort study. ENVIRONMENT INTERNATIONAL 2022; 161:107118. [PMID: 35147081 DOI: 10.1016/j.envint.2022.107118] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Revised: 01/13/2022] [Accepted: 01/26/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Growing epidemiological evidence suggests an adverse relationship between exposure to air pollutants and cognitive decline. However, there is still some heterogeneity in the findings, with inconsistent results depending on the pollutant and the cognitive domain considered. We wanted to determine whether air pollution was associated with global and domain-specific cognitive decline. METHODS This analysis used data from the French Three-City prospective cohort (participants aged 65 and older at recruitment and followed for up to 12 years). A battery of cognitive tests was administered at baseline and every 2 years, to assess global cognition (Mini Mental State Examination, MMSE), visual memory (Benton Visual Retention Test), semantic fluency (Isaacs Set Test) and executive functions (Trail Making Tests A and B). Exposure to fine particulate matter (PM2.5), nitrogen dioxide (NO2) and black carbon (BC) at the participants' residential address during the 5 years before the baseline visit was estimated with land use regression models. Linear mixed models and latent process mixed models were used to assess the association of each pollutant with global and domain-specific cognitive decline. RESULTS The participants' (n = 6380) median age was 73.4 years (IQR: 8.0), and 61.5% were women. At baseline, the median MMSE score was 28 (IQR: 3). Global cognition decline, assessed with the MMSE, was slightly accelerated among participants with higher PM2.5 exposure: one IQR increment in PM2.5 (1.5 µg/m3) was associated with accelerated decline (β: -0.0060 [-0.0112; -0.0007] standard unit per year). Other associations were inconsistent in direction, and of small magnitude. CONCLUSION In this large population-based cohort, higher PM2.5 exposure was associated with accelerated global cognition decline. We did not detect any significant association for the specific cognitive domains or the other pollutants. Evidence concerning PM2.5 effects on cognition is growing, but more research is needed on other ambient air pollutants.
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Affiliation(s)
- Jeanne Duchesne
- Institute for Neurosciences of Montpellier INM, Univ Montpellier, Inserm, Montpellier, France
| | - Laure-Anne Gutierrez
- Institute for Neurosciences of Montpellier INM, Univ Montpellier, Inserm, Montpellier, France
| | - Isabelle Carrière
- Institute for Neurosciences of Montpellier INM, Univ Montpellier, Inserm, Montpellier, France
| | - Thibault Mura
- Institute for Neurosciences of Montpellier INM, Univ Montpellier, Inserm, Montpellier, France
| | - Jie Chen
- Institute for Risk Assessment Sciences (IRAS), Utrecht University, 3584 CM Utrecht, the Netherlands
| | - Danielle Vienneau
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
| | - Kees de Hoogh
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
| | - Catherine Helmer
- INSERM, Univ Bordeaux, Bordeaux Population Health Research Center, UMR 1219, Bordeaux, France
| | - Bénédicte Jacquemin
- INSERM, Univ Rennes, EHESP, Irset Institut de Recherche en Santé, Environnement et Travail, UMR-S 1085, Rennes, France
| | - Claudine Berr
- Institute for Neurosciences of Montpellier INM, Univ Montpellier, Inserm, Montpellier, France.
| | - Marion Mortamais
- Institute for Neurosciences of Montpellier INM, Univ Montpellier, Inserm, Montpellier, France
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11
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Kreft D, Doblhammer G. Sex and Gender Differences in Environmental Influences on Dementia Incidence in Germany, 2014-2019: An Observational Cohort Study Based on Health Claims Data. J Alzheimers Dis 2022; 87:223-237. [PMID: 35275528 PMCID: PMC9198799 DOI: 10.3233/jad-215030] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/09/2022] [Indexed: 11/15/2022]
Abstract
BACKGROUND There is an ongoing debate about whether environmental characteristics influence dementia risk like individual traits do, and whether these differ by sex and gender. OBJECTIVE This study examines the influence of regional characteristics on the incidence of dementia and explores sex and gender differences using individual-level health information and regional characteristics. METHODS Using a random sample of 250,000 people aged 70 + insured through Germany's largest German public health agency, we analyzed quarterly data about diagnoses and place of residence from 2014 to 2019. Using five-digit postal codes, we added data on various dimensions of regional characteristics offered by the INKAR database and the 2011 Census database. We used multilevel survival regressions to tease out regional incidence differences while accounting for spatial clustering. RESULTS After adjusting for multi-morbidity and relocation-related selection bias, we saw that people living in regions with the highest tertile of income (HR = 0.87, p < 0.001), and who had the highest tertile of remaining life expectancy at age 60 (HR = 0.93, p = 0.012) had lower dementia risks. There was no gender difference in the regional income effect, but the effect of education (HR = 0.91, p = 0.015) was significant only for men and remaining life-expectancy was significant only for women (HR = 0.93, p = 0.026). CONCLUSION Environmental characteristics related to wealth and health resources of a region influence the risk of dementia among the elderly in Germany. This effect is independent of the health profiles of the individuals and differs between the two genders. Health policies need to acknowledge these modifiable risk factors and consider how they affect men and women differently.
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Affiliation(s)
- Daniel Kreft
- Institute for Sociology and Demography, University of Rostock, Rostock, Germany
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
| | - Gabriele Doblhammer
- Institute for Sociology and Demography, University of Rostock, Rostock, Germany
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
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12
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Zhao YL, Qu Y, Ou YN, Zhang YR, Tan L, Yu JT. Environmental factors and risks of cognitive impairment and dementia: A systematic review and meta-analysis. Ageing Res Rev 2021; 72:101504. [PMID: 34755643 DOI: 10.1016/j.arr.2021.101504] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 10/22/2021] [Accepted: 10/26/2021] [Indexed: 01/10/2023]
Abstract
BACKGROUND Dementia is a challenging neurodegenerative disease. This systematic review aimed to summarize natural, physical, and social environmental factors that are associated with age-related cognitive impairment and dementia. METHODS We systematically searched PubMed, EMBASE, Web of Science, and PsychINFO till January 11, 2021 for observational studies. The hazard ratio (HR), relative risk (RR), and odds ratio (OR) with 95% confidence interval (CI) were aggregated using random-effects methods. The quality of evidence for each association was evaluated. RESULTS Of the 48,399 publications identified, there were 185 suitable for review across 44 environmental factors. Meta-analyses were performed for 22 factors. With high-to-moderate quality of evidence, risks were suggested in exposure to PM2.5 (HR=1.24, 95%CI: 1.17-1.31), NO2 (HR=1.07, 95%CI: 1.02-1.12), aluminum (OR=1.35, 95%CI: 1.14-1.59), solvents (OR=1.14, 95%CI: 1.07-1.22), road proximity (OR=1.08, 95%CI: 1.04-1.12) and other air pollutions, yet more frequent social contact (HR=0.82, 95%CI: 0.76-0.90) and more greenness (OR=0.97, 95%CI: 0.95-0.995) were protective. With low-to-very low quality, electromagnetic fields, pesticides, SO2, neighborhood socioeconomic status, and rural living were suggested risks, but more community cultural engagement might be protective. No significant associations were observed in exposure to PM10, NOx, noise, silicon, community group, and temperature. For the remaining 22 factors, only a descriptive analysis was undertaken as too few studies or lack of information. CONCLUSIONS This review highlights that air pollutions, especially PM2.5 and NO2 play important role in the risk for age-related cognitive impairment and dementia.
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13
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Letellier N, Ilango SD, Mortamais M, Tzourio C, Gabelle A, Empana JP, Samieri C, Berr C, Benmarhnia T. Socioeconomic inequalities in dementia risk among a French population-based cohort: quantifying the role of cardiovascular health and vascular events. Eur J Epidemiol 2021; 36:1015-1023. [PMID: 34308532 PMCID: PMC8542549 DOI: 10.1007/s10654-021-00788-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Accepted: 07/08/2021] [Indexed: 12/29/2022]
Abstract
This study aimed to investigate the role of cardiovascular health (CVH) and vascular events as potential contributors to socioeconomic inequalities in dementia using causal mediation analyses. We used data from the Three-City Cohort, a French population-based study with 12 years of follow-up, with active search of dementia cases and validated diagnosis. Individual socioeconomic status was assessed using education, occupation and income. A CVH score as defined by the American Heart Association and incident vascular events were considered separately as mediators. We performed multi-level Cox proportional and Aalen additive hazard regression models to estimate the total effects of socioeconomic status on dementia risk. To estimate natural direct and indirect effects through CVH and vascular events, we applied two distinct weighting methods to quantify the role of CVH and vascular events: Inverse Odds Ratio Weighting (IORW) and Marginal Structural Models (MSM) respectively. Among 5581 participants, the risk of dementia was higher among participants with primary education (HR 1.60, 95%CI 1.44–1.78), blue-collar workers (HR 1.62, 95%CI 1.43–1.84) and with lower income (HR 1.23, 95%CI 1.09–1.29). Using additive models, 571 (95% CI 288–782) and 634 (95% CI 246–1020) additional cases of dementia per 100 000 person and year were estimated for primary education and blue-collar occupation, respectively. Using IORW, the CVH score mediate the relationship between education or income, and dementia (proportion mediated 17% and 26%, respectively). Yet, considering vascular events as mediator, MSM generated indirect effects that were smaller and more imprecise. Socioeconomic inequalities in dementia risk were observed but marginally explained by CVH or vascular events mediators.
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Affiliation(s)
- Noémie Letellier
- Institute for Neurosciences of Montpellier INM, Univ Montpellier, INSERM, Montpellier, France.
| | - Sindana D Ilango
- School of Public Health, San Diego State University, San Diego, CA, USA
- Herbert Wertheim School of Public Health, University of California San Diego, La Jolla, CA, USA
| | - Marion Mortamais
- Institute for Neurosciences of Montpellier INM, Univ Montpellier, INSERM, Montpellier, France
| | - Christophe Tzourio
- Université de Bordeaux, INSERM, Bordeaux Population Health Research Center, UMR 1219, Bordeaux, France
| | - Audrey Gabelle
- Institute for Neurosciences of Montpellier INM, Univ Montpellier, INSERM, Montpellier, France
- Memory Research and Resources Center, Department of Neurology, Montpellier University Hospital Gui de Chauliac, Montpellier, France
| | - Jean-Philippe Empana
- Université de Paris, INSERM U970, Paris Cardiovascular Research Center, Paris, France
| | - Cécilia Samieri
- Université de Bordeaux, INSERM, Bordeaux Population Health Research Center, UMR 1219, Bordeaux, France
| | - Claudine Berr
- Institute for Neurosciences of Montpellier INM, Univ Montpellier, INSERM, Montpellier, France
- Memory Research and Resources Center, Department of Neurology, Montpellier University Hospital Gui de Chauliac, Montpellier, France
| | - Tarik Benmarhnia
- Herbert Wertheim School of Public Health, University of California San Diego, La Jolla, CA, USA
- Scripps Institution of Oceanography, University of California, San Diego, La Jolla, CA, USA
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Peterson RL, George KM, Tran D, Malladi P, Gilsanz P, Kind AJH, Whitmer RA, Besser LM, Meyer OL. Operationalizing Social Environments in Cognitive Aging and Dementia Research: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:7166. [PMID: 34281103 PMCID: PMC8296955 DOI: 10.3390/ijerph18137166] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Revised: 06/29/2021] [Accepted: 06/30/2021] [Indexed: 12/29/2022]
Abstract
BACKGROUND Social environments are a contributing determinant of health and disparities. This scoping review details how social environments have been operationalized in observational studies of cognitive aging and dementia. METHODS A systematic search in PubMed and Web of Science identified studies of social environment exposures and late-life cognition/dementia outcomes. Data were extracted on (1) study design; (2) population; (3) social environment(s); (4) cognitive outcome(s); (5) analytic approach; and (6) theorized causal pathways. Studies were organized using a 3-tiered social ecological model at interpersonal, community, or policy levels. RESULTS Of 7802 non-duplicated articles, 123 studies met inclusion criteria. Eighty-four studies were longitudinal (range 1-28 years) and 16 examined time-varying social environments. When sorted into social ecological levels, 91 studies examined the interpersonal level; 37 examined the community/neighborhood level; 3 examined policy level social environments; and 7 studies examined more than one level. CONCLUSIONS Most studies of social environments and cognitive aging and dementia examined interpersonal factors measured at a single point in time. Few assessed time-varying social environmental factors or considered multiple social ecological levels. Future studies can help clarify opportunities for intervention by delineating if, when, and how social environments shape late-life cognitive aging and dementia outcomes.
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Affiliation(s)
- Rachel L. Peterson
- Department of Neurology, University of California Davis, Sacramento, CA 95817, USA; (K.M.G.); (O.L.M.)
| | - Kristen M. George
- Department of Neurology, University of California Davis, Sacramento, CA 95817, USA; (K.M.G.); (O.L.M.)
| | - Duyen Tran
- Department of Psychology, University of California Davis, Davis, CA 95616, USA;
| | - Pallavi Malladi
- Department of Physiology and Membrane Biology, University of California Davis, Davis, CA 95616, USA;
| | - Paola Gilsanz
- Kaiser Permanente Northern California Division of Research, Oakland, CA 94612, USA;
| | - Amy J. H. Kind
- Center for Health Disparities Research, University of Wisconsin School of Medicine and Public Health, Madison, WI 53726, USA;
- Health Services and Care Research Program, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI 53726, USA
- Department of Medicine, Division of Geriatrics and Gerontology, University of Wisconsin School of Medicine and Public Health, Madison, WI 53726, USA
- Geriatrics Research Education and Clinical Center, Department of Veterans Affairs, Madison, WI 53726, USA
| | - Rachel A. Whitmer
- Public Health Sciences, Division of Epidemiology, University of California Davis, Davis, CA 95616, USA;
- Alzheimer’s Disease Research Center, University of California Davis, Sacramento, CA 95817, USA
| | - Lilah M. Besser
- Department of Urban and Regional Planning, Florida Atlantic University, Boca Raton, FL 33431, USA;
| | - Oanh L. Meyer
- Department of Neurology, University of California Davis, Sacramento, CA 95817, USA; (K.M.G.); (O.L.M.)
- Alzheimer’s Disease Research Center, University of California Davis, Sacramento, CA 95817, USA
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15
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Gong J, Harris K, Peters SAE, Woodward M. Sex differences in the association between major cardiovascular risk factors in midlife and dementia: a cohort study using data from the UK Biobank. BMC Med 2021; 19:110. [PMID: 34006267 PMCID: PMC8132382 DOI: 10.1186/s12916-021-01980-z] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2021] [Accepted: 04/07/2021] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Sex differences in major cardiovascular risk factors for incident (fatal or non-fatal) all-cause dementia were assessed in the UK Biobank. The effects of these risk factors on all-cause dementia were explored by age and socioeconomic status (SES). METHODS Cox proportional hazards models were used to estimate hazard ratios (HRs) and women-to-men ratio of HRs (RHR) with 95% confidence intervals (CIs) for systolic blood pressure (SBP) and diastolic blood pressure (DBP), smoking, diabetes, adiposity, stroke, SES and lipids with dementia. Poisson regression was used to estimate the sex-specific incidence rate of dementia for these risk factors. RESULTS 502,226 individuals in midlife (54.4% women, mean age 56.5 years) with no prevalent dementia were included in the analyses. Over 11.8 years (median), 4068 participants (45.9% women) developed dementia. The crude incidence rates were 5.88 [95% CI 5.62-6.16] for women and 8.42 [8.07-8.78] for men, per 10,000 person-years. Sex was associated with the risk of dementia, where the risk was lower in women than men (HR = 0.83 [0.77-0.89]). Current smoking, diabetes, high adiposity, prior stroke and low SES were associated with a greater risk of dementia, similarly in women and men. The relationship between blood pressure (BP) and dementia was U-shaped in men but had a dose-response relationship in women: the HR for SBP per 20 mmHg was 1.08 [1.02-1.13] in women and 0.98 [0.93-1.03] in men. This sex difference was not affected by the use of antihypertensive medication at baseline. The sex difference in the effect of raised BP was consistent for dementia subtypes (vascular dementia and Alzheimer's disease). CONCLUSIONS Several mid-life cardiovascular risk factors were associated with dementia similarly in women and men, but not raised BP. Future bespoke BP-lowering trials are necessary to understand its role in restricting cognitive decline and to clarify any sex difference.
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Affiliation(s)
- Jessica Gong
- The George Institute for Global Health, University of New South Wales, Level 5, 1 King St, Newtown, NSW, 2042, Australia.
| | - Katie Harris
- The George Institute for Global Health, University of New South Wales, Level 5, 1 King St, Newtown, NSW, 2042, Australia
| | - Sanne A E Peters
- The George Institute for Global Health, University of New South Wales, Level 5, 1 King St, Newtown, NSW, 2042, Australia.,The George Institute for Global Health, Imperial College London, Central Working - Fourth Floor, Translation and Innovation Hub, Imperial College London, 80 Wood Lane, London, W12 0BZ, UK.,Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, PO Box 85500, 3508, GA, Utrecht, The Netherlands
| | - Mark Woodward
- The George Institute for Global Health, University of New South Wales, Level 5, 1 King St, Newtown, NSW, 2042, Australia.,The George Institute for Global Health, Imperial College London, Central Working - Fourth Floor, Translation and Innovation Hub, Imperial College London, 80 Wood Lane, London, W12 0BZ, UK.,Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University, Baltimore, MD, USA
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16
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Abstract
OBJECTIVES Summarise studies of outdoor green space exposure and brain health measures related to Alzheimer's disease and related disorders (ADRD), and determine scientific gaps for future research. DESIGN Rapid review of primary research studies. METHODS AND OUTCOMES PubMed, Embase and Web of Science Core Collection were searched for articles meeting the criteria published on/before 13 February 2020. The review excluded papers not in English, focused on transient states (eg, mental fatigue) or not using individual-level measures of brain health (eg, average school test scores). Brain health measures of interest included cognitive function, clinical diagnosis of cognitive impairment/dementia/ADRD and brain biomarkers such as those from MRI, measures typically associated with ADRD risk and disease progression. RESULTS Twenty-two papers were published from 2012 to 2020, 36% on <18 years old, 32% on 18-64 years old and 59% on ≥65 years old. Sixty-four per cent defined green space based on the Normalised Difference Vegetation Index ('greenness'/healthy vegetation) and 68% focused on cognitive measures of brain health (eg, memory). Seventeen studies (77%) found green space-brain health associations (14 positive, 4 inverse). Greater greenness/green space was positively associated various cognitive domains in 10 studies and with MRI outcomes (regional brain volumes, cortical thickness, amygdala integrity) in three studies. Greater neighbourhood greenness was associated with lower odds/risk of cognitive impairment/ADRD in some studies but increased odds/risk in others (n=4 studies). CONCLUSIONS Published studies suggest positive green space-brain health associations across the life course, but the methods and cohorts were limited and heterogeneous. Future research using racially/ethnically and geographically diverse cohorts, life course methods and more specific green space and brain health measures (eg, time spent in green spaces, ADRD biomarkers) will strengthen evidence for causal associations.
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Affiliation(s)
- Lilah Besser
- Institute for Human Health and Disease Intervention, Florida Atlantic University, Boca Raton, Florida, USA
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17
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Mortamais M, Gutierrez LA, de Hoogh K, Chen J, Vienneau D, Carrière I, Letellier N, Helmer C, Gabelle A, Mura T, Sunyer J, Benmarhnia T, Jacquemin B, Berr C. Long-term exposure to ambient air pollution and risk of dementia: Results of the prospective Three-City Study. ENVIRONMENT INTERNATIONAL 2021; 148:106376. [PMID: 33484961 DOI: 10.1016/j.envint.2020.106376] [Citation(s) in RCA: 56] [Impact Index Per Article: 18.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Revised: 12/07/2020] [Accepted: 12/30/2020] [Indexed: 05/22/2023]
Abstract
BACKGROUND Emerging epidemiological evidence suggests a relationship between exposure to air pollution and dementia. However, most of the existing studies relied on health administrative databases for the diagnosis of dementia. In a large French population-based cohort (the 3C Study), we assessed the effects of particulate matter ≤2.5 µm (PM2.5), nitrogen dioxide (NO2) and black carbon (BC) on the risk of dementia diagnosed with reliable tools. METHODS Participants aged ≥65 years were recruited between 1999 and 2001 and followed for 12 years. At baseline and every 2 years, dementia was suspected on the basis of the neuropsychological and neurological examination and confirmed by an independent committee of clinicians. Exposure to NO2, BC and PM2.5 at the participants' residential address was estimated using land use regression models. For each pollutant and year of follow-up, the 10-year moving average of past exposure was estimated. Multilevel spatial random-effects Cox proportional hazards models were used in which exposure was included as a time-varying variable. Analyses were adjusted for individual (age, sex, education, APOE4 genotype, health behaviours) and contextual (neighbourhood deprivation index) confounders. RESULTS At baseline, the median age of the 7066 participants was 73.4 years, and 62% were women. The median follow-up duration was 10.0 years during which 791 participants developed dementia (n = 541 Alzheimer's disease (AD) and n = 155 vascular/mixed dementia (VaD)). The 10-year moving average of PM2.5 concentrations ranged from 14.6 to 31.3 µg/m3. PM2.5 concentration was positively associated with dementia risk: HR = 1.20, 95% CI (1.08-1.32) for all-cause dementia, 1.20 (1.09-1.32) for AD, and 1.33 (1.05-1.68) for VaD per 5 µg/m3 PM2.5 increase. No association was detected between NO2 or BC exposure and dementia risk. CONCLUSION In this large cohort of older adults, long-term PM2.5 exposure was associated with increased dementia incidence. Reducing PM2.5 emissions might lessen the burden of dementia in aging populations.
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Affiliation(s)
| | | | - Kees de Hoogh
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
| | - Jie Chen
- Institute for Risk Assessment Sciences (IRAS), Utrecht University, Postbrus 80125, 3508 TC Utrecht, the Netherlands
| | - Danielle Vienneau
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
| | | | | | - Catherine Helmer
- INSERM, Univ Bordeaux, Bordeaux Population Health Research Centre, UMR 1219, Bordeaux, France
| | - Audrey Gabelle
- INM, Univ Montpellier, Inserm, Montpellier, France; Memory Resources and Research Centre, Department of Neurology, Gui de Chauliac Hospital, Montpellier, France
| | | | - Jordi Sunyer
- Universitat Pompeu Fabra (UPF), Barcelona, Spain; ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain; CIBER Epidemiologia y Salud Publica (CIBERESP), Barcelona, Spain
| | - Tarik Benmarhnia
- Department of Family Medicine and Public Health, University of California San Diego, La Jolla, CA, USA; Scripps Institution of Oceanography, University of California, San Diego, La Jolla, CA, USA
| | - Bénédicte Jacquemin
- INSERM, Univ Rennes, EHESP, Irset Institut de Recherche en Santé, Environnement et Travail, UMR-S 1085 Rennes, France
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18
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Perales-Puchalt J, Gauthreaux K, Shaw A, McGee JL, Teylan MA, Chan KCG, Rascovsky K, Kukull WA, Vidoni ED. Risk of mild cognitive impairment among older adults in the United States by ethnoracial group. Int Psychogeriatr 2021; 33:51-62. [PMID: 31948505 PMCID: PMC7365740 DOI: 10.1017/s1041610219002175] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVES To compare the risk of mild cognitive impairment (MCI) among a wide range of ethnoracial groups in the US. DESIGN Non-probabilistic longitudinal clinical research. SETTING Participants enrolling into the National Alzheimer's Coordinating Center Unified Data Set recruited via multiple approaches including clinician referral, self-referral by patients or family members, or active recruitment through community organizations. PARTICIPANTS Cognitively normal individuals 55 and older at the initial visit, who reported race and ethnicity information, with at least two visits between September 2005 and November 2018. MEASUREMENTS Ethnoracial information was self-reported and grouped into non-Latino Whites, Asian Americans, Native Americans, African Americans (AAs), and individuals simultaneously identifying as AAs and another minority race (AA+), as well as Latinos of Caribbean, Mexican, and Central/South American origin. MCI was evaluated clinically following standard criteria. Four competing risk analysis models were used to calculate MCI risk adjusting for risk of death, including an unadjusted model, and models adjusting for non-modifiable and modifiable risk factors. RESULTS After controlling for sex and age at initial visit, subhazard ratios of MCI were statistically higher than non-Latino Whites among Native Americans (1.73), Caribbean Latinos (1.80), and Central/South American Latinos (1.55). Subhazard ratios were higher among AA+ compared to non-Latino Whites only in the model controlling for all risk factors (1.40). CONCLUSION Compared to non-Latino Whites, MCI risk was higher among Caribbean and South/Central American Latinos as well as Native Americans and AA+. The factors explaining the differential MCI risk among ethnoracial groups are not clear and warrant future research.
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Affiliation(s)
| | - Kathryn Gauthreaux
- Department of Epidemiology, National Alzheimer's Coordinating Center, University of Washington, Seattle, WA98195, USA
| | - Ashley Shaw
- Alzheimer's Disease Center, University of Kansas, MS6002, Fairway, KS66205, USA
| | - Jerrihlyn L McGee
- School of Nursing, University of Kansas, MS 4043, Kansas City, KS66160, USA
| | - Merilee A Teylan
- Department of Epidemiology, National Alzheimer's Coordinating Center, University of Washington, Seattle, WA98195, USA
| | - Kwun C G Chan
- Department of Biostatistics, National Alzheimer's Coordinating Center, University of Washington, Seattle, WA98195, USA
| | - Katya Rascovsky
- Department of Neurology, Philadelphia, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Walter A Kukull
- Department of Epidemiology, National Alzheimer's Coordinating Center, University of Washington, Seattle, WA98195, USA
| | - Eric D Vidoni
- Alzheimer's Disease Center, University of Kansas, MS6002, Fairway, KS66205, USA
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19
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The association between sociodemographic characteristics and dementia in patients with atrial fibrillation. Aging Clin Exp Res 2020; 32:2319-2327. [PMID: 31927710 PMCID: PMC7591421 DOI: 10.1007/s40520-019-01449-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Accepted: 12/11/2019] [Indexed: 01/02/2023]
Abstract
Objectives Association between socio-demographic factors and dementia risk is studied in general but not for atrial fibrillation (AF) patients. Methods We studied AF patients ≥ 45 years in Sweden 1998–2012 (n = 537,513) using the Total Population Register for socio-demographic factors, the Swedish Cause of Death Register, and the National Patient Register (NPR) for incident dementia. Cox regression with hazard ratios (HR) and 95% confidence intervals (CI) was used for the association between exposure and outcome, adjusting for age and comorbidities. Results Totally 30,332 patients (5.6%) were diagnosed with dementia during the follow-up (mean 5.4 years). Of these, 14,097 were men (4.9%) and 16,235 were women (6.5%). Lower educational levels (reference: highest level) were associated with increased dementia, HRs (95% CI) for basic school for men 1.23 (1.18–1.29) and women 1.36 (1.30–1.42), and middle-level school for men 1.17 (1.11–1.22) and women 1.28 (1.22–1.34). Divorced men and women (reference: married) showed increased risk of dementia, HR 1.07 (1.01–1.13) and 1.12 (1.06–1.18), respectively, while widowed men showed lower risk, HR 0.84 (0.80–0.88). High deprivation neighborhood socio-economic status (NSES; reference: medium level) was associated with increased dementia in men, HR 1.11 (1.05–1.17), and low deprivation neighborhood socio-economic status (NSES) with increased dementia in men and women, HR 1.12 (1.06–1.18) and 1.18 (1.12–1.24), respectively. Conclusions Some results were expected, i.e. association between lower educational level and dementia. The higher risk of dementia in low deprivation NSES-areas could be due to a higher awareness about dementia, and subsequent earlier diagnosis and treatment of dementia. Electronic supplementary material The online version of this article (10.1007/s40520-019-01449-3) contains supplementary material, which is available to authorized users.
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Effects of socioeconomic status on mortality after Parkinson's disease: A nationwide population-based matched cohort study in Korean populations. Parkinsonism Relat Disord 2020; 80:206-211. [PMID: 33129703 DOI: 10.1016/j.parkreldis.2020.10.017] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Revised: 08/29/2020] [Accepted: 10/09/2020] [Indexed: 10/23/2022]
Abstract
INTRODUCTION To evaluate the mortality rate and impact of SES on mortality in PD using a nationwide cohort in Korea. METHODS We selected patients diagnosed with PD (ICD-10 code: G20) and registration code for PD (V124) in the program for rare intractable diseases between 2004 and 2015. After that, atypical parkinsonism was excluded. A matched cohort of individuals without PD were enrolled by randomly matching patients by sex, age, and year of diagnosis to the PD group with a ratio of 1:9. Cox proportional hazard models were used to identify the effects of SES on mortality using Hazard Ratios and 95% confidence intervals. RESULTS In total, 26,570 participants were enrolled. The mortality rate was 30.37% in PD cohort and 16.69% in the comparison cohort. According to income level, PD patients in low-middle group revealed significantly decreased HRs of 0.704 (95% CI, 0.533-0.930) compared to those in the lowest group. The medical aid group showed an increased mortality rate (HR = 1.552, 95% CI, 1.191-2.021) compared to the national health insurance group. In the subgroup analyses, medical aid was associated with mortality only in PD with female (HR = 1.740, 95% CI, 1.242-2.438) or aged 60-79 years (HR = 1.434, 95% CI 1.005-2.045). There was no significant difference in mortality rate according to residential area in PD. CONCLUSIONS In Korea, individual level low SES including income level and insurance type were significantly associated with increased mortality, whereas regional level SES (residential area) was not related with mortality on PD.
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21
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Liu CC, Sun Y, Kung SF, Kuo HW, Huang NC, Li CY, Hu SC. Effects of physical and social environments on the risk of dementia among Taiwanese older adults: a population-based case-control study. BMC Geriatr 2020; 20:226. [PMID: 32590941 PMCID: PMC7318767 DOI: 10.1186/s12877-020-01624-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Accepted: 06/18/2020] [Indexed: 12/29/2022] Open
Abstract
Background Physical and social environments may influence cognition health in older adults. However, evidence regarding physical and social environments linked to dementia is lacking, especially in Asia. This study aims to explore the influence of physical and social environments on the incidence of dementia through a population-based case-control design in Taiwan. Methods We identified 26,206 incident cases with dementia aged≧65 years in 2010, with the same no. of controls from National Health Insurance claims. Environmental measures were collected from government statistics including three physical environments and three social environments. Multilevel logistic regression was used to estimate the odds ratios (ORs) and 95% confidence intervals (CI) of the association between dementia incidence and the environmental measures at the township level. Results We observed a significant reduction of 12% in the odds ratios of dementia in areas with higher availability of playgrounds and sport venues (OR 0.88, 95% CI 0.81–0.95), after controlling for individual and other environmental characteristics. Community center availability was also significantly associated with an 8% decreased odds for dementia (OR 0.92, 95% CI 0.87–0.99), but the association was not significant after further consideration of individual-level characteristics. Although higher odds of dementia were found in areas with high median annual family income (OR 1.14, 95% CI 1.04–1.25), such a significant relationship did not appear in the full model. Conclusions Our study suggests that specific physical and social environmental features have different influences on the risk of dementia. Public health interventions may consider these environmental aspects for preventing dementia incidence.
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Affiliation(s)
- Chih-Ching Liu
- Department of Healthcare Administration, College of Medical and Health Science, Asia University, No. 500, Lioufeng Road, Wufeng District, Taichung, 41354, Taiwan
| | - Yu Sun
- Department of Neurology, En Chu Kong Hospital, No. 399, Fuxing Road, Sanxia District, New Taipei City, 23702, Taiwan
| | - Shiann-Far Kung
- Department of Urban Planning, College of Planning & Design, National Cheng Kung University, No.1, University Road, Tainan City, 701, Taiwan.,Healthy Cities Research Center, Research and Services Headquarters, National Cheng Kung University, No.1, University Road, Tainan City, 701, Taiwan
| | - Hsien-Wen Kuo
- Institute of Environmental and Occupational Health Sciences, School of Medicine, National Yang-Ming University, No.155, Sec.2, Linong Street, Taipei city, 112, Taiwan
| | - Nuan-Ching Huang
- Healthy Cities Research Center, Research and Services Headquarters, National Cheng Kung University, No.1, University Road, Tainan City, 701, Taiwan
| | - Chung-Yi Li
- Department of Healthcare Administration, College of Medical and Health Science, Asia University, No. 500, Lioufeng Road, Wufeng District, Taichung, 41354, Taiwan.,Department of Public Health, College of Medicine, National Cheng Kung University, No.1, University Road, Tainan City, 701, Taiwan.,Department of Public Health, College of Public Health, China Medical University, Taichung, 404, Taiwan
| | - Susan C Hu
- Healthy Cities Research Center, Research and Services Headquarters, National Cheng Kung University, No.1, University Road, Tainan City, 701, Taiwan. .,Department of Public Health, College of Medicine, National Cheng Kung University, No.1, University Road, Tainan City, 701, Taiwan.
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Letellier N, Carrière I, Cadot E, Berkman L, Goldberg M, Zins M, Berr C. Individual and neighbourhood socioeconomic inequalities in cognitive impairment: cross-sectional findings from the French CONSTANCES cohort. BMJ Open 2020; 10:e033751. [PMID: 32193263 PMCID: PMC7150592 DOI: 10.1136/bmjopen-2019-033751] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
OBJECTIVES Despite the recent awareness of the environment impact on brain ageing, the influence of the neighbourhood socioeconomic status on cognitive impairment remains unclear. Here, we investigated the effects of individual and neighbourhood deprivation on cognitive impairment in middle-aged and young-old people. DESIGN Cross-sectional study. SETTINGS 21 Health Screening Centres in the entire French metropolitan territory. PARTICIPANTS A total of 44 648 participants (age range: 45 to 69 years) from the French CONSTANCES cohort were included in the analyses. MAIN OUTCOMES Associations between the overall cognitive score (based on a standardised battery of cognitive tests administered by neuropsychologists) and individual deprivation (Evaluation of Deprivation and Inequalities in Health Screening Centres; EPICES score) and geographical deprivation (French Deprivation Index; FDep index). RESULTS Based on the EPICES score (validated cut-off ≥30.17), 12% of participants were considered to be deprived. After mutual adjustment, individual and geographical deprivation were associated with higher cognitive impairment in a multilevel logistic regression analysis that was also adjusted for sociodemographic, lifestyle and health factors. Specifically, individual deprivation was associated with an odds increase of 55% (OR=1.55, 95% CI: 1.45 to 1.66). The risk of global cognitive impairment progressively increased with the neighbourhood deprivation level, evaluated by the FDep index (reference Q1; Q2: OR=1.09, 95% CI: 0.98 to 1.20; Q3: OR=1.15, 95% CI: 1.04 to 1.27; Q4: OR=1.15, 95% CI: 1.04 to 1.28; Q5: OR=1.25, 95% CI: 1.13 to 1.39). CONCLUSION Our results suggest that the neighbourhood socioeconomic deprivation level is associated with cognitive impairment, independently of the individual deprivation level. A better understanding of this association could help to define new prevention strategies to target high-risk residents and high-risk geographical areas in order to reduce social health inequalities.
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Affiliation(s)
- Noémie Letellier
- Neuropsychiat Epidemiol & Clin Res, Univ Montpellier, INSERM, Montpellier, France
| | - Isabelle Carrière
- Neuropsychiat Epidemiol & Clin Res, Univ Montpellier, INSERM, Montpellier, France
| | - Emmanuelle Cadot
- IRD - Hydrosciences UMR 5569, Montpellier University, Montpellier, France
| | - Lisa Berkman
- Harvard Center for Population and Development Studies, Harvard University, Cambridge, Massachusetts, USA
| | - Marcel Goldberg
- Paris Descartes University, Paris, France
- INSERM, Population-Based Epidemiological Cohorts Research Unit, UMS 011, Villejuif, France
| | - Marie Zins
- Paris Descartes University, Paris, France
- INSERM, Population-Based Epidemiological Cohorts Research Unit, UMS 011, Villejuif, France
- UVSQ, INSERM, VIMA; Aging and chronic diseases, U1168, Villejuif, France
| | - Claudine Berr
- Neuropsychiat Epidemiol & Clin Res, Univ Montpellier, INSERM, Montpellier, France
- Memory Research and Resources Center, Department of Neurology, Montpellier University Hospital Gui de Chauliac, Montpellier, France
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23
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Letellier N, Choron G, Artaud F, Descatha A, Goldberg M, Zins M, Elbaz A, Berr C. Association between occupational solvent exposure and cognitive performance in the French CONSTANCES study. Occup Environ Med 2020; 77:223-230. [PMID: 32075885 PMCID: PMC7079188 DOI: 10.1136/oemed-2019-106132] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Revised: 01/22/2020] [Accepted: 01/27/2020] [Indexed: 12/22/2022]
Abstract
OBJECTIVE The objective of this study was to evaluate the association between occupational exposure to solvents and cognitive performance in middle-aged and early-ageing participants, taking into account the working environment. METHODS In the French Cohorte des consultants des Centres d'examens de santé (CONSTANCES) cohort, 41 854 participants aged 45-69 years completed a self-reported, lifetime occupational exposure questionnaire. Exposure to solvents (gasoline for hand washing, trichloroethylene, white spirit, cellulosic thinner) was first considered as a binary variable (exposed/not exposed). We computed number of solvent types to which participants were exposed, solvent exposure time and delay since last exposure. Cognitive performance was assessed and analysed in reference to norms of neuropsychological battery previously established in CONSTANCES according to age, sex and education. Multiple linear and modified Poisson regression were used to estimate the associations between solvent exposure and cognitive performance adjusting for individual and environmental characteristics, and working conditions (night shift, repetitive and noisy work). RESULTS Men had a greater risk of global cognitive impairment when they were exposed to gasoline (relative risk (RR)=1.12, 95% CI 1.03 to 1.22), white spirit (RR=1.14, 95% CI 1.05 to 1.25) or cellulosic thinner (RR=1.17, 95% CI 1.06 to 1.31) at the workplace, even after adjusting for confounders. Women exposed to white spirit or exposed for more than 20 years had poorer global cognitive performance. CONCLUSION These findings strengthen our understanding of the detrimental effect of solvent exposure on cognitive health not only in men but also in women for the first time, in a large general population middle-aged and early-ageing sample from France, taking into account working conditions.
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Affiliation(s)
- Noémie Letellier
- Neuropsychiat Epidemiol & Clin Res, Univ Montpellier, INSERM, Montpellier, France
| | - Guillaume Choron
- Neuropsychiat Epidemiol & Clin Res, Univ Montpellier, INSERM, Montpellier, France.,Univ Montpellier, CHU, Montpellier, France, Montpellier, France
| | - Fanny Artaud
- Université Paris-Saclay, Univ. Paris-Sud, UVSQ, CESP, INSERM, Villejuif, France
| | - Alexis Descatha
- INSERM, IRSET, ESTER Team, University of Angers, U1085, Angers, France.,INSERM, Population-Based Epidemiological Cohorts Research Unit, UMS 011, Villejuif, France.,UVSQ, INSERM, VIMA; Aging and Chronic Diseases, U1168, Villejuif, France
| | - Marcel Goldberg
- INSERM, Population-Based Epidemiological Cohorts Research Unit, UMS 011, Villejuif, France.,Faculty of Medicine, Paris Descartes University, Paris, France
| | - Marie Zins
- INSERM, Population-Based Epidemiological Cohorts Research Unit, UMS 011, Villejuif, France.,UVSQ, INSERM, VIMA; Aging and Chronic Diseases, U1168, Villejuif, France.,Faculty of Medicine, Paris Descartes University, Paris, France
| | - Alexis Elbaz
- Université Paris-Saclay, Univ. Paris-Sud, UVSQ, CESP, INSERM, Villejuif, France
| | - C Berr
- Neuropsychiat Epidemiol & Clin Res, Univ Montpellier, INSERM, Montpellier, France.,Memory Research and Resources Center, Department of Neurology, Montpellier University Hospital Gui de Chauliac, Montpellier, France
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Besser L, Galvin JE, Rodriguez D, Seeman T, Kukull W, Rapp SR, Smith J. Associations between neighborhood built environment and cognition vary by apolipoprotein E genotype: Multi-Ethnic Study of Atherosclerosis. Health Place 2019; 60:102188. [PMID: 31797769 PMCID: PMC6901106 DOI: 10.1016/j.healthplace.2019.102188] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Revised: 07/26/2019] [Accepted: 08/07/2019] [Indexed: 01/02/2023]
Abstract
We examined whether neighborhood built environment (BE) and cognition associations in older adults vary by apolipoprotein E (APOE) genotype, a genetic risk factor for Alzheimer's disease (AD). We conducted a cross-sectional analysis of 4091 participants. Neighborhood characteristics included social and walking destination density (SDD, WDD), intersection density, and proportion of land dedicated to retail. Individuals were categorized as APOE ε2 (lower AD risk), APOE ε4 (higher AD risk), or APOE ε3 carriers. Among APOE ε2 carriers, greater proportion of land dedicated to retail was associated with better global cognition, and greater SDD, WDD, intersection density, and proportion of land dedicated to retail was associated with better processing speed. These associations were not observed in APOE ε3 or ε4 carriers. APOE ε2 carriers may be more susceptible to the potentially beneficial effects of denser neighborhood BEs on cognition; however, longitudinal studies are needed.
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Affiliation(s)
- Lilah Besser
- School of Urban and Regional Planning, Institute for Human Health and Disease Intervention, Florida Atlantic University, 777 Glades Rd, SO-284H, Boca Raton, FL, 33431, USA.
| | - James E Galvin
- Charles E. Schmidt College of Medicine, Florida Atlantic University, 777 Glades Rd, ME-104, First Floor, Boca Raton, FL, 33431, USA.
| | - Daniel Rodriguez
- Department of City and Regional Planning, College of Environmental Design, Office 313B, Wurster Hall #1820, University of California, Berkeley, CA, 94720-1820, USA.
| | - Teresa Seeman
- David Geffen School of Medicine, University of California Los Angeles, 10945 Le Conte Avenue, Suite 2339 (PVUB Uberroth Building), Los Angeles, CA, 90095, USA.
| | - Walter Kukull
- National Alzheimer's Coordinating Center, Department of Epidemiology, University of Washington, 4311 11th Avenue NE, Suite 300, Seattle, WA, 98105, USA.
| | - Stephen R Rapp
- Departments of Psychiatry and Behavioral Medicine & Public Health Sciences, Wake Forest School of Medicine, 791 Jonestown Road, Winston-Salem, NC, 27103, USA.
| | - Jennifer Smith
- Department of Epidemiology, University of Michigan, 1415 Washington Heights, Room 2631, Ann Arbor, MI, 48109-2029, USA.
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Liu CC, Li CY, Kung SF, Kuo HW, Huang NC, Sun Y, Hu SC. Association of Environmental Features and the Risk of Alzheimer's Dementia in Older Adults: A Nationwide Longitudinal Case-Control Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16162828. [PMID: 31398817 PMCID: PMC6721060 DOI: 10.3390/ijerph16162828] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Revised: 07/31/2019] [Accepted: 07/31/2019] [Indexed: 12/19/2022]
Abstract
Little is known about the association between environmental features and the risk of Alzheimer’s dementia (AD). This study aims to investigate the association of physical and social environments with the incidence of AD. We identified 12,401 newly diagnosed AD cases aged ≥65 years in 2010, with the same no. of matched controls from National Health Insurance claims in Taiwan. Environmental data were collected from government statistics including three physical environments and three social environments. Multilevel logistic regression was conducted to calculate the odds ratios (OR) of AD in association with environmental features at the township level. Results showed that living in the areas with higher availability of playgrounds and sport venues was associated with a 3% decreased odds of AD (95% CI = 0.96–0.99), while higher density of elderly living alone was associated with a 5% increased odds of AD (95% CI = 1.01–1.11), after controlling for individual and other environmental factors. In further examination by urbanization level, the above relationships were found only in rural areas but not in urban areas. This study provides evidence that specific physical and social environmental features have different impacts on the risk of AD.
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Affiliation(s)
- Chih-Ching Liu
- Department of Public Health, College of Medicine, National Cheng Kung University, Tainan 701, Taiwan
| | - Chung-Yi Li
- Department of Public Health, College of Medicine, National Cheng Kung University, Tainan 701, Taiwan
- Department of Public Health, College of Public Health, China Medical University, Taichung 404, Taiwan
| | - Shiann-Far Kung
- Department of Urban Planning, National Cheng Kung University, Tainan 701, Taiwan
- Healthy Cities Research Center, Research and Services Headquarters, National Cheng Kung University, Tainan 701, Taiwan
| | - Hsien-Wen Kuo
- Institute of Environmental and Occupational Health Sciences, National Yang-Ming University, Taipei 112, Taiwan
| | - Nuan-Ching Huang
- Healthy Cities Research Center, Research and Services Headquarters, National Cheng Kung University, Tainan 701, Taiwan
| | - Yu Sun
- Department of Neurology, En Chu Kong Hospital, New Taipei City 23702, Taiwan.
| | - Susan C Hu
- Department of Public Health, College of Medicine, National Cheng Kung University, Tainan 701, Taiwan.
- Healthy Cities Research Center, Research and Services Headquarters, National Cheng Kung University, Tainan 701, Taiwan.
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26
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Climie RE, Boutouyrie P, Perier MC, Guibout C, van Sloten TT, Thomas F, Danchin N, Sharman JE, Laurent S, Jouven X, Empana JP. Individual and Neighborhood Deprivation and Carotid Stiffness. Hypertension 2019; 73:1185-1194. [DOI: 10.1161/hypertensionaha.118.12186] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Affiliation(s)
- Rachel E. Climie
- From the INSERM, U970, Department of Epidemiology (R.E.C., MC.P., C.G., T.T.v.S., X.J., JP.E.)
- Baker Heart and Diabetes Institute; Melbourne, Australia (R.E.C.)
- Menzies Institute for Medical Research, University of Tasmanian, Hobart, Australia (R.E.C., J.E.S.)
| | | | - Marie-Cecile Perier
- From the INSERM, U970, Department of Epidemiology (R.E.C., MC.P., C.G., T.T.v.S., X.J., JP.E.)
| | - Catherine Guibout
- From the INSERM, U970, Department of Epidemiology (R.E.C., MC.P., C.G., T.T.v.S., X.J., JP.E.)
| | - Thomas T. van Sloten
- From the INSERM, U970, Department of Epidemiology (R.E.C., MC.P., C.G., T.T.v.S., X.J., JP.E.)
- Cardiovascular Research Institute Maastricht and Department of Internal Medicine, Maastricht University Medical Centre, the Netherlands (T.T.v.S.)
| | - Frederique Thomas
- Investigations Préventives et cliniques (IPC), Paris, France (F.T., N.D.)
| | - Nicolas Danchin
- Investigations Préventives et cliniques (IPC), Paris, France (F.T., N.D.)
| | - James E. Sharman
- Menzies Institute for Medical Research, University of Tasmanian, Hobart, Australia (R.E.C., J.E.S.)
| | | | - Xavier Jouven
- From the INSERM, U970, Department of Epidemiology (R.E.C., MC.P., C.G., T.T.v.S., X.J., JP.E.)
| | - Jean-Philippe Empana
- From the INSERM, U970, Department of Epidemiology (R.E.C., MC.P., C.G., T.T.v.S., X.J., JP.E.)
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Tani Y, Suzuki N, Fujiwara T, Hanazato M, Kondo K. Neighborhood Food Environment and Dementia Incidence: the Japan Gerontological Evaluation Study Cohort Survey. Am J Prev Med 2019; 56:383-392. [PMID: 30777158 PMCID: PMC6375726 DOI: 10.1016/j.amepre.2018.10.028] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2018] [Revised: 10/08/2018] [Accepted: 10/09/2018] [Indexed: 12/25/2022]
Abstract
INTRODUCTION Interventions targeting built environmental factors may encourage older people to engage in favorable behaviors and decrease dementia risk, but epidemiologic evidence is limited. This study investigated the association between neighborhood food environment and dementia incidence. METHODS A 3-year follow-up (2010-2013) was conducted among participants in the Japan Gerontological Evaluation Study, a population-based cohort study of older adults aged ≥65 years. Dementia incidence for 49,511 participants was assessed through the public long-term care insurance system. Availability of food stores (defined as the number of food stores selling fruits and vegetables within 500 meters or 1 kilometer of residence) was assessed for each participant using objective (GIS-based) and subjective (participant-reported) measurements. Data were analyzed from 2017 to 2018. RESULTS A total of 3,162 cases of dementia occurred during the follow-up. Compared with the highest quartile for objective availability of food stores, the hazard ratio adjusting for age and sex was 1.60 (95% CI=1.43, 1.78) for the second-lowest quartile. Compared with the highest subjective availability of food stores, the hazard ratio was 1.74 (95% CI=1.49, 2.04) for the lowest category. After successive adjustment for sociodemographic characteristics, health status, and other geographic neighborhood factors (availability of restaurants, convenience stores, and community centers), the hazard ratio remained statistically significant. CONCLUSIONS Lower food store availability was associated with increased dementia incidence. Given that food shopping is a routine activity and a main motive for going out among older adults, increasing the availability of food stores may contribute to dementia prevention.
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Affiliation(s)
- Yukako Tani
- Department of Global Health Promotion, Tokyo Medical and Dental University, Tokyo, Japan; Japan Society for the Promotion of Science, Tokyo, Japan.
| | - Norimichi Suzuki
- Center for Preventive Medical Sciences, Chiba University, Chiba, Japan
| | - Takeo Fujiwara
- Department of Global Health Promotion, Tokyo Medical and Dental University, Tokyo, Japan
| | | | - Katsunori Kondo
- Center for Preventive Medical Sciences, Chiba University, Chiba, Japan; Department of Gerontological Evaluation, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Aichi, Japan
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28
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Letellier N, Carrière I, Gutierrez LA, Gabelle A, Dartigues JF, Dufouil C, Helmer C, Cadot E, Berr C. Influence of activity space on the association between neighborhood characteristics and dementia risk: results from the 3-City study cohort. BMC Geriatr 2019; 19:4. [PMID: 30616586 PMCID: PMC6323794 DOI: 10.1186/s12877-018-1017-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2018] [Accepted: 12/14/2018] [Indexed: 12/12/2022] Open
Abstract
Background Socioeconomic level of residential environment was found to influence cognitive performance. However, individuals from the same place of residence may be affected differently. We aim to investigate for the first time the influence of individual activity space on the association between neighborhood socioeconomic status (NSES) and the risk of dementia. Methods In the frame of the Three-City cohort, a French population-based study, we followed longitudinally (12 years) 7009 participants aged over 65. The activity space (i.e., the spatial area through which a person moves daily) was defined using two questions from Lawton’s Instrumental Activities of Daily Living scale (“Goes shopping independently”,“Travels alone”), and one question about mobility restriction. The survival analysis was performed using a Cox marginal model that takes into account intra-neighborhood correlations and includes a large number of potential confounders. Results Among people with a limited activity space (n = 772, 11%), risk of dementia is increased in subjects living in a deprived area (characterized by high GINI index or low median income) compared to those living in more favored. Conclusion This study shows that the individual activity space modifies the association between NSES and the risk of dementia providing a more complete picture of residential inequalities. If confirmed in different populations, these findings suggest that people with limited activity space and living in a deprived neighborhood are particularly at risk and should be targeted for prevention.
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Affiliation(s)
- Noémie Letellier
- INSERM, University Montpellier, Neuropsychiatry: Epidemiological and Clinical Research, Montpellier, France.
| | - Isabelle Carrière
- INSERM, University Montpellier, Neuropsychiatry: Epidemiological and Clinical Research, Montpellier, France
| | - Laure-Anne Gutierrez
- INSERM, University Montpellier, Neuropsychiatry: Epidemiological and Clinical Research, Montpellier, France
| | - Audrey Gabelle
- INSERM, University Montpellier, Neuropsychiatry: Epidemiological and Clinical Research, Montpellier, France.,Department of Neurology, Memory Research and Resources Center, Montpellier University Hospital Gui de Chauliac, F-34295, Montpellier, France
| | - Jean-François Dartigues
- Inserm, Bordeaux Population Health Research Center, team SEPIA, UMR 1219, University Bordeaux, F-33000, Bordeaux, France.,CHU Bordeaux, CMRR, F-33000, Bordeaux, France
| | - Carole Dufouil
- CHU Bordeaux, CMRR, F-33000, Bordeaux, France.,Bordeaux school of public health (ISPED), Inserm, Bordeaux Population Health Research Center, team VINTAGE, UMR 1219, University Bordeaux, F-33000, Bordeaux, France
| | - Catherine Helmer
- Inserm, Bordeaux Population Health Research Center, team LEHA, UMR 1219, University Bordeaux, F-33000, Bordeaux, France
| | - Emmanuelle Cadot
- IRD - Hydrosciences UMR 5569, Montpellier University, F-34090, Montpellier, France
| | - Claudine Berr
- INSERM, University Montpellier, Neuropsychiatry: Epidemiological and Clinical Research, Montpellier, France.,Department of Neurology, Memory Research and Resources Center, Montpellier University Hospital Gui de Chauliac, F-34295, Montpellier, France
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McFall GP, McDermott KL, Dixon RA. Modifiable Risk Factors Discriminate Memory Trajectories in Non-Demented Aging: Precision Factors and Targets for Promoting Healthier Brain Aging and Preventing Dementia. J Alzheimers Dis 2019; 70:S101-S118. [PMID: 30775975 PMCID: PMC6700610 DOI: 10.3233/jad-180571] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/03/2018] [Indexed: 12/19/2022]
Abstract
BACKGROUND Non-demented cognitive aging trajectories are characterized by vast level and slope differences and a spectrum of outcomes, including dementia. OBJECTIVE The goal of AD risk management (and its corollary, promoting healthy brain aging) is aided by two converging objectives: 1) classifying dynamic distributions of non-demented cognitive trajectories, and 2) identifying modifiable risk-elevating and risk-reducing factors that discriminate stable or normal trajectory patterns from declining or pre-impairment patterns. METHOD Using latent class growth analysis we classified three episodic memory aging trajectories for n = 882 older adults (baseline Mage=71.6, SD=8.9, range = 53-95, female=66%): Stable (SMA; above average level, sustained slope), Normal (NMA; average level, moderately declining slope), and Declining (DMA; below average level, substantially declining slope). Using random forest analyses, we simultaneously assessed 17 risk/protective factors from non-modifiable demographic, functional, psychological, and lifestyle domains. Within two age strata (Young-Old, Old-Old), three pairwise prediction analyses identified important discriminating factors. RESULTS Prediction analyses revealed that different modifiable risk predictors, both shared and unique across age strata, discriminated SMA (i.e., education, depressive symptoms, living status, body mass index, heart rate, social activity) and DMA (i.e., lifestyle activities [cognitive, self-maintenance, social], grip strength, heart rate, gait) groups. CONCLUSION Memory trajectory analyses produced empirical classes varying in level and slope. Prediction analyses revealed different predictors of SMA and DMA that also varied by age strata. Precision approaches for promoting healthier memory aging-and delaying memory impairment-may identify modifiable factors that constitute specific targets for intervention in the differential context of age and non-demented trajectory patterns.
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Affiliation(s)
- G. Peggy McFall
- Department of Psychology, University of Alberta, Edmonton, AB, Canada
- Neuroscience and Mental Health Institute, University of Alberta, Edmonton, AB, Canada
| | - Kirstie L. McDermott
- Neuroscience and Mental Health Institute, University of Alberta, Edmonton, AB, Canada
| | - Roger A. Dixon
- Department of Psychology, University of Alberta, Edmonton, AB, Canada
- Neuroscience and Mental Health Institute, University of Alberta, Edmonton, AB, Canada
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