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Power MC, Lynch KM, Bennett EE, Ying Q, Park ES, Xu X, Smith RL, Stewart JD, Yanosky JD, Liao D, van Donkelaar A, Kaufman JD, Sheppard L, Szpiro AA, Whitsel EA. A comparison of PM 2.5 exposure estimates from different estimation methods and their associations with cognitive testing and brain MRI outcomes. ENVIRONMENTAL RESEARCH 2024; 256:119178. [PMID: 38768885 PMCID: PMC11186721 DOI: 10.1016/j.envres.2024.119178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Revised: 05/16/2024] [Accepted: 05/17/2024] [Indexed: 05/22/2024]
Abstract
BACKGROUND Reported associations between particulate matter with aerodynamic diameter ≤2.5 μm (PM2.5) and cognitive outcomes remain mixed. Differences in exposure estimation method may contribute to this heterogeneity. OBJECTIVES To assess agreement between PM2.5 exposure concentrations across 11 exposure estimation methods and to compare resulting associations between PM2.5 and cognitive or MRI outcomes. METHODS We used Visit 5 (2011-2013) cognitive testing and brain MRI data from the Atherosclerosis Risk in Communities (ARIC) Study. We derived address-linked average 2000-2007 PM2.5 exposure concentrations in areas immediately surrounding the four ARIC recruitment sites (Forsyth County, NC; Jackson, MS; suburbs of Minneapolis, MN; Washington County, MD) using 11 estimation methods. We assessed agreement between method-specific PM2.5 concentrations using descriptive statistics and plots, overall and by site. We used adjusted linear regression to estimate associations of method-specific PM2.5 exposure estimates with cognitive scores (n = 4678) and MRI outcomes (n = 1518) stratified by study site and combined site-specific estimates using meta-analyses to derive overall estimates. We explored the potential impact of unmeasured confounding by spatially patterned factors. RESULTS Exposure estimates from most methods had high agreement across sites, but low agreement within sites. Within-site exposure variation was limited for some methods. Consistently null findings for the PM2.5-cognitive outcome associations regardless of method precluded empirical conclusions about the potential impact of method on study findings in contexts where positive associations are observed. Not accounting for study site led to consistent, adverse associations, regardless of exposure estimation method, suggesting the potential for substantial bias due to residual confounding by spatially patterned factors. DISCUSSION PM2.5 estimation methods agreed across sites but not within sites. Choice of estimation method may impact findings when participants are concentrated in small geographic areas. Understanding unmeasured confounding by factors that are spatially patterned may be particularly important in studies of air pollution and cognitive or brain health.
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Affiliation(s)
- Melinda C Power
- Milken Institute School of Public Health, George Washington University, 950 New Hampshire Ave, Washington, DC, 20052, USA.
| | - Katie M Lynch
- Milken Institute School of Public Health, George Washington University, 950 New Hampshire Ave, Washington, DC, 20052, USA
| | - Erin E Bennett
- Milken Institute School of Public Health, George Washington University, 950 New Hampshire Ave, Washington, DC, 20052, USA
| | - Qi Ying
- Zachry Department of Civil & Environmental Engineering, Texas A&M University, 201 Dwight Look, College Station, TX, 77840, USA
| | - Eun Sug Park
- Texas A&M Transportation Institute, Texas A&M University System, 3135 TAMU, College Station, TX, 77843, USA
| | - Xiaohui Xu
- Department of Epidemiology & Biostatistics, Texas A&M Health Science Center School of Public Health, 212 Adriance Lab Rd, College Station, TX, 77843, USA
| | - Richard L Smith
- Department of Statistics and Operations Research, University of North Carolina at Chapel Hill, 318 E Cameron Ave, Chapel Hill, NC, 27599, USA; Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 135 Daur Dr, Chapel Hill, NC, 27516, USA
| | - James D Stewart
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 135 Daur Dr, Chapel Hill, NC, 27516, USA
| | - Jeff D Yanosky
- Department of Public Health Sciences, College of Medicine, The Pennsylvania State University, 700 HMC Cres Rd, Hershey, PA, 17033, USA
| | - Duanping Liao
- Department of Public Health Sciences, College of Medicine, The Pennsylvania State University, 700 HMC Cres Rd, Hershey, PA, 17033, USA
| | - Aaron van Donkelaar
- Department of Energy, Environmental, and Chemical Engineering McKelvey School of Engineering, 1 Brookings Dr, St. Louis, MO, 63130, USA
| | - Joel D Kaufman
- Department of Medicine, School of Medicine, University of Washington, 1959 NE Pacific St, Seattle, WA, 98195, USA; Department of Epidemiology, School of Public Health, University of Washington, 3980 15th Ave NE, Seattle, WA, 98195, USA; Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, 3980 15th Ave NE, Seattle, WA, 98195, USA
| | - Lianne Sheppard
- Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, 3980 15th Ave NE, Seattle, WA, 98195, USA; Department of Biostatistics, School of Public Health, University of Washington, 3980 15th Ave NE, Seattle, WA, 98195, USA
| | - Adam A Szpiro
- Department of Biostatistics, School of Public Health, University of Washington, 3980 15th Ave NE, Seattle, WA, 98195, USA
| | - Eric A Whitsel
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 135 Daur Dr, Chapel Hill, NC, 27516, USA; Department of Medicine, School of Medicine, University of North Carolina at Chapel Hill, 321 S Columbia St, Chapel Hill, NC, 27599, USA
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Wang Q, Li S, Cai B, Zhong L, Liu F, Wang X, Chen T. Genetic evidence supports a causal relationship between air pollution and brain imaging-derived phenotypes. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2024; 281:116664. [PMID: 38954909 DOI: 10.1016/j.ecoenv.2024.116664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/10/2024] [Revised: 06/25/2024] [Accepted: 06/27/2024] [Indexed: 07/04/2024]
Abstract
BACKGROUND Observational studies have reported associations between air pollutants and brain imaging-derived phenotypes (IDPs); however, whether this relationship is causal remains uncertain. METHODS We conducted bidirectional two-sample Mendelian randomization (MR) analyses to explore the causal relationships between 5 types of air pollutants (N=423,796 to 456,380 individuals) and 587 reliable IDPs (N=33,224 individuals). Two-step MR was also conducted to assess whether the identified effects are mediated through the modulation of circulating cytokines (N=8293). RESULTS We found genetic evidence supporting the association of nitrogen oxides (NOx) with mean intra-cellular volume fraction (ICVF) in the left uncinate fasciculus (IVW β=-0.42, 95 % CI -0.62 to -0.23, P=1.51×10-5) and mean fractional anisotropy (FA) in the left uncinate fasciculus (IVW β=-0.42, 95 % CI -0.62 to -0.21, P=4.89×10-5). In further two-step MR analyses, we did not find evidence that genetic predictions of any circulating cytokines mediated the association between NOx and IDPs. CONCLUSION This study provides evidence for the association between air pollutants and brain IDPs, emphasizing the importance of controlling air pollution to improve brain health.
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Affiliation(s)
- Qitong Wang
- Hainan General Hospital, Hainan Affiliated Hospital of Hainan Medical University, Haikou, Hainan 570311, China
| | - Shuzhu Li
- Hainan General Hospital, Hainan Affiliated Hospital of Hainan Medical University, Haikou, Hainan 570311, China
| | - Benchi Cai
- Hainan General Hospital, Hainan Affiliated Hospital of Hainan Medical University, Haikou, Hainan 570311, China
| | - Lifan Zhong
- Hainan General Hospital, Hainan Affiliated Hospital of Hainan Medical University, Haikou, Hainan 570311, China
| | - Fang Liu
- Hainan General Hospital, Hainan Affiliated Hospital of Hainan Medical University, Haikou, Hainan 570311, China
| | - Xinyu Wang
- Hainan General Hospital, Hainan Affiliated Hospital of Hainan Medical University, Haikou, Hainan 570311, China
| | - Tao Chen
- Hainan General Hospital, Hainan Affiliated Hospital of Hainan Medical University, Haikou, Hainan 570311, China; Hainan Provincial Bureau of Disease Prevention and Control, Haikou 570100, China.
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Li H, Cui F, Wang T, Wang W, Zhang D. The impact of sunlight exposure on brain structural markers in the UK Biobank. Sci Rep 2024; 14:10313. [PMID: 38705875 PMCID: PMC11070413 DOI: 10.1038/s41598-024-59633-z] [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: 01/13/2024] [Accepted: 04/12/2024] [Indexed: 05/07/2024] Open
Abstract
Sunlight is closely intertwined with daily life. It remains unclear whether there are associations between sunlight exposure and brain structural markers. General linear regression analysis was used to compare the differences in brain structural markers among different sunlight exposure time groups. Stratification analyses were performed based on sex, age, and diseases (hypertension, stroke, diabetes). Restricted cubic spline was performed to examine the dose-response relationship between natural sunlight exposure and brain structural markers, with further stratification by season. A negative association of sunlight exposure time with brain structural markers was found in the upper tertile compared to the lower tertile. Prolonged natural sunlight exposure was associated with the volumes of total brain (β: - 0.051, P < 0.001), white matter (β: - 0.031, P = 0.023), gray matter (β: - 0.067, P < 0.001), and white matter hyperintensities (β: 0.059, P < 0.001). These associations were more pronounced in males and individuals under the age of 60. The results of the restricted cubic spline analysis showed a nonlinear relationship between sunlight exposure and brain structural markers, with the direction changing around 2 h of sunlight exposure. This study demonstrates that prolonged exposure to natural sunlight is associated with brain structural markers change.
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Affiliation(s)
- Huihui Li
- Department of Epidemiology and Health Statistics, Public Health College, Qingdao University, No. 308 Ningxia Road, QingdaoShandong Province, 266071, China
| | - Fusheng Cui
- Department of Epidemiology and Health Statistics, Public Health College, Qingdao University, No. 308 Ningxia Road, QingdaoShandong Province, 266071, China
| | - Tong Wang
- Department of Epidemiology and Health Statistics, Public Health College, Qingdao University, No. 308 Ningxia Road, QingdaoShandong Province, 266071, China
| | - Weijing Wang
- Department of Epidemiology and Health Statistics, Public Health College, Qingdao University, No. 308 Ningxia Road, QingdaoShandong Province, 266071, China.
| | - Dongfeng Zhang
- Department of Epidemiology and Health Statistics, Public Health College, Qingdao University, No. 308 Ningxia Road, QingdaoShandong Province, 266071, China.
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Qi J, Zhao N, Liu M, Guo Y, Fu J, Zhang Y, Wang W, Su Z, Zeng Y, Yao Y, Hu K. Long-term exposure to fine particulate matter constituents and cognitive impairment among older adults: An 18-year Chinese nationwide cohort study. JOURNAL OF HAZARDOUS MATERIALS 2024; 468:133785. [PMID: 38367441 DOI: 10.1016/j.jhazmat.2024.133785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Revised: 01/27/2024] [Accepted: 02/12/2024] [Indexed: 02/19/2024]
Abstract
BACKGROUND Although growing evidence has shown independent links of long-term exposure to fine particulate matter (PM2.5) with cognitive impairment, the effects of its constituents remain unclear. This study aims to explore the associations of long-term exposure to ambient PM2.5 constituents' mixture with cognitive impairment in Chinese older adults, and to further identify the main contributor. METHODS 15,274 adults ≥ 65 years old were recruited by the Chinese Longitudinal Healthy Longevity Study (CLHLS) and followed up through 7 waves during 2000-2018. Concentrations of ambient PM2.5 and its constituents (i.e., black carbon [BC], organic matter [OM], ammonium [NH4+], sulfate [SO42-], and nitrate [NO3-]) were estimated by satellite retrievals and machine learning models. Quantile-based g-computation model was employed to assess the joint effects of a mixture of 5 PM2.5 constituents and their relative contributions to cognitive impairment. Analyses stratified by age group, sex, residence (urban vs. rural), and region (north vs. south) were performed to identify vulnerable populations. RESULTS During the average 3.03 follow-up visits (89,296.9 person-years), 4294 (28.1%) participants had developed cognitive impairment. The adjusted hazard ratio [HR] (95% confidence interval [CI]) for cognitive impairment for every quartile increase in mixture exposure to 5 PM2.5 constituents was 1.08 (1.05-1.11). BC held the largest index weight (0.69) in the positive direction in the qg-computation model, followed by OM (0.31). Subgroup analyses suggested stronger associations in younger old adults and rural residents. CONCLUSION Long-term exposure to ambient PM2.5, particularly its constituents BC and OM, is associated with an elevated risk of cognitive impairment onset among Chinese older adults.
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Affiliation(s)
- Jin Qi
- Department of Big Data in Health Science, School of Public Health, Zhejiang University, Hangzhou 310058, China
| | - Naizhuo Zhao
- Department of Land Resource Management, School of Humanities and Law, Northeastern University, Shenyang 110004, China
| | - Minhui Liu
- School of Management, University of Science and Technology of China, Hefei 230026, China
| | - Yiwen Guo
- Department of Big Data in Health Science, School of Public Health, Zhejiang University, Hangzhou 310058, China
| | - Jingqiao Fu
- Ocean College, Zhejiang University, Zhoushan 316021, China
| | - Yunquan Zhang
- School of Public Health, Wuhan University of Science and Technology, Wuhan 430065, China
| | - Wanjie Wang
- Department of Big Data in Health Science, School of Public Health, Zhejiang University, Hangzhou 310058, China
| | - Zhiyang Su
- Department of Big Data in Health Science, School of Public Health, Zhejiang University, Hangzhou 310058, China
| | - Yi Zeng
- Center for Healthy Aging and Development Studies, National School of Development, Peking University, Beijing 100871, China.
| | - Yao Yao
- China Center for Health Development Studies, Peking University, Beijing 100191, China.
| | - Kejia Hu
- Department of Big Data in Health Science, School of Public Health, Zhejiang University, Hangzhou 310058, China; Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Hangzhou 310058, China.
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Wood D, Evangelopoulos D, Beevers S, Kitwiroon N, Demakakos P, Katsouyanni K. Exposure to ambient air pollution and cognitive function: an analysis of the English Longitudinal Study of Ageing cohort. Environ Health 2024; 23:35. [PMID: 38575976 PMCID: PMC10996194 DOI: 10.1186/s12940-024-01075-1] [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: 09/12/2023] [Accepted: 03/25/2024] [Indexed: 04/06/2024]
Abstract
BACKGROUND An increasing number of studies suggest adverse effects of exposure to ambient air pollution on cognitive function, but the evidence is still limited. We investigated the associations between long-term exposure to air pollutants and cognitive function in the English Longitudinal Study of Ageing (ELSA) cohort of older adults. METHODS Our sample included 8,883 individuals from ELSA, based on a nationally representative study of people aged ≥ 50 years, followed-up from 2002 until 2017. Exposure to air pollutants was modelled by the CMAQ-urban dispersion model and assigned to the participants' residential postcodes. Cognitive test scores of memory and executive function were collected biennially. The associations between these cognitive measures and exposure to ambient concentrations of NO2, PM10, PM2.5 and ozone were investigated using mixed-effects models adjusted for time-varying age, physical activity and smoking status, as well as baseline gender and level of education. RESULTS Increasing long-term exposure per interquartile range (IQR) of NO2 (IQR: 13.05 μg/m3), PM10 (IQR: 3.35 μg/m3) and PM2.5 (IQR: 2.7 μg/m3) were associated with decreases in test scores of composite memory by -0.10 (95% confidence interval [CI]: -0.14, -0.07), -0.02 [-0.04, -0.01] and -0.08 [-0.11, -0.05], respectively. The same increases in NO2, PM10 and PM2.5 were associated with decreases in executive function score of -0.31 [-0.38, -0.23], -0.05 [-0.08, -0.02] and -0.16 [-0.22, -0.10], respectively. The association with ozone was inverse across both tests. Similar results were reported for the London-dwelling sub-sample of participants. CONCLUSIONS The present study was based on a long follow-up with several repeated measurements per cohort participant and long-term air pollution exposure assessment at a fine spatial scale. Increasing long-term exposure to NO2, PM10 and PM2.5 was associated with a decrease in cognitive function in older adults in England. This evidence can inform policies related to modifiable environmental exposures linked to cognitive decline.
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Affiliation(s)
- Dylan Wood
- Environmental Research Group, School of Public Health, Imperial College, Sir Michael Uren Hub, 86 Wood Ln, London, W12 0BZ, UK.
- MRC Centre for Environment and Health, Environmental Research Group, Imperial College, London, W12 0BZ, UK.
- NIHR HPRU in Environmental Exposures and Health, Imperial College, London, UK.
| | - Dimitris Evangelopoulos
- Environmental Research Group, School of Public Health, Imperial College, Sir Michael Uren Hub, 86 Wood Ln, London, W12 0BZ, UK
- MRC Centre for Environment and Health, Environmental Research Group, Imperial College, London, W12 0BZ, UK
- NIHR HPRU in Environmental Exposures and Health, Imperial College, London, UK
| | - Sean Beevers
- Environmental Research Group, School of Public Health, Imperial College, Sir Michael Uren Hub, 86 Wood Ln, London, W12 0BZ, UK
- MRC Centre for Environment and Health, Environmental Research Group, Imperial College, London, W12 0BZ, UK
- NIHR HPRU in Environmental Exposures and Health, Imperial College, London, UK
| | - Nutthida Kitwiroon
- Environmental Research Group, School of Public Health, Imperial College, Sir Michael Uren Hub, 86 Wood Ln, London, W12 0BZ, UK
- MRC Centre for Environment and Health, Environmental Research Group, Imperial College, London, W12 0BZ, UK
- NIHR HPRU in Environmental Exposures and Health, Imperial College, London, UK
| | - Panayotes Demakakos
- Department of Epidemiology and Public Health, University College London (UCL), London, UK
| | - Klea Katsouyanni
- Environmental Research Group, School of Public Health, Imperial College, Sir Michael Uren Hub, 86 Wood Ln, London, W12 0BZ, UK
- MRC Centre for Environment and Health, Environmental Research Group, Imperial College, London, W12 0BZ, UK
- NIHR HPRU in Environmental Exposures and Health, Imperial College, London, UK
- Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
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Chen GC, Nyarko Hukportie D, Wan Z, Li FR, Wu XB. The Association Between Exposure to Air Pollution and Dementia Incidence: The Modifying Effect of Smoking. J Gerontol A Biol Sci Med Sci 2023; 78:2309-2317. [PMID: 36373950 DOI: 10.1093/gerona/glac228] [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: 02/22/2022] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND The influence of overall air pollution on dementia risk and the potential effect modification by other risk factors remain to be clarified. METHODS We included 459 844 UK residents who were free of dementia and had data on the exposure to particulate matter (PM)2.5, PM2.5-10, PM10, NO2, and NOx during baseline recruitment. The combined exposure to various PMs and NOx was estimated by using an air pollution score. Hazard ratios (HRs) and 95% confidence intervals (CIs) for incident dementia were estimated by multivariable Cox models. RESULTS During a median 11.7 years follow-up, 5 905 incident cases of all-cause dementia were identified. With the exception of PM2.5-10, all other air pollutants were separately associated with a higher risk of all-cause dementia (all p-trend < .001) with generally similar associations for dementia subtypes. An increasing air pollution score was associated with higher risks of all-cause as well as individual dementia outcomes, with adjusted HRs (95% CI) of 1.27 (1.18, 1.37) for all-cause dementia, 1.27 (1.14, 1.43) for Alzheimer's disease, and 1.35 (1.16, 1.57) for vascular dementia when comparing the highest with the lowest quartile of the score (all p-trend < .001). These associations of air pollution score with dementia and its subtypes were observed among never and former smokers but not among current smokers (all p-interaction
< .030). CONCLUSION Air pollution was associated with a higher risk of dementia among nonsmokers but not current smokers. Additional studies are required to confirm our findings and to explore the potential mechanisms underlying the possible effect modification by smoking status.
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Affiliation(s)
- Guo-Chong Chen
- Department of Nutrition and Food Hygiene, School of Public Health, Suzhou Medical College of Soochow University, Suzhou, China
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Daniel Nyarko Hukportie
- School of Public Health and Emergency Management, Southern University of Science and Technology, Shenzhen, China
| | - Zhongxiao Wan
- Department of Nutrition and Food Hygiene, School of Public Health, Suzhou Medical College of Soochow University, Suzhou, China
| | - Fu-Rong Li
- School of Public Health and Emergency Management, Southern University of Science and Technology, Shenzhen, China
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, Guangdong, China
| | - Xian-Bo Wu
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, Guangdong, China
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Gan W, Manning KJ, Cleary EG, Fortinsky RH, Brugge D. Exposure to ultrafine particles and cognitive decline among older people in the United States. ENVIRONMENTAL RESEARCH 2023; 227:115768. [PMID: 36965813 PMCID: PMC10246447 DOI: 10.1016/j.envres.2023.115768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Revised: 03/21/2023] [Accepted: 03/23/2023] [Indexed: 05/08/2023]
Abstract
BACKGROUND Some studies suggest that ambient particulate air pollution is associated with cognitive decline. However, the findings are mixed, and there is no relevant research examining the influences of ultrafine particles (UFP), which may have more toxicity than larger particles. We therefore conducted this study to investigate whether residential UFP exposure is associated with cognitive decline using data from the Alzheimer's Disease Research Centers in the United States. METHODS This is a longitudinal study of participants who were aged 65 years and older and had normal cognitive status at baseline. Residential UFP exposure, expressed as particle number concentrations (PNC), was assessed in 2016-2017 using a nationwide land use regression model, and was assigned to each participant using their 3-digit residential ZIP codes. Cognitive functions including memory, attention, language, executive function, and global function were assessed annually using 15 neuropsychological tests from March 2015 to February 2022. Linear mixed-effects models were used to examine the associations after adjustment for covariates including baseline age, sex, APOE ε4 status, race, education, smoking status, history of diabetes, quartiles of neighborhood median household income, and interaction terms of follow-up time with each covariate. RESULTS This study included 5646 participants (mean age 76 years, 65% female). On average, each participant had 4 annual visits. When PNC was treated as a continuous variable, there were no statistically or clinically significant changes in annual decline of each cognitive function in relation to an interquartile range elevation in PNC (4026 particles/cm3). Similarly, when PNC was treated as a categorical variable including five exposure groups, there were no linear exposure-response trends in annual decline of each cognitive function across the five exposure groups. CONCLUSIONS This study found no meaningful associations between residential UFP exposure and cognitive decline in global and domain-specific functions. There is a need for further research that assigns UFP exposure at a finer geographic scale.
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Affiliation(s)
- Wenqi Gan
- Department of Public Health Sciences, University of Connecticut School of Medicine, Farmington, CT, USA.
| | - Kevin J Manning
- Department of Psychiatry, University of Connecticut School of Medicine, Farmington, CT, USA
| | | | - Richard H Fortinsky
- Department of Public Health Sciences, University of Connecticut School of Medicine, Farmington, CT, USA; UConn Center on Aging, University of Connecticut School of Medicine, Farmington, CT, USA; Department of Medicine, University of Connecticut School of Medicine, Farmington, CT, USA
| | - Doug Brugge
- Department of Public Health Sciences, University of Connecticut School of Medicine, Farmington, CT, USA
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Zhang RQ, Ou YN, Huang SY, Li YZ, Huang YY, Zhang YR, Chen SD, Dong Q, Feng JF, Cheng W, Yu JT. Poor Oral Health and Risk of Incident Dementia: A Prospective Cohort Study of 425,183 Participants. J Alzheimers Dis 2023:JAD221176. [PMID: 37212101 DOI: 10.3233/jad-221176] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
BACKGROUND The association between poor oral health and the risk of incident dementia remains unclear. OBJECTIVE To investigate the associations of poor oral health with incident dementia, cognitive decline, and brain structure in a large population-based cohort study. METHODS A total of 425,183 participants free of dementia at baseline were included from the UK Biobank study. The associations between oral health problems (mouth ulcers, painful gums, bleeding gums, loose teeth, toothaches, and dentures) and incident dementia were examined using Cox proportional hazards models. Mixed linear models were used to investigate whether oral health problems were associated with prospective cognitive decline. We examined the associations between oral health problems and regional cortical surface area using linear regression models. We further explored the potential mediating effects underlying the relationships between oral health problems and dementia. RESULTS Painful gums (HR = 1.47, 95% CI [1.317-1.647], p < 0.001), toothaches (HR = 1.38, 95% CI [1.244-1.538], p < 0.001), and dentures (HR = 1.28, 95% CI [1.223-1.349], p < 0.001) were associated with increased risk of incident dementia. Dentures were associated with a faster decline in cognitive functions, including longer reaction time, worse numeric memory, and worse prospective memory. Participants with dentures had smaller surface areas of the inferior temporal cortex, inferior parietal cortex, and middle temporal cortex. Brain structural changes, smoking, alcohol drinking, and diabetes may mediate the associations between oral health problems and incident dementia. CONCLUSION Poor oral health is associated with a higher risk of incident dementia. Dentures may predict accelerated cognitive decline and are associated with regional cortical surface area changes. Improvement of oral health care could be beneficial for the prevention of dementia.
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Affiliation(s)
- Rui-Qi Zhang
- Department of Neurology and National Center for Neurological Disorders, Huashan Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Shanghai Medical College, Fudan University, Shanghai, China
| | - Ya-Nan Ou
- Department of Neurology, Qingdao Municipal Hospital, Qingdao University, China
| | - Shu-Yi Huang
- Department of Neurology and National Center for Neurological Disorders, Huashan Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Shanghai Medical College, Fudan University, Shanghai, China
| | - Yu-Zhu Li
- Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China
| | - Yu-Yuan Huang
- Department of Neurology and National Center for Neurological Disorders, Huashan Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Shanghai Medical College, Fudan University, Shanghai, China
| | - Ya-Ru Zhang
- Department of Neurology and National Center for Neurological Disorders, Huashan Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Shanghai Medical College, Fudan University, Shanghai, China
| | - Shi-Dong Chen
- Department of Neurology and National Center for Neurological Disorders, Huashan Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Shanghai Medical College, Fudan University, Shanghai, China
| | - Qiang Dong
- Department of Neurology and National Center for Neurological Disorders, Huashan Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Shanghai Medical College, Fudan University, Shanghai, China
| | - Jian-Feng Feng
- Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China
| | - Wei Cheng
- Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China
| | - Jin-Tai Yu
- Department of Neurology and National Center for Neurological Disorders, Huashan Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Shanghai Medical College, Fudan University, Shanghai, China
- Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China
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Ma LZ, Zhang YR, Li YZ, Ou YN, Yang L, Chen SD, Dong Q, Feng JF, Cheng W, Tan L, Yu JT. Cataract, Cataract Surgery, and Risk of Incident Dementia: A Prospective Cohort Study of 300,823 Participants. Biol Psychiatry 2023; 93:810-819. [PMID: 35940935 DOI: 10.1016/j.biopsych.2022.06.005] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Revised: 06/02/2022] [Accepted: 06/02/2022] [Indexed: 11/02/2022]
Abstract
BACKGROUND Visual impairment and interventions to preserve vision may impact dementia risk. Thus, we aimed to explore the associations of cataract and cataract surgery with the risk of dementia. METHODS Prospective data from 300,823 individuals in the UK Biobank were used. We used multivariate Cox proportional hazards regression models to estimate hazard ratios (HRs) and 95% confidence intervals for associations, with healthy control subjects as a reference. The same method was used to explore the effects of surgery on dementia outcomes of patients with cataract. One-way analysis of variance was performed to examine the associations between cataract and brain morphometric measures. RESULTS After a mean follow-up of 8.4 years, 3226 individuals were diagnosed with dementia. The nonsurgical cataract group had increased risk of all-cause dementia (HR, 1.214; 95% CI, 1.012-1.456; p = .037) and Alzheimer's disease (HR, 1.479; 95% CI, 1.105-1.981; p = .009). However, there was no difference in dementia risk between the cataract surgery group and the healthy control group. Cataract surgery was associated with decreased risk of all-cause dementia (HR, 0.632; 95% CI, 0.421-0.947; p = .026) and Alzheimer's disease (HR, 0.399; 95% CI, 0.196-0.812; p = .011) compared with the nonsurgical group. Additionally, cataract was negatively associated with cortical volumes, aging-related subcortical volumes, and fractional anisotropy of white matter fibers. CONCLUSIONS Cataract patients who did not receive surgical treatment had an increased risk of dementia. However, cataract surgery could reverse the risk of dementia. Our findings on brain structures and pathways in patients with cataract also provided evidence for the mechanism. Reversible visual impairment, such as cataract, is a promising modifiable risk factor for dementia.
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Affiliation(s)
- Ling-Zhi Ma
- Department of Neurology and National Center for Neurological Disorders, Huashan Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Shanghai Medical College, Fudan University, Shanghai, China; Department of Neurology, Qingdao Municipal Hospital, Qingdao University, Qingdao, China
| | - Ya-Ru Zhang
- Department of Neurology and National Center for Neurological Disorders, Huashan Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Shanghai Medical College, Fudan University, Shanghai, China
| | - Yu-Zhu Li
- Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China
| | - Ya-Nan Ou
- Department of Neurology, Qingdao Municipal Hospital, Qingdao University, Qingdao, China
| | - Liu Yang
- Department of Neurology and National Center for Neurological Disorders, Huashan Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Shanghai Medical College, Fudan University, Shanghai, China
| | - Shi-Dong Chen
- Department of Neurology and National Center for Neurological Disorders, Huashan Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Shanghai Medical College, Fudan University, Shanghai, China
| | - Qiang Dong
- Department of Neurology and National Center for Neurological Disorders, Huashan Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Shanghai Medical College, Fudan University, Shanghai, China
| | - Jian-Feng Feng
- Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China; Key Laboratory of Computational Neuroscience and Brain-Inspired Intelligence, Ministry of Education, Fudan University, Shanghai, China; Fudan ISTBI-ZJNU Algorithm Centre for Brain-Inspired Intelligence, Zhejiang Normal University, Jinhua, China; Department of Computer Science, University of Warwick, Coventry, United Kingdom
| | - Wei Cheng
- Department of Neurology and National Center for Neurological Disorders, Huashan Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Shanghai Medical College, Fudan University, Shanghai, China; Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China; Key Laboratory of Computational Neuroscience and Brain-Inspired Intelligence, Ministry of Education, Fudan University, Shanghai, China; Fudan ISTBI-ZJNU Algorithm Centre for Brain-Inspired Intelligence, Zhejiang Normal University, Jinhua, China
| | - Lan Tan
- Department of Neurology, Qingdao Municipal Hospital, Qingdao University, Qingdao, China.
| | - Jin-Tai Yu
- Department of Neurology and National Center for Neurological Disorders, Huashan Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Shanghai Medical College, Fudan University, Shanghai, China.
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10
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Wang Y, Crowe M, Knibbs LD, Fuller-Tyszkiewicz M, Mygind L, Kerr JA, Wake M, Olsson CA, Enticott PG, Peters RL, Daraganova G, Mavoa S, Lycett K. Greenness modifies the association between ambient air pollution and cognitive function in Australian adolescents, but not in mid-life adults. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2023; 324:121329. [PMID: 36822308 DOI: 10.1016/j.envpol.2023.121329] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 01/31/2023] [Accepted: 02/19/2023] [Indexed: 06/18/2023]
Abstract
UNLABELLED Exposure to ambient air pollution has been associated with reduced cognitive function in childhood and later life, with too few mid-life studies to draw conclusions. In contrast, residential greenness has been associated with enhanced cognitive function throughout the lifecourse. Here we examine the extent to which (1) ambient air pollution and residential greenness predict later cognitive function in adolescence and mid-life, and (2) greenness modifies air pollution-cognitive function associations. PARTICIPANTS 6220 adolescents (51% male) and 2623 mid-life adults (96% mothers) from the Longitudinal Study of Australian Children. MEASURES Exposures: Annual average particulate matter <2.5 μm (PM2.5), nitrogen dioxide (NO2) and greenness (Normalised Difference Vegetation Index) for residential addresses from validated land-use regression models over a 10-13-year period. OUTCOMES Cognitive function from CogState tests of attention, working memory and executive function, dichotomised into poorer (worst quartile) versus not poor. ANALYSES Adjusted mixed-effects generalised linear models with residential greenness assessed as an effect modifier (high vs. low divided at median). The annual mean for PM2.5 and NO2 across exposure windows was 6.3-6.8 μg/m3, and 5.5-7.1 ppb, respectively. For adolescents, an IQR increment of NO2 was associated with 19-24% increased odds of having poorer executive function across all time windows, while associations weren't observed between air pollution and other outcomes. For adults, high NO2 predicted poorer cognitive function across all outcomes, while high PM2.5 predicted poorer attention only. There was little evidence of associations between greenness and cognitive function in adjusted models for both generations. Interactions were found between residential greenness, air pollutants and cognitive function in adolescents, but not adults. The magnitude of effects was similar across generations and exposure windows. Findings highlight the potential benefits of cognitive health associated with the regulation of air pollution and urban planning strategies for increasing green spaces and vegetation.
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Affiliation(s)
- Yichao Wang
- Centre for Social and Early Emotional Development, School of Psychology, Deakin University, Geelong, VIC, 3220, Australia; Department of Paediatrics, University of Melbourne, Parkville, VIC, 3010, Australia; Population Health Theme, Murdoch Children's Research Institute, Parkville, VIC, 3052, Australia.
| | - Mallery Crowe
- Centre for Social and Early Emotional Development, School of Psychology, Deakin University, Geelong, VIC, 3220, Australia
| | - Luke D Knibbs
- School of Public Health, University of Sydney, Sydney, NSW, 2006, Australia; Public Health Unit, Sydney Local Health District, Camperdown, NSW, 2050, Australia
| | - Matthew Fuller-Tyszkiewicz
- Centre for Social and Early Emotional Development, School of Psychology, Deakin University, Geelong, VIC, 3220, Australia
| | - Lærke Mygind
- Cognitive Neuroscience Unit, School of Psychology, Deakin University, Burwood, VIC, 3125, Australia; Unit of Medical Psychology, University of Copenhagen, Copenhagen, 1353, Denmark; Center for Clinical Research and Prevention, Copenhagen University Hospital - Bispebjerg and Frederiksberg, The Capital Region of Denmark, Copenhagen, 2000, Denmark
| | - Jessica A Kerr
- Department of Paediatrics, University of Melbourne, Parkville, VIC, 3010, Australia; Population Health Theme, Murdoch Children's Research Institute, Parkville, VIC, 3052, Australia; Department of Psychological Medicine, University of Otago Christchurch, New Zealand
| | - Melissa Wake
- Department of Paediatrics, University of Melbourne, Parkville, VIC, 3010, Australia; Population Health Theme, Murdoch Children's Research Institute, Parkville, VIC, 3052, Australia; Liggins Institute, University of Auckland, New Zealand
| | - Craig A Olsson
- Centre for Social and Early Emotional Development, School of Psychology, Deakin University, Geelong, VIC, 3220, Australia; Population Health Theme, Murdoch Children's Research Institute, Parkville, VIC, 3052, Australia; Psychological Sciences, University of Melbourne, Parkville, VIC, 3010, Australia
| | - Peter G Enticott
- Cognitive Neuroscience Unit, School of Psychology, Deakin University, Burwood, VIC, 3125, Australia
| | - Rachel L Peters
- Department of Paediatrics, University of Melbourne, Parkville, VIC, 3010, Australia; Population Health Theme, Murdoch Children's Research Institute, Parkville, VIC, 3052, Australia
| | - Galina Daraganova
- Psychological Sciences, University of Melbourne, Parkville, VIC, 3010, Australia; Business Intelligence, South Eastern Melbourne Primary Health Network, Melbourne, VIC, 3202, Australia
| | - Suzanne Mavoa
- Population Health Theme, Murdoch Children's Research Institute, Parkville, VIC, 3052, Australia; Environmental Public Health Branch, Environment Protection Authority Victoria, Melbourne, VIC, 3001, Australia; Melbourne School of Population and Global Health, University of Melbourne, Parkville, VIC, 3010, Australia
| | - Kate Lycett
- Centre for Social and Early Emotional Development, School of Psychology, Deakin University, Geelong, VIC, 3220, Australia; Population Health Theme, Murdoch Children's Research Institute, Parkville, VIC, 3052, Australia
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11
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Wyatt LH, Cleland SE, Wei L, Paul N, Patil A, Ward-Caviness C, Henderson SB, Rappold AG. Long-term exposure to ambient O 3 and PM 2.5 is associated with reduced cognitive performance in young adults: A retrospective longitudinal repeated measures study in adults aged 18-90 years. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2023; 320:121085. [PMID: 36642175 DOI: 10.1016/j.envpol.2023.121085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 01/11/2023] [Accepted: 01/12/2023] [Indexed: 06/17/2023]
Abstract
A growing body of evidence indicates that exposure to air pollution affects cognitive performance; however, few studies have assessed this in the context of repeated measures within a large group of individuals or in a population with a large age range. In this study, we evaluated the associations between long-term exposure to fine particulate matter (PM2.5) and ozone (O3) in large cohort of adults aged 18-90 years. The study cohort included 29,091 Lumosity users in the contiguous US who completed 20 repetitions of the Lost in Migration game between 2017 and 2018. Game scores reflect the ability to filter information and avoid distracting information. Long-term air pollution data included ambient PM2.5 and O3 averaged for the 365-day period before each gameplay date. Generalized linear models were used to examine the associations between long-term PM2.5 and O3 and game score percentile. Co-pollutant models were adjusted for meteorology, time trend, age, gender, device, education, local socioeconomic factors, and urbanicity. Results represent the change in attention game score percentile per 1 μg/m3 increase in PM2.5 or 0.01 ppm increase in O3. In the entire cohort, a -0.10 (95% CI: -0.16, -0.04) change in score percentile was associated with PM2.5, while no significant association was observed with O3. Modification of these associations by age was observed for both PM2.5 and O3, with stronger associations observed in younger users. In users aged 18-29, a -0.25 (-0.45, -0.05) change in score percentile was associated with PM2.5, while no associations were observed in other age groups. With O3, there was a -2.92 (-4.63, -1.19) and -2.81 (-4.29, -1.25) change in score percentile for users aged 18-29 and 30-39, respectively. We observed that elevated long-term PM2.5 and O3 were associated with decreased focus scores in young adults, but follow-up research is necessary to further illuminate these associations.
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Affiliation(s)
- Lauren H Wyatt
- Center for Public Health and Environmental Assessment, Office of Research and Development, United States Environmental Protection Agency, Research Triangle Park, NC, USA
| | - Stephanie E Cleland
- Oak Ridge Institute for Science and Education at the Center for Public Health and Environmental Assessment, Office of Research and Development, United States Environmental Protection Agency, Research Triangle Park, NC, USA; Department of Environmental Sciences and Engineering, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - Linda Wei
- Center for Public Health and Environmental Assessment, Office of Research and Development, United States Environmental Protection Agency, Research Triangle Park, NC, USA
| | - Naman Paul
- British Columbia Centre for Disease Control, Vancouver, BC, Canada
| | - Amrita Patil
- Center for Public Health and Environmental Assessment, Office of Research and Development, United States Environmental Protection Agency, Research Triangle Park, NC, USA
| | - Cavin Ward-Caviness
- Center for Public Health and Environmental Assessment, Office of Research and Development, United States Environmental Protection Agency, Research Triangle Park, NC, USA
| | | | - Ana G Rappold
- Center for Public Health and Environmental Assessment, Office of Research and Development, United States Environmental Protection Agency, Research Triangle Park, NC, USA.
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12
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Thompson R, Smith RB, Karim YB, Shen C, Drummond K, Teng C, Toledano MB. Air pollution and human cognition: A systematic review and meta-analysis. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 859:160234. [PMID: 36427724 DOI: 10.1016/j.scitotenv.2022.160234] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Revised: 11/01/2022] [Accepted: 11/13/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND This systematic review summarises and evaluates the literature investigating associations between exposure to air pollution and general population cognition, which has important implications for health, social and economic inequalities, and human productivity. METHODS The engines MEDLINE, Embase Classic+Embase, APA PsycInfo, and SCOPUS were searched up to May 2022. Our inclusion criteria focus on the following pollutants: particulate matter, NOx, and ozone. The cognitive abilities of interest are: general/global cognition, executive function, attention, working memory, learning, memory, intelligence and IQ, reasoning, reaction times, and processing speed. The collective evidence was assessed using the NTP-OHAT framework and random-effects meta-analyses. RESULTS Eighty-six studies were identified, the results of which were generally supportive of associations between exposures and worsened cognition, but the literature was varied and sometimes contradictory. There was moderate certainty support for detrimental associations between PM2.5 and general cognition in adults 40+, and PM2.5, NOx, and PM10 and executive function (especially working memory) in children. There was moderate certainty evidence against associations between ozone and general cognition in adults age 40+, and NOx and reasoning/IQ in children. Some associations were also supported by meta-analysis (N = 14 studies, all in adults aged 40+). A 1 μg/m3 increase in NO2 was associated with reduced performance on general cognitive batteries (β = -0.02, p < 0.05) as was a 1 μg/m3 increase in PM2.5 exposure (β = -0.02, p < 0.05). A 1μgm3 increase in PM2.5 was significantly associated with lower verbal fluency by -0.05 words (p = 0.01) and a decrease in executive function task performance of -0.02 points (p < 0.001). DISCUSSION Evidence was found in support of some exposure-outcome associations, however more good quality research is required, particularly with older teenagers and young adults (14-40 years), using multi-exposure modelling, incorporating mechanistic investigation, and in South America, Africa, South Asia and Australasia.
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Affiliation(s)
- Rhiannon Thompson
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, UK; MRC Centre for Environment and Health, School of Public Health, Imperial College London, UK
| | - Rachel B Smith
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, UK; MRC Centre for Environment and Health, School of Public Health, Imperial College London, UK; Mohn Centre for Children's Health and Wellbeing, School of Public Health, Imperial College London, UK
| | - Yasmin Bou Karim
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, UK; MRC Centre for Environment and Health, School of Public Health, Imperial College London, UK
| | - Chen Shen
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, UK; MRC Centre for Environment and Health, School of Public Health, Imperial College London, UK
| | - Kayleigh Drummond
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, UK; MRC Centre for Environment and Health, School of Public Health, Imperial College London, UK
| | - Chloe Teng
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, UK; MRC Centre for Environment and Health, School of Public Health, Imperial College London, UK
| | - Mireille B Toledano
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, UK; MRC Centre for Environment and Health, School of Public Health, Imperial College London, UK; Mohn Centre for Children's Health and Wellbeing, School of Public Health, Imperial College London, UK; National Institute for Health Research Health Protection Research Unit (NIHR HPRU) in Environmental Exposures and Health, School of Public Health, Imperial College London, UK; National Institute for Health Research Health Protection Research Unit (NIHR HPRU) in Chemical and Radiation Threats and Hazards, School of Public Health, Imperial College London, UK.
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13
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Gong Y, Zhang X, Zhao X, Chang H, Zhang J, Gao Z, Mi Y, Chen Y, Zhang H, Huang C, Yu Z. Global ambient particulate matter pollution and neurodegenerative disorders: a systematic review of literature and meta-analysis. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023; 30:39418-39430. [PMID: 36763275 DOI: 10.1007/s11356-023-25731-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Accepted: 02/01/2023] [Indexed: 02/11/2023]
Abstract
Previous studies on particulate matter (PM) exposure and neurodegenerative disorders showed inconsistent results, and few studies systematically examined the long-term effect of PM on neurodegenerative diseases, including all-cause dementia, Alzheimer's disease, Parkinson's disease, vascular dementia, amyotrophic lateral sclerosis, and cognitive function decline. We systematically searched for published studies in PubMed, Embase, Cochrane Library, and Web of Science up to October 31, 2022. To facilitate a comparison of effect sizes from different studies, we standardized units across studies to a 10 μg/m3 increase for PM. Heterogeneity was assessed by Cochran's Q test and I2 statistic. Publication bias was evaluated using funnel plots and Egger's tests. Subgroup analysis, meta-regression, and sensitivity analysis were performed. The protocol for this review was registered with PROSPERO (CRD42021277112). Of the 3403 originally identified studies, a meta-analysis was finally performed in 49 studies. The results showed that there was a significant positive association between long-term PM2.5 exposure and all-cause dementia, Alzheimer's disease as well as Parkinson's disease, with pooled OR of 1.30 (95%CI: 1.14, 1.47, I2 = 99.3%), 1.65 (95%CI: 1.37, 1.94, I2 = 98.2%), and 1.17 (95%CI: 1.00, 1.33, I2 = 91.8%). A positive association between PM10 and vascular dementia was observed (OR = 1.12, 95%CI: 1.04, 1.21, I2 = 0.0%). Association between PM exposure and decreased cognitive function score was found. Our results highlight the important role of PM pollution, particularly PM2.5, in the risk of age-related neurodegenerative diseases and cognitive function decline.
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Affiliation(s)
- Yuting Gong
- The Fifth Affiliated Hospital of Zhengzhou University, Zhengzhou, China.,School of Public Health, Zhengzhou University, Zhengzhou, 450001, Henan, China
| | - Xiaoan Zhang
- The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Xin Zhao
- The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Hui Chang
- The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Junxi Zhang
- NHC Key Laboratory of Birth Defects Prevention & Henan Key Laboratory of Population Defects Prevention, Zhengzhou, China
| | - Zhan Gao
- The Fifth Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yang Mi
- The Fifth Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yao Chen
- The Fifth Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Huanhuan Zhang
- School of Public Health, Zhengzhou University, Zhengzhou, 450001, Henan, China.
| | - Cunrui Huang
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Zengli Yu
- School of Public Health, Zhengzhou University, Zhengzhou, 450001, Henan, China.,NHC Key Laboratory of Birth Defects Prevention & Henan Key Laboratory of Population Defects Prevention, Zhengzhou, China
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14
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Takeuchi H, Kawashima R. Nutrients and Dementia: Prospective Study. Nutrients 2023; 15:842. [PMID: 36839199 PMCID: PMC9960559 DOI: 10.3390/nu15040842] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Revised: 02/02/2023] [Accepted: 02/02/2023] [Indexed: 02/10/2023] Open
Abstract
The association of diet and nutrients with dementia risk is an interesting research topic. Middle-aged and older Europeans not diagnosed with dementia within two years of baseline were followed up and their data were analysed until 2021. The association between the nutrient quintiles measured by the web-based 24 h dietary and the risk of developing dementia was examined using a Cox proportional hazard model after adjusting for potential confounding factors. Approximately 160,000 subjects and 1200 cases were included in the analysis of each nutrient. A greater risk of dementia was associated with (a) no alcohol intake (compared with moderate to higher intake), (b) higher intake of total sugars and carbohydrates (compared with lower intake), (c) highest or lowest fat intake (compared with moderate intake), (d) quintiles of highest or lowest magnesium intake (compared with the quintile of the second highest intake), and (e) highest protein intake (compared with moderate intake). Overall, the present results are congruent with the importance of a moderate intake of certain nutrients.
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Affiliation(s)
- Hikaru Takeuchi
- Division of Developmental Cognitive Neuroscience, Institute of Development, Aging and Cancer, Tohoku University, Sendai 980-8575, Japan
| | - Ryuta Kawashima
- Division of Developmental Cognitive Neuroscience, Institute of Development, Aging and Cancer, Tohoku University, Sendai 980-8575, Japan
- Smart Aging Research Center, Tohoku University, Sendai 980-8575, Japan
- Department of Advanced Brain Science, Institute of Development, Aging and Cancer, Tohoku University, Sendai 980-8575, Japan
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15
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Franz CE, Gustavson DE, Elman JA, Fennema-Notestine C, Hagler DJ, Baraff A, Tu XM, Wu TC, DeAnda J, Beck A, Kaufman JD, Whitsel N, Finch CE, Chen JC, Lyons MJ, Kremen WS. Associations Between Ambient Air Pollution and Cognitive Abilities from Midlife to Early Old Age: Modification by APOE Genotype. J Alzheimers Dis 2023; 93:193-209. [PMID: 36970897 PMCID: PMC10827529 DOI: 10.3233/jad-221054] [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] [Indexed: 05/09/2023]
Abstract
BACKGROUND Fine particulate matter (PM2.5) and nitrogen dioxide (NO2) measures of ambient air pollution are associated with accelerated age-related cognitive impairment, and Alzheimer's disease and related dementias (ADRD). OBJECTIVE We examined associations between air pollution, four cognitive factors, and the moderating role of apolipoprotein E (APOE) genotype in the understudied period of midlife. METHODS Participants were ∼1,100 men in the Vietnam Era Twin Study of Aging. Baseline cognitive assessments were from 2003 to 2007. Measures included past (1993-1999) and recent (3 years prior to baseline assessment) PM2.5 and NO2 exposure, in-person assessment of episodic memory, executive function, verbal fluency, and processing speed, and APOE genotype. Average baseline age was 56 years with a 12-year follow-up. Analyses adjusted for health and lifestyle covariates. RESULTS Performance in all cognitive domains declined from age 56 to 68. Higher PM2.5 exposures were associated with worse general verbal fluency. We found significant exposure-by-APOE genotype interactions for specific cognitive domains: PM2.5 with executive function and NO2 with episodic memory. Higher PM2.5 exposure was related to worse executive function in APOE ɛ4 carriers, but not in non-carriers. There were no associations with processing speed. CONCLUSION These results indicate negative effects of ambient air pollution exposure on fluency alongside intriguing differential modifications of cognitive performance by APOE genotype. APOE ɛ4 carriers appeared more sensitive to environmental differences. The process by which air pollution and its interaction with genetic risk for ADRD affects risk for later life cognitive decline or progression to dementia may begin in midlife.
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Affiliation(s)
- Carol E. Franz
- Department of Psychiatry and Center for Behavior Genetics of Aging, University of California San Diego, La Jolla, CA
| | - Daniel E. Gustavson
- Institute for Behavior Genetics, University of Colorado Boulder, Boulder, CO
| | - Jeremy A. Elman
- Department of Psychiatry and Center for Behavior Genetics of Aging, University of California San Diego, La Jolla, CA
| | - Christine Fennema-Notestine
- Department of Psychiatry and Center for Behavior Genetics of Aging, University of California San Diego, La Jolla, CA
- Department of Radiology, University of California, San Diego, La Jolla, CA
| | - Donald J. Hagler
- Department of Psychiatry and Center for Behavior Genetics of Aging, University of California San Diego, La Jolla, CA
- Department of Radiology, University of California, San Diego, La Jolla, CA
- Department of Neurosciences, University of California, San Diego, La Jolla, CA
| | - Aaron Baraff
- Vietnam Era Twin Registry, VA Puget Sound Health Care, Seattle, WA
| | - Xin M. Tu
- Herbert Wertheim School of Public Health & Human Longevity Science, University of California San Diego, CA
| | - Tsung-Chin Wu
- Herbert Wertheim School of Public Health & Human Longevity Science, University of California San Diego, CA
| | - Jaden DeAnda
- Department of Psychiatry and Center for Behavior Genetics of Aging, University of California San Diego, La Jolla, CA
- Department of Psychology, San Diego State University, San Diego, CA
| | - Asad Beck
- Graduate Program in Neuroscience, University of Washington, Seattle, WA
| | - Joel D. Kaufman
- Epidemiology, Environmental and Occupational Health Sciences, and General Internal Medicine, University of Washington, Seattle, WA
| | - Nathan Whitsel
- Department of Psychiatry and Center for Behavior Genetics of Aging, University of California San Diego, La Jolla, CA
| | - Caleb E. Finch
- Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA
| | - Jiu-Chiuan Chen
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA
| | - Michael J. Lyons
- Department of Psychological and Brain Sciences, Boston University, Boston, MA
| | - William S. Kremen
- Department of Psychiatry and Center for Behavior Genetics of Aging, University of California San Diego, La Jolla, CA
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16
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Tan P, Jiang Y, Gong D, Shi Y, Shi X, Wu P, Tan L. Synthetic polyurethane nanofibrous membrane with sustained rechargeability for integrated air cleaning. POLYMER 2022. [DOI: 10.1016/j.polymer.2022.125279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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17
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Li Z, Christensen GM, Lah JJ, Marcus M, Russell AG, Ebelt S, Waller LA, Hüls A. Neighborhood characteristics as confounders and effect modifiers for the association between air pollution exposure and subjective cognitive functioning. ENVIRONMENTAL RESEARCH 2022; 212:113221. [PMID: 35378125 PMCID: PMC9233127 DOI: 10.1016/j.envres.2022.113221] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 03/25/2022] [Accepted: 03/28/2022] [Indexed: 05/25/2023]
Abstract
BACKGROUND Air pollution has been associated with cognitive function in the elderly. Previous studies have not evaluated the simultaneous effect of neighborhood-level socioeconomic status (N-SES), which can be an essential source of bias. OBJECTIVES We explored N-SES as a confounder and effect modifier in a cross-sectional study of air pollution and subjective cognitive function. METHODS We included 12,058 participants age 50+ years from the Emory Healthy Aging Study in Metro Atlanta using the Cognitive Function Instrument (CFI) score as our outcome, with higher scores representing worse subjective cognitive function. We estimated 9-year average ambient carbon monoxide (CO), nitrogen oxides (NOx), and fine particulate matter (PM2.5) concentrations at residential addresses using a fusion of dispersion and chemical transport models. We collected census-tract level N-SES indicators and created two composite measures via principal component analysis and k-means clustering. Associations between pollutants and CFI and effect modification by N-SES were estimated via linear regression models adjusted for age, education, race and N-SES. RESULTS N-SES confounded the association between air pollution and CFI, independent of individual characteristics. We found significant effect modifications by N-SES for the association between air pollution and CFI (p-values<0.001) suggesting that effects of air pollution differ depending on N-SES. Participants living in areas with low N-SES were most vulnerable to air pollution. In the lowest N-SES urban areas, interquartile range (IQR) increases in CO, NOx, and PM2.5 were associated with 5.4% (95%-confidence interval, -0.2,11.3), 4.9% (-0.4,10.4), and 9.8% (2.2,18.0) changes in CFI, respectively. In lowest N-SES suburban areas, IQR increases in CO, NOx, and PM2.5 were associated with higher changes in CFI, namely 13.0% (0.9,26.5), 13.0% (-0.1,27.8), and 17.3% (2.5,34.2), respectively. DISCUSSION N-SES is an important confounder and effect modifier in our study. This finding could have implications for studying health effects of air pollution and identifying susceptible populations.
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Affiliation(s)
- Zhenjiang Li
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Grace M Christensen
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - James J Lah
- Department of Neurology, School of Medicine, Emory University, Atlanta, GA, USA
| | - Michele Marcus
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA; Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Armistead G Russell
- School of Civil and Environmental Engineering, Georgia Institute of Technology, Atlanta, GA, USA
| | - Stefanie Ebelt
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA; Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Lance A Waller
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA; Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Anke Hüls
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA; Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
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Christensen GM, Li Z, Pearce J, Marcus M, Lah JJ, Waller LA, Ebelt S, Hüls A. The complex relationship of air pollution and neighborhood socioeconomic status and their association with cognitive decline. ENVIRONMENT INTERNATIONAL 2022; 167:107416. [PMID: 35868076 PMCID: PMC9382679 DOI: 10.1016/j.envint.2022.107416] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Revised: 06/22/2022] [Accepted: 07/13/2022] [Indexed: 06/13/2023]
Abstract
BACKGROUND Air pollution and neighborhood socioeconomic status (nSES) have been shown to affect cognitive decline in older adults. In previous studies, nSES acts as both a confounder and an effect modifier between air pollution and cognitive decline. OBJECTIVES This study aims to examine the individual and joint effects of air pollution and nSES on cognitive decline on adults 50 years and older in Metro Atlanta, USA. METHODS Perceived memory and cognitive decline was assessed in 11,897 participants aged 50+ years from the Emory Healthy Aging Study (EHAS) using the cognitive function instrument (CFI). Three-year average air pollution concentrations for 12 pollutants and 16 nSES characteristics were matched to participants using census tracts. Individual exposure linear regression and LASSO models explore individual exposure effects. Environmental mixture modeling methods including, self-organizing maps (SOM), Bayesian kernel machine regression (BKMR), and quantile-based G-computation explore joint effects, and effect modification between air pollutants and nSES characteristics on cognitive decline. RESULTS Participants living in areas with higher air pollution concentrations and lower nSES experienced higher CFI scores (beta: 0.121; 95 % CI: 0.076, 0.167) compared to participants living in areas with low air pollution and high nSES. Additionally, the BKMR model showed a significant overall mixture effect on cognitive decline, suggesting synergy between air pollution and nSES. These joint effects explain protective effects observed in single-pollutant linear regression models, even after adjustment for confounding by nSES (e.g., an IQR increase in CO was associated with a 0.038-point lower (95 % CI: -0.06, -0.01) CFI score). DISCUSSION Observed protective effects of single air pollutants on cognitive decline can be explained by joint effects and effect modification of air pollutants and nSES. Researchers must consider nSES as an effect modifier if not a co-exposure to better understand the complex relationships between air pollution and nSES in urban settings.
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Affiliation(s)
- Grace M Christensen
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Zhenjiang Li
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - John Pearce
- Department of Public Health Sciences, College of Medicine, Medical University of South Carolina, Charleston, SC, USA
| | - Michele Marcus
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA; Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - James J Lah
- Department of Neurology, School of Medicine, Emory University, Atlanta, GA, USA
| | - Lance A Waller
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA; Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Stefanie Ebelt
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA; Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Anke Hüls
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA; Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
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Ma H, Li X, Zhou T, Wang M, Heianza Y, Qi L. Long-term exposure to low-level air pollution, genetic susceptibility and risk of dementia. Int J Epidemiol 2022:6645760. [PMID: 35849335 DOI: 10.1093/ije/dyac146] [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: 09/21/2021] [Accepted: 06/22/2022] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND We aimed to assess the association between low-level air pollution and the risk of dementia, and examine the modification effect by genetic susceptibility on the relationship. METHODS A total of 164 447 participants who were free of dementia at baseline and aged ≥60 years were included. Annual average concentrations of particulate matter (PM) with diameters of ≤2.5 μm (PM2.5), between 2.5 and 10 μm (PMcoarse), PM2.5 absorbance and nitrogen dioxides (NO2) were evaluated using the Land Use Regression models. Cox proportional hazards regression was used to estimate the association between air pollutants and incident dementia. RESULTS The adjusted hazard ratio (HR) of dementia for a 5-μg/m3 increase in NO2 was 1.09 (95% CI, 1.05-1.14); the adjusted HR of dementia for a 1-μg/m3 increase in PM2.5 was 1.10 (1.04-1.17). Such significant associations were present even within concentration ranges well below the present World Health Organization, US and European annual mean limit values. In addition, higher PM2.5 absorbance, a marker closely related to motorized traffic, was associated with higher risk of dementia. We found the risk of dementia associated with a combination of air pollutants (NO2 or PM2.5) and high genetic susceptibility (APOE-ε4 alleles or overall genetic susceptibility) was greater than the addition of the risk associated with each individual factor, indicating significant interactions on an additive scale (all P-interaction < 0.05). CONCLUSION Long-term exposure to PM2.5 or NO2, even at relatively low levels, is associated with a higher risk of dementia. Air pollution may additively interact with the genetic susceptibility on dementia risk.
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Affiliation(s)
- Hao Ma
- Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LAUSA
| | - Xiang Li
- Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LAUSA
| | - Tao Zhou
- Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LAUSA
| | - Mengying Wang
- Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LAUSA
| | - Yoriko Heianza
- Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LAUSA
| | - Lu Qi
- Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LAUSA.,Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA USA
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Raichlen DA, Furlong M, Klimentidis YC, Sayre MK, Parra KL, Bharadwaj PK, Wilcox RR, Alexander GE. Association of Physical Activity with Incidence of Dementia Is Attenuated by Air Pollution. Med Sci Sports Exerc 2022; 54:1131-1138. [PMID: 35704438 PMCID: PMC9204780 DOI: 10.1249/mss.0000000000002888] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
INTRODUCTION Physical activity (PA) is recognized as one of the key lifestyle behaviors that reduces risk of developing dementia late in life. However, PA also leads to increased respiration, and in areas with high levels of air pollution, PA may increase exposure to pollutants linked with higher risk of developing dementia. Here, we investigate whether air pollution attenuates the association between PA and dementia risk. METHODS This prospective cohort study included 35,562 adults 60 yrs and older from the UK Biobank. Average acceleration magnitude (ACCave) from wrist-worn accelerometers was used to assess PA levels. Air pollution levels (NO, NO2, PM10, PM2.5, PM2.5-10, and PM2.5 absorbance) were estimated with land use regression methods. Incident all-cause dementia was derived from inpatient hospital records and death registry data. RESULTS In adjusted models, ACCave was associated with reduced risk of developing dementia (HR = 0.71, 95% confidence interval [CI] = 0.60-0.83), whereas air pollution variables were not associated with dementia risk. There were significant interactions between ACCave and PM2.5 (HRinteraction = 1.33, 95% CI = 1.13-1.57) and PM2.5 absorbance (HRinteraction = 1.24, 95% CI = 1.07-1.45) on incident dementia. At the lowest tertiles of pollution, ACCave was associated with reduced risk of incident dementia (HRPM 2.5 = 0.66, 95% CI = 0.49-0.91; HRPM 2.5 absorbance = 0.60, 95% CI = 0.44-0.81). At the highest tertiles of these pollutants, there was no significant association of ACCave with incident dementia (HRPM 2.5 = 0.88, 95% CI = 0.68-1.14; HRPM 2.5 absorbance = 0.79, 95% CI = 0.60-1.04). CONCLUSIONS PA is associated with reduced risk of developing all-cause dementia. However, exposure to even moderate levels of air pollution attenuates the benefits of PA on risk of dementia.
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Affiliation(s)
- David A Raichlen
- Human and Evolutionary Biology Section, Department of Biological Sciences, University of Southern California, CA
| | - Melissa Furlong
- Department of Community, Environment, and Policy, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ
| | | | - M Katherine Sayre
- Human and Evolutionary Biology Section, Department of Biological Sciences, University of Southern California, CA
| | - Kimberly L Parra
- Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ
| | | | - Rand R Wilcox
- Department of Psychology, University of Southern California, CA
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Effects of Diastolic Blood Pressure on Brain Structures and Cognitive Functions in Middle and Old Ages: Longitudinal Analyses. Nutrients 2022; 14:nu14122464. [PMID: 35745194 PMCID: PMC9229545 DOI: 10.3390/nu14122464] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Revised: 06/07/2022] [Accepted: 06/08/2022] [Indexed: 01/21/2023] Open
Abstract
Hypertension is a pervasive public health concern due to strong associations with cardiovascular diseases and stroke. Alternatively, the associations between hypertension and the risk of Alzheimer's disease are complex and recent large sample studies reported positive associations. In this paper, we examine the associations between diastolic blood pressure (BP) and subsequent changes in brain structure and cognitive function over several years by multiple regression analyses (with adjustment for a wide range of potential confounding variables) among a large cohort from the UK Biobank. Higher baseline diastolic BP was associated with a slightly smaller relative increase (relative improvements) in reaction time and a slightly greater reduction in depression scores. Higher baseline diastolic BP was also associated with a greater total gray matter volume (GMV) retention, while aging alone was associated with GMV reduction. White matter microstructural analyses revealed that a greater diastolic BP was associated with reduced longitudinal mean and regional fractional anisotropy, greater increases in mean and regional mean diffusivity, radial diffusivity, and axial diffusivity, a greater decline in mean intracellular volume fraction, and greater increases in mean and regional isotropic volume fraction. These white matter microstructural changes were consistent with those seen in the aging process. Additional analyses revealed a greater cheese intake level at baseline, which is associated with a subsequent decline in diastolic BP and a relative subsequent increase in depressive tendency together with a relative increase in fluid intelligence and visuospatial memory performance. These results are congruent with the view that a higher BP in the aging brain has a complex role.
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22
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Parra KL, Alexander GE, Raichlen DA, Klimentidis YC, Furlong MA. Exposure to air pollution and risk of incident dementia in the UK Biobank. ENVIRONMENTAL RESEARCH 2022; 209:112895. [PMID: 35149105 PMCID: PMC8976829 DOI: 10.1016/j.envres.2022.112895] [Citation(s) in RCA: 37] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/09/2021] [Revised: 01/14/2022] [Accepted: 02/02/2022] [Indexed: 05/03/2023]
Abstract
BACKGROUND Air pollution may cause inflammatory and oxidative stress damage to the brain, leading to neurodegenerative disease. The association between air pollution and dementia, and modification by apolipoprotein E genotype 4 (APOE-ε4) has yet to be fully investigated. OBJECTIVES To examine associations of air pollution with three types of incident dementias (Alzheimer's disease (AD), frontotemporal dementia (FTD), and vascular dementia (VAD)), and their potential modification by APOE-ε4 genotype. METHODS The UK Biobank enrolled >500,000 participants (2006-2010) with ongoing follow-up. We used annual averages of air pollution (PM2.5, PM10, PM2.5-10, PM2.5absorbance, NO2, NOX) for 2010 scaled to interquartile ranges (IQR). We included individuals aged ≥60 years, with no dementia diagnosis prior to January 1, 2010. Time to incident dementia and follow-up time were reported from baseline (January 01, 2010) to last censor event (death, last hospitalization, or loss to follow-up). Cox proportional hazard ratios (HR) and 95% confidence intervals (95% CI) were calculated to estimate the association of air pollutants and incident dementia, and modification of these associations by APOE-ε4. RESULTS Our sample included 187,194 individuals (including N = 680 AD, N = 377 VAD, N = 63 FTD) with a mean follow-up of 7.04 years. We observed consistent associations of PM2.5 with greater risk of all-cause dementia (HR = 1.17, 95% CI: 1.10, 1.24) and AD (HR = 1.17, 95% CI: 1.06, 1.29). NO2 was also associated with greater risk of any incident dementia (HR = 1.18, 95% CI: 1.10, 1.25), AD (HR = 1.15, 95% CI: 1.04, 1.28) and VAD (HR = 1.18, 95% CI: 1.03, 1.35). APOE-ε4 did not modify the association between any air pollutants and dementia. DISCUSSION PM2.5 and NO2 levels were associated with several types of dementia, and these associations were not modified by APOE-ε4. Findings from the UK Biobank support and extend to other epidemiological evidence for the potential association of air pollutants with detrimental brain health during aging.
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Affiliation(s)
- Kimberly L Parra
- Department of Epidemiology & Biostatistics, University of Arizona Mel and Enid Zuckerman College of Public Health, Tucson, AZ, USA.
| | - Gene E Alexander
- Departments of Psychology and Psychiatry, Neuroscience and Physiological Sciences Graduate Interdisciplinary Programs, BIO5 Institute, and Evelyn F. McKnight Brain Institute, University of Arizona, Tucson, AZ, USA; Arizona Alzheimer's Consortium, Phoenix, AZ, USA
| | - David A Raichlen
- Department of Biological Sciences, Human and Evolutionary Biology Section, University of Southern California, Los Angeles, CA, USA
| | - Yann C Klimentidis
- Department of Epidemiology & Biostatistics, University of Arizona Mel and Enid Zuckerman College of Public Health, Tucson, AZ, USA
| | - Melissa A Furlong
- Department of Community, Environment, and Policy, Division of Environmental Health Sciences, University of Arizona Mel and Enid Zuckerman College of Public Health, Tucson, AZ, USA
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Tham R, Wheeler AJ, Carver A, Dunstan D, Donaire-Gonzalez D, Anstey KJ, Shaw JE, Magliano DJ, Martino E, Barnett A, Cerin E. Associations between Traffic-Related Air Pollution and Cognitive Function in Australian Urban Settings: The Moderating Role of Diabetes Status. TOXICS 2022; 10:289. [PMID: 35736898 PMCID: PMC9228131 DOI: 10.3390/toxics10060289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Revised: 05/14/2022] [Accepted: 05/24/2022] [Indexed: 11/29/2022]
Abstract
Traffic-related air pollution (TRAP) is associated with lower cognitive function and diabetes in older adults, but little is known about whether diabetes status moderates the impact of TRAP on older adult cognitive function. We analysed cross-sectional data from 4141 adults who participated in the Australian Diabetes, Obesity and Lifestyle (AusDiab) study in 2011-2012. TRAP exposure was estimated using major and minor road density within multiple residential buffers. Cognitive function was assessed with validated psychometric scales, including: California Verbal Learning Test (memory) and Symbol-Digit Modalities Test (processing speed). Diabetes status was measured using oral glucose tolerance tests. We observed positive associations of some total road density measures with memory but not processing speed. Minor road density was not associated with cognitive function, while major road density showed positive associations with memory and processing speed among larger buffers. Within a 300 m buffer, the relationship between TRAP and memory tended to be positive in controls (β = 0.005; p = 0.062), but negative in people with diabetes (β = -0.013; p = 0.026) and negatively associated with processing speed in people with diabetes only (β = -0.047; p = 0.059). Increased TRAP exposure may be positively associated with cognitive function among urban-dwelling people, but this benefit may not extend to those with diabetes.
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Affiliation(s)
- Rachel Tham
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, VIC 3000, Australia; (A.J.W.); (A.C.); (A.B.)
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC 3053, Australia; (R.T.); (E.M.)
| | - Amanda J. Wheeler
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, VIC 3000, Australia; (A.J.W.); (A.C.); (A.B.)
- Menzies Institute for Medical Research, College of Health and Medicine, University of Tasmania, Hobart, TAS 7000, Australia
| | - Alison Carver
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, VIC 3000, Australia; (A.J.W.); (A.C.); (A.B.)
| | - David Dunstan
- School of Exercise and Nutrition Sciences, Deakin University, Burwood, VIC 3125, Australia
- Baker Heart and Diabetes Institute, Melbourne, VIC 3004, Australia; (D.D.); (J.E.S.); (D.J.M.)
| | | | - Kaarin J. Anstey
- School of Psychology, University of New South Wales, Randwick, NSW 2052, Australia;
- Neuroscience Research Australia (NeuRA), Sydney, NSW 2031, Australia
| | - Jonathan E. Shaw
- Baker Heart and Diabetes Institute, Melbourne, VIC 3004, Australia; (D.D.); (J.E.S.); (D.J.M.)
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia
- School of Life Sciences, La Trobe University, Melbourne, VIC 3086, Australia
| | - Dianna J. Magliano
- Baker Heart and Diabetes Institute, Melbourne, VIC 3004, Australia; (D.D.); (J.E.S.); (D.J.M.)
| | - Erika Martino
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC 3053, Australia; (R.T.); (E.M.)
| | - Anthony Barnett
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, VIC 3000, Australia; (A.J.W.); (A.C.); (A.B.)
| | - Ester Cerin
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, VIC 3000, Australia; (A.J.W.); (A.C.); (A.B.)
- School of Public Health, The University of Hong Kong, 7 Sassoon Rd., Pokfulam, Hong Kong, China
- Department of Community Medicine, UiT The Artic University of Norway, 9019 Tromsø, Norway
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Zhang L, Luo Y, Zhang Y, Pan X, Zhao D, Wang Q. Green Space, Air Pollution, Weather, and Cognitive Function in Middle and Old Age in China. Front Public Health 2022; 10:871104. [PMID: 35586008 PMCID: PMC9108722 DOI: 10.3389/fpubh.2022.871104] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 03/09/2022] [Indexed: 11/13/2022] Open
Abstract
Prior research has shown that environmental hazards, such as limited green space, air pollution, and harmful weather, have the strong adverse impact on older adults' cognitive function; however, most of the studies were conducted in developed countries and limited to cross-sectional analyses. China has the largest aging population in the world so the research evidence from it can offer an insight to the study in other developing countries facing similar issues and inform future public health policy and disease control. This study examined the long-term impact of environmental factors, namely, green space coverage, air pollution, and weather conditions on cognitive function using a nationally representative sample consisting of adults aged 45 years and older selected from the China Health and Retirement Longitudinal Study (CHARLS 2011–2018), the China City Statistical Yearbook, and other sources. Multilevel growth curve models were utilized for analysis and the mediator effects of physical activity and social engagement on the relationship between environmental factors and cognitive function were examined. Findings of this study showed that after controlling for sociodemographic characteristics, annual precipitation of 80 cm or more, living in areas with July temperature of 28°C or higher, urban community, and green space coverage were positively associated with cognition score at the baseline and lower precipitation, urban community, and greater green space coverage were associated with slower cognitive decline over a 7-year period. The impact of gross domestic product (GDP) seemed to take into effect more and more over time. These effects did not substantially change after weekly total hours of physical activities and levels of social engagement were added. More research on the mechanisms of the effect of environmental factors on cognition is needed such as the subgroup analyses and/or with more aspects of environmental measures.
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Affiliation(s)
- Lingling Zhang
- Department of Nursing, University of Massachusetts Boston, Boston, MA, United States
| | - Ye Luo
- Department of Sociology, Anthropology and Criminal Justice, Clemson University, Clemson, SC, United States
- *Correspondence: Ye Luo
| | - Yao Zhang
- Department of Nursing, University of Massachusetts Boston, Boston, MA, United States
| | - Xi Pan
- Department of Sociology, Texas State University, San Marcos, TX, United States
| | - Dandan Zhao
- Department of Sociology, Anthropology and Criminal Justice, Clemson University, Clemson, SC, United States
| | - Qing Wang
- Department of Biostatistics, Shandong University, Jinan, China
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Guo C, Yu T, Bo Y, Lin C, Chang LY, Wong MCS, Yu Z, Lau AKH, Tam T, Lao XQ. Long-term Exposure to Fine Particulate Matter and Mortality A Longitudinal Cohort Study of 400,459 Adults. Epidemiology 2022; 33:309-317. [PMID: 35067568 DOI: 10.1097/ede.0000000000001464] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Cohort studies on the association between long-term exposure to fine particulate matter (PM2.5) and mortality have been well established for America and Europe, but limited and inconsistent in Asia with much higher air pollution. This study aims to investigate the associations between ambient PM2.5 and all-cause and cause-specific mortality over a period of rising and then declining PM2.5. METHODS We enrolled a total of 400,459 adults from an open cohort between 2001 and 2016, and followed them up until 31 May 2019. We obtained mortality data from the National Death Registry maintained by the Ministry of Health and Welfare in Taiwan. We estimated ambient PM2.5 exposures using a satellite-based spatiotemporal model. We performed a Cox regression model with time-dependent covariates to investigate the associations of PM2.5 with deaths from all causes and specific causes. RESULTS This study identified 14,627 deaths and had a total of 5 million person-years of follow-up. Each 10 µg/m3 increase in PM2.5 was associated with an increased hazard risk of 29% (95% confidence interval: 24%-35%) in all-cause mortality. Risk of death increased by 30% for natural causes, 20% for cancer, 42% for cardiovascular disease (CVD) causes, and 53% for influenza and pneumonia causes, for each 10 µg/m3 increase in PM2.5. Sensitivity analyses generally yielded similar results. CONCLUSION Long-term exposure to ambient PM2.5 was associated with increased risks of all-cause mortality and deaths from cancers, natural causes, CVD, and influenza and pneumonia. Longitudinal study design should be encouraged for air pollution epidemiologic investigation.
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Affiliation(s)
- Cui Guo
- From the Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Tsung Yu
- Department of Public Health, National Cheng Kung University, Tainan, Taiwan
| | - Yacong Bo
- From the Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Changqing Lin
- Division of Environment and Sustainability, The Hong Kong University of Science and Technology, Hong Kong SAR, China
| | | | - Martin C S Wong
- From the Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
- The School of Public Health, The Chinese Academy of Medical Sciences and Peking Union Medical Colleges, Beijing, China
- The School of Public Health, The Peking University, Beijing, China
| | - Zengli Yu
- Department of Nutrition and Food Hygiene, School of Public Health, Zhengzhou University, Henan, China
| | - Alexis K H Lau
- Division of Environment and Sustainability, The Hong Kong University of Science and Technology, Hong Kong SAR, China
- Department of Civil and Environmental Engineering, The Hong Kong University of Science and Technology, Hong Kong SAR, China
| | - Tony Tam
- Department of Sociology, the Chinese University of Hong Kong, Hong Kong
| | - Xiang Qian Lao
- From the Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
- Shenzhen Research Institute of the Chinese University of Hong Kong, Shenzhen, China
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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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Younan D, Wang X, Millstein J, Petkus AJ, Beavers DP, Espeland MA, Chui HC, Resnick SM, Gatz M, Kaufman JD, Wellenius GA, Whitsel EA, Manson JE, Rapp SR, Chen JC. Air quality improvement and cognitive decline in community-dwelling older women in the United States: A longitudinal cohort study. PLoS Med 2022; 19:e1003893. [PMID: 35113870 PMCID: PMC8812844 DOI: 10.1371/journal.pmed.1003893] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Accepted: 12/15/2021] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Late-life exposure to ambient air pollution is a modifiable risk factor for dementia, but epidemiological studies have shown inconsistent evidence for cognitive decline. Air quality (AQ) improvement has been associated with improved cardiopulmonary health and decreased mortality, but to the best of our knowledge, no studies have examined the association with cognitive function. We examined whether AQ improvement was associated with slower rate of cognitive decline in older women aged 74 to 92 years. METHODS AND FINDINGS We studied a cohort of 2,232 women residing in the 48 contiguous US states that were recruited from more than 40 study sites located in 24 states and Washington, DC from the Women's Health Initiative (WHI) Memory Study (WHIMS)-Epidemiology of Cognitive Health Outcomes (WHIMS-ECHO) study. They were predominantly non-Hispanic White women and were dementia free at baseline in 2008 to 2012. Measures of annual (2008 to 2018) cognitive function included the modified Telephone Interview for Cognitive Status (TICSm) and the telephone-based California Verbal Learning Test (CVLT). We used regionalized universal kriging models to estimate annual concentrations (1996 to 2012) of fine particulate matter (PM2.5) and nitrogen dioxide (NO2) at residential locations. Estimates were aggregated to the 3-year average immediately preceding (recent exposure) and 10 years prior to (remote exposure) WHIMS-ECHO enrollment. Individual-level improved AQ was calculated as the reduction from remote to recent exposures. Linear mixed effect models were used to examine the associations between improved AQ and the rates of cognitive declines in TICSm and CVLT trajectories, adjusting for sociodemographic (age; geographic region; race/ethnicity; education; income; and employment), lifestyle (physical activity; smoking; and alcohol), and clinical characteristics (prior hormone use; hormone therapy assignment; depression; cardiovascular disease (CVD); hypercholesterolemia; hypertension; diabetes; and body mass index [BMI]). For both PM2.5 and NO2, AQ improved significantly over the 10 years before WHIMS-ECHO enrollment. During a median of 6.2 (interquartile range [IQR] = 5.0) years of follow-up, declines in both general cognitive status (β = -0.42/year, 95% CI: -0.44, -0.40) and episodic memory (β = -0.59/year, 95% CI: -0.64, -0.54) were observed. Greater AQ improvement was associated with slower decline in TICSm (βPM2.5improvement = 0.026 per year for improved PM2.5 by each IQR = 1.79 μg/m3 reduction, 95% CI: 0.001, 0.05; βNO2improvement = 0.034 per year for improved NO2 by each IQR = 3.92 parts per billion [ppb] reduction, 95% CI: 0.01, 0.06) and CVLT (βPM2.5 improvement = 0.070 per year for improved PM2.5 by each IQR = 1.79 μg/m3 reduction, 95% CI: 0.02, 0.12; βNO2improvement = 0.060 per year for improved NO2 by each IQR = 3.97 ppb reduction, 95% CI: 0.005, 0.12) after adjusting for covariates. The respective associations with TICSm and CVLT were equivalent to the slower decline rate found with 0.9 to 1.2 and1.4 to 1.6 years of younger age and did not significantly differ by age, region, education, Apolipoprotein E (ApoE) e4 genotypes, or cardiovascular risk factors. The main limitations of this study include measurement error in exposure estimates, potential unmeasured confounding, and limited generalizability. CONCLUSIONS In this study, we found that greater improvement in long-term AQ in late life was associated with slower cognitive declines in older women. This novel observation strengthens the epidemiologic evidence of an association between air pollution and cognitive aging.
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Affiliation(s)
- Diana Younan
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, California, United States of America
| | - Xinhui Wang
- Department of Neurology, University of Southern California, Los Angeles, California, United States of America
| | - Joshua Millstein
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, California, United States of America
| | - Andrew J. Petkus
- Department of Neurology, University of Southern California, Los Angeles, California, United States of America
| | - Daniel P. Beavers
- Department of Biostatistics and Data Science, Wake Forest School of Medicine, Winston-Salem, North Carolina, United States of America
| | - Mark A. Espeland
- Department of Biostatistics and Data Science, Wake Forest School of Medicine, Winston-Salem, North Carolina, United States of America
| | - Helena C. Chui
- Department of Neurology, University of Southern California, Los Angeles, California, United States of America
| | - Susan M. Resnick
- Laboratory of Behavioral Neuroscience, National Institute on Aging, Baltimore, Maryland, United States of America
| | - Margaret Gatz
- Center for Economic and Social Research, University of Southern California, Los Angeles, California, United States of America
| | - Joel D. Kaufman
- Departments of Environmental & Occupational Health Sciences, Medicine, and Epidemiology, University of Washington, Seattle, Washington, United States of America
| | - Gregory A. Wellenius
- Department of Environmental Health, Boston University, Boston, Massachusetts, United States of America
| | - Eric A. Whitsel
- Departments of Epidemiology and Medicine, University of North Carolina, Chapel Hill, North Carolina, United States of America
| | - JoAnn E. Manson
- Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Stephen R. Rapp
- Departments of Psychiatry and Behavioral Medicine and Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem, North Carolina, United States of America
| | - Jiu-Chiuan Chen
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, California, United States of America
- Department of Neurology, University of Southern California, Los Angeles, California, United States of America
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Park SY, Han J, Kim SH, Suk HW, Park JE, Lee DY. Impact of Long-Term Exposure to Air Pollution on Cognitive Decline in Older Adults Without Dementia. J Alzheimers Dis 2022; 86:553-563. [DOI: 10.3233/jad-215120] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background: Air pollution control is necessary to decrease the burden on older adults with cognitive impairment, especially in low- and middle-income countries (LMICs). Objective: This study retrospectively examined the effect of cumulative exposure to air pollution, including NO2, SO2, CO, fine particulate matter (PM)10, PM2.5, and O3, on cognitive function in older individuals. Methods: Community-dwelling older adults who underwent the Mini-Mental State Examination (MMSE) from 2007 to 2018 were included in the analyses. We excluded older individuals diagnosed with dementia at baseline, while those who had completed more than two MMSE tests were included in the longitudinal analyses. Baseline MMSE and changes in MMSE scores were analyzed according to 5-year average concentrations of the district-level air pollutants, after controlling for covariates associated with cognitive decline in older adults. Results: In total, 884,053 (74.3±7.1 years; 64.1% females) and 398,889 (72.3±6.4 years; 67.0% females) older individuals were included in the cross-sectional and longitudinal analyses, respectively. Older individuals exposed to higher levels of NO2, SO2, CO, and PM10 showed lower baseline MMSE scores. During follow-up, exposure to higher levels of NO2, SO2, CO, and PM10 was associated with greater decreases in MMSE scores in older individuals; for O3, the opposite pattern was observed. Conclusion: Our findings suggest that exposure to high levels of air pollutants can worsen the cognitive performance of older adults without dementia. Efforts to reduce air pollution in LMICs that have similar levels of pollutants to South Korea are necessary to reduce the burden on older adults with cognitive impairment.
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Affiliation(s)
- Seon Young Park
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, South Korea
| | - Jiyeon Han
- Medical Research Collaborating Center, Seoul National University Hospital, Seoul, South Korea
| | - Seon Hwa Kim
- Seoul Metropolitan Center for Dementia, Seoul, South Korea
| | - Hye Won Suk
- Departement of Psychology, Sogang University, Seoul, South Korea
| | - Jee Eun Park
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, South Korea
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, South Korea
- Jongno Community Center for Dementia, Seoul, South Korea
| | - Dong Young Lee
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, South Korea
- Seoul Metropolitan Center for Dementia, Seoul, South Korea
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, South Korea
- Medical Research Center, Institute of Human Behavioral Medicine, Seoul National University, Seoul, South Korea
- Interdisiplinary Program in Cognitive Science, Seoul National University, Seoul, South Korea
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Chandra M, Rai CB, Kumari N, Sandhu VK, Chandra K, Krishna M, Kota SH, Anand KS, Oudin A. Air Pollution and Cognitive Impairment across the Life Course in Humans: A Systematic Review with Specific Focus on Income Level of Study Area. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031405. [PMID: 35162428 PMCID: PMC8835599 DOI: 10.3390/ijerph19031405] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Revised: 12/23/2021] [Accepted: 12/25/2021] [Indexed: 02/01/2023]
Abstract
Cognitive function is a crucial determinant of human capital. The Lancet Commission (2020) has recognized air pollution as a risk factor for dementia. However, the scientific evidence on the impact of air pollution on cognitive outcomes across the life course and across different income settings, with varying levels of air pollution, needs further exploration. A systematic review was conducted, using Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) Guidelines to assess the association between air pollution and cognitive outcomes across the life course with a plan to analyze findings as per the income status of the study population. The PubMed search included keywords related to cognition and to pollution (in their titles) to identify studies on human participants published in English until 10 July 2020. The search yielded 84 relevant studies that described associations between exposure to air pollutants and an increased risk of lower cognitive function among children and adolescents, cognitive impairment and decline among adults, and dementia among older adults with supportive evidence of neuroimaging and inflammatory biomarkers. No study from low- and middle-income countries (LMICs)was identified despite high levels of air pollutants and high rates of dementia. To conclude, air pollution may impair cognitive function across the life-course, but a paucity of studies from reLMICs is a major lacuna in research.
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Affiliation(s)
- Mina Chandra
- Department of Psychiatry, Centre of Excellence in Mental Health, Atal Bihari Vajpayee Institute of Medical Sciences (formerly PGIMER) and Dr. Ram Manohar Lohia Hospital, New Delhi 110001, India; (C.B.R.); (N.K.); (V.K.S.)
- Correspondence: ; Tel.: +91-98-1183-1902
| | - Chandra Bhushan Rai
- Department of Psychiatry, Centre of Excellence in Mental Health, Atal Bihari Vajpayee Institute of Medical Sciences (formerly PGIMER) and Dr. Ram Manohar Lohia Hospital, New Delhi 110001, India; (C.B.R.); (N.K.); (V.K.S.)
| | - Neelam Kumari
- Department of Psychiatry, Centre of Excellence in Mental Health, Atal Bihari Vajpayee Institute of Medical Sciences (formerly PGIMER) and Dr. Ram Manohar Lohia Hospital, New Delhi 110001, India; (C.B.R.); (N.K.); (V.K.S.)
| | - Vipindeep Kaur Sandhu
- Department of Psychiatry, Centre of Excellence in Mental Health, Atal Bihari Vajpayee Institute of Medical Sciences (formerly PGIMER) and Dr. Ram Manohar Lohia Hospital, New Delhi 110001, India; (C.B.R.); (N.K.); (V.K.S.)
| | - Kalpana Chandra
- Delhi Jal Board, Government of National Capital Territory of Delhi, New Delhi 110094, India;
| | - Murali Krishna
- JSS Academy of Higher Education & Research, Mysore 570015, Karnataka, India;
| | - Sri Harsha Kota
- Department of Civil Engineering, Indian Institute of Technology Delhi, New Delhi 110016, India;
| | - Kuljeet Singh Anand
- Department of Neurology, Atal Bihari Vajpayee Institute of Medical Sciences (Formerly PGIMER) and Dr. Ram Manohar Lohia Hospital, New Delhi 110001, India;
| | - Anna Oudin
- Department of Public Health and Clinical Medicine, Umeå University, 901 87 Umea, Sweden;
- Department of Laboratory Medicine, Lund University, 901 87 Umea, Sweden
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30
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Chua SYL, Khawaja AP, Desai P, Rahi JS, Day AC, Hammond CJ, Khaw PT, Foster PJ. The Association of Ambient Air Pollution With Cataract Surgery in UK Biobank Participants: Prospective Cohort Study. Invest Ophthalmol Vis Sci 2021; 62:7. [PMID: 34874411 PMCID: PMC8662572 DOI: 10.1167/iovs.62.15.7] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Accepted: 11/04/2021] [Indexed: 12/02/2022] Open
Abstract
Purpose Air pollution is associated with chronic diseases of later life. Cataract is the most common cause of blindess globally. It is biologically plausible that cataract risk is increased by pollution exposure. Therefore, the relationship between air pollution and incident cataract surgery was examined. Methods This was a prospective, observational study involving 433,727 UK Biobank participants. Ambient air pollution measures included particulates, nitrogen dioxide (NO2) and nitrogen oxides (NOx). Outdoor air pollution was estimated based on land use regression models. Participants undergoing cataract surgery in either eye were ascertained via data linkage to the National Health Service procedure statistics. Those undergoing cataract surgery within 1 year of baseline assessment and those reporting cataract at baseline were excluded. Cox proportional hazards models were used to examine the associations between air pollutants and incident cataract surgery, adjusting for sociodemographic and lifestyle factors. Results There were 16,307 incident cases of cataract surgery. Higher exposure to PM2.5 was associated with a 5% increased risk of incident cataract surgery (per interquartile range [IQR] increase). Compared to the lowest quartile, participants with exposures to PM2.5, NO2, and NOx in the highest quartile were 14%, 11%, and 9% more likely to undergo cataract surgery, respectively. A continuous exposure-response relationship was observed, with the likelihood of undergoing cataract surgery being progressively higher with greater levels of PM2.5, NO2, and NOx (P for trend P < 0.001). Conclusions Although the results of our study showed a 5% increased risk of future cataract surgery following an exposure to PM2.5, NO2, and NOx, the effect estimates were relatively small. Further research is required to determine if the associations identified are causal.
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Affiliation(s)
- Sharon Y L Chua
- NIHR Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust & UCL Institute of Ophthalmology, London, United Kingdom; Moorfields Eye Hospital, London; UCL Institute of Ophthalmology, London, United Kingdom
| | - Anthony P Khawaja
- NIHR Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust & UCL Institute of Ophthalmology, London, United Kingdom; Moorfields Eye Hospital, London; UCL Institute of Ophthalmology, London, United Kingdom
| | - Parul Desai
- Moorfields Eye Hospital, 162 City Road, London, United Kingdom
| | - Jugnoo S Rahi
- NIHR Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust & UCL Institute of Ophthalmology, London, United Kingdom; Moorfields Eye Hospital, London; UCL Institute of Ophthalmology, London, United Kingdom
- UCL Great Ormond Street Institute of Child Health & Institute of Ophthalmology UCL, Holborn, London, London, United Kingdom
- Great Ormond Street Hospital NHS Trust, London, United Kingdom
| | - Alex C Day
- NIHR Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust & UCL Institute of Ophthalmology, London, United Kingdom; Moorfields Eye Hospital, London; UCL Institute of Ophthalmology, London, United Kingdom
- Moorfields Eye Hospital, 162 City Road, London, United Kingdom
| | - Christopher J Hammond
- Section of Ophthalmology, School of Life Course Sciences, King's College London, St Thomas' Hospital, London, United Kingdom
| | - Peng T Khaw
- NIHR Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust & UCL Institute of Ophthalmology, London, United Kingdom; Moorfields Eye Hospital, London; UCL Institute of Ophthalmology, London, United Kingdom
| | - Paul J Foster
- NIHR Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust & UCL Institute of Ophthalmology, London, United Kingdom; Moorfields Eye Hospital, London; UCL Institute of Ophthalmology, London, United Kingdom
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Weuve J, Bennett EE, Ranker L, Gianattasio KZ, Pedde M, Adar SD, Yanosky JD, Power MC. Exposure to Air Pollution in Relation to Risk of Dementia and Related Outcomes: An Updated Systematic Review of the Epidemiological Literature. ENVIRONMENTAL HEALTH PERSPECTIVES 2021; 129:96001. [PMID: 34558969 PMCID: PMC8462495 DOI: 10.1289/ehp8716] [Citation(s) in RCA: 86] [Impact Index Per Article: 28.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 08/04/2021] [Accepted: 08/05/2021] [Indexed: 05/02/2023]
Abstract
BACKGROUND Dementia is a devastating neurologic condition that is common in older adults. We previously reviewed the epidemiological evidence examining the hypothesis that long-term exposure to air pollution affects dementia risk. Since then, the evidence base has expanded rapidly. OBJECTIVES With this update, we collectively review new and previously identified epidemiological studies on air pollution and late-life cognitive health, highlighting new developments and critically discussing the merits of the evidence. METHODS Using a registered protocol (PROSPERO 2020 CRD42020152943), we updated our literature review to capture studies published through 31 December 2020, extracted data, and conducted a bias assessment. RESULTS We identified 66 papers (49 new) for inclusion in this review. Cognitive level remained the most commonly considered outcome, and particulate matter (PM) remained the most commonly considered air pollutant. Since our prior review, exposure estimation methods in this research have improved, and more papers have looked at cognitive change, neuroimaging, and incident cognitive impairment/dementia, though methodological concerns remain common. Many studies continue to rely on administrative records to ascertain dementia, have high potential for selection bias, and adjust for putative mediating factors in primary models. A subset of 35 studies met strict quality criteria. Although high-quality studies of fine particulate matter with aerodynamic diameter ≤ 2.5 μ m (PM 2.5 ) and cognitive decline generally supported an adverse association, other findings related to PM 2.5 and findings related to particulate matter with aerodynamic diameter ≤ 10 μ m (PM 10 , NO 2 , and NO x ) were inconclusive, and too few papers reported findings with ozone to comment on the likely direction of association. Notably, only a few findings on dementia were included for consideration on the basis of quality criteria. DISCUSSION Strong conclusions remain elusive, although the weight of the evidence suggests an adverse association between PM 2.5 and cognitive decline. However, we note a continued need to confront methodological challenges in this line of research. https://doi.org/10.1289/EHP8716.
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Affiliation(s)
- Jennifer Weuve
- Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Erin E. Bennett
- Department of Epidemiology, The George Washington University Milken Institute School of Public Health, Washington, DC, USA
| | - Lynsie Ranker
- Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Kan Z. Gianattasio
- Department of Epidemiology, The George Washington University Milken Institute School of Public Health, Washington, DC, USA
| | - Meredith Pedde
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
| | - Sara D. Adar
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
| | - Jeff D. Yanosky
- Department of Public Health Sciences, The Pennsylvania State University College of Medicine, Hershey, Pennsylvania, USA
| | - Melinda C. Power
- Department of Epidemiology, The George Washington University Milken Institute School of Public Health, Washington, DC, USA
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Saenz JL. Solid cooking fuel use and cognitive decline among older Mexican adults. INDOOR AIR 2021; 31:1522-1532. [PMID: 33896051 PMCID: PMC8380681 DOI: 10.1111/ina.12844] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 03/29/2021] [Accepted: 04/09/2021] [Indexed: 05/02/2023]
Abstract
Studies of air pollution and cognition often rely on measures from outdoor environments. Many individuals in low- and middle-income countries are exposed to indoor air pollution from combustion of solid cooking fuels. Little is known about how solid cooking fuel use affects cognitive decline over time. This study uses data from the 2012, 2015, and 2018 Mexican Health and Aging Study (n = 14 245, age 50+) to assess how use of wood or coal for cooking fuel affects cognition of older adults relative to use of gas. It uses latent change score modeling to determine how using solid cooking fuel affected performance in Verbal Learning, Verbal Recall, Visual Scanning, and Verbal Fluency. Solid cooking fuel was used by 17% of the full sample but was more common in rural areas. Solid fuel users also had lower socioeconomic status. Compared to those using gas, solid fuel users had lower baseline scores and faster decline in Verbal Learning (β = -0.18, p < 0.05), Visual Scanning (β = -1.00, p < 0.001), and Verbal Fluency (β = -0.33, p < 0.001). Indoor air pollution from solid cooking fuels may represent a modifiable risk factor for cognitive decline. Policy should focus on facilitating access to clean cooking fuels.
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Affiliation(s)
- Joseph L. Saenz
- University of Southern California, Leonard Davis School of Gerontology, Los Angeles, CA
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Peters R, Mudway I, Booth A, Peters J, Anstey KJ. Putting Fine Particulate Matter and Dementia in the Wider Context of Noncommunicable Disease: Where are We Now and What Should We Do Next: A Systematic Review. Neuroepidemiology 2021; 55:253-265. [PMID: 34062541 DOI: 10.1159/000515394] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Accepted: 02/18/2021] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION A significant proportion of the global population regularly experience air quality poorer than that recommended by the World Health Organization. Air pollution, especially fine particulate matter (PM2.5), is a risk factor for various noncommunicable diseases (NCDs) and is emerging as a risk factor for dementia. To begin to understand the full impact of PM2.5, we review the longitudinal epidemiological evidence linking PM2.5 to both dementia and to other leading NCDs and highlight the evidence gaps. Our objective was to systematically review the current epidemiological evidence for PM2.5 as a risk factor for cognitive decline and incident dementia and to put this in context with a systematic overview of PM2.5 as a potential risk factor in other leading NCDs. METHODS We performed 2 systematic reviews. A high-level review of reviews examining the relationship between PM2.5 and leading NCDs and an in-depth review of the longitudinal epidemiological data examining relationships between PM2.5 incident dementia and cognitive decline. RESULTS There were robust associations between PM2.5 and NCDs although in some cases the evidence was concentrated on short rather than longer term exposure. For those articles reporting on incident dementia, all reported on longer term exposure and 5 of the 7 eligible articles found PM2.5 to be associated with increased risk. CONCLUSION The evidence base for PM2.5 as a risk factor for dementia is growing. It is not yet as strong as that for other NCDs. However, varied measurement/methodology hampers clarity across the field. We propose next steps.
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Affiliation(s)
- Ruth Peters
- School of Psychology, University of New South Wales, Sydney, New South Wales, Australia.,Neuroscience Research Australia, Sydney, New South Wales, Australia
| | - Ian Mudway
- MRC-PHE Centre for Environment and Health, NIHR Health Protection Research Unit in Environmental Exposures and Health, School of Public Health, Imperial College London, London, United Kingdom
| | - Andrew Booth
- School of Health and Related Research, University of Sheffield, Sheffield, United Kingdom
| | - Jean Peters
- School of Health and Related Research, University of Sheffield, Sheffield, United Kingdom
| | - Kaarin J Anstey
- School of Psychology, University of New South Wales, Sydney, New South Wales, Australia.,Neuroscience Research Australia, Sydney, New South Wales, Australia
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Delgado-Saborit JM, Guercio V, Gowers AM, Shaddick G, Fox NC, Love S. A critical review of the epidemiological evidence of effects of air pollution on dementia, cognitive function and cognitive decline in adult population. THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 757:143734. [PMID: 33340865 DOI: 10.1016/j.scitotenv.2020.143734] [Citation(s) in RCA: 88] [Impact Index Per Article: 29.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Revised: 10/26/2020] [Accepted: 11/01/2020] [Indexed: 05/24/2023]
Abstract
Dementia is arguably the most pressing public health challenge of our age. Since dementia does not have a cure, identifying risk factors that can be controlled has become paramount to reduce the personal, societal and economic burden of dementia. The relationship between exposure to air pollution and effects on cognitive function, cognitive decline and dementia has stimulated increasing scientific interest in the past few years. This review of the literature critically examines the available epidemiological evidence of associations between exposure to ambient air pollutants, cognitive performance, acceleration of cognitive decline, risk of developing dementia, neuroimaging and neurological biomarker studies, following Bradford Hill guidelines for causality. The evidence reviewed has been consistent in reporting associations between chronic exposure to air pollution and reduced global cognition, as well as impairment in specific cognitive domains including visuo-spatial abilities. Cognitive decline and dementia incidence have also been consistently associated with exposure to air pollution. The neuro-imaging studies reviewed report associations between exposure to air pollution and white matter volume reduction. Other reported effects include reduction in gray matter, larger ventricular volume, and smaller corpus callosum. Findings relating to ischemic (white matter hyperintensities/silent cerebral infarcts) and hemorrhagic (cerebral microbleeds) markers of cerebral small vessel disease have been heterogeneous, as have observations on hippocampal volume and air pollution. The few studies available on neuro-inflammation tend to report associations with exposure to air pollution. Several effect modifiers have been suggested in the literature, but more replication studies are required. Traditional confounding factors have been controlled or adjusted for in most of the reviewed studies. Additional confounding factors have also been considered, but the inclusion of these has varied among the different studies. Despite all the efforts to adjust for confounding factors, residual confounding cannot be completely ruled out, especially since the factors affecting cognition and dementia are not yet fully understood. The available evidence meets many of the Bradford Hill guidelines for causality. The reported associations between a range of air pollutants and effects on cognitive function in older people, including the acceleration of cognitive decline and the induction of dementia, are likely to be causal in nature. However, the diversity of study designs, air pollutants and endpoints examined precludes the attribution of these adverse effects to a single class of pollutant and makes meta-analysis inappropriate.
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Affiliation(s)
- Juana Maria Delgado-Saborit
- Universitat Jaume I, Perinatal Epidemiology, Environmental Health and Clinical Research, School of Medicine, Castellon, Spain; Environmental Research Group, MRC Centre for Environment and Health, Imperial College London, UK; ISGlobal Barcelona Institute for Global Health, Barcelona Biomedical Research Park, Barcelona, Spain; Division of Environmental Health & Risk Management, School of Geography, Earth & Environmental Sciences, University of Birmingham, Birmingham, UK.
| | - Valentina Guercio
- Air Quality and Public Health Group, Environmental Hazards and Emergencies Department, Centre for Radiation, Chemical and Environmental Hazards, Public Health England, Didcot, UK
| | - Alison M Gowers
- Air Quality and Public Health Group, Environmental Hazards and Emergencies Department, Centre for Radiation, Chemical and Environmental Hazards, Public Health England, Didcot, UK
| | | | - Nick C Fox
- Department of Neurodegenerative Disease, Dementia Research Centre, University College London, Institute of Neurology, London, UK
| | - Seth Love
- Institute of Clinical Neurosciences, University of Bristol, School of Medicine, Level 2 Learning and Research, Southmead Hospital, Bristol, UK
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Petkus AJ, Younan D, Wang X, Beavers DP, Espeland MA, Gatz M, Gruenewald T, Kaufman JD, Chui HC, Millstein J, Rapp SR, Manson JE, Resnick SM, Wellenius GA, Whitsel EA, Widaman K, Chen JC. Associations Between Air Pollution Exposure and Empirically Derived Profiles of Cognitive Performance in Older Women. J Alzheimers Dis 2021; 84:1691-1707. [PMID: 34744078 PMCID: PMC9057084 DOI: 10.3233/jad-210518] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Elucidating associations between exposures to ambient air pollutants and profiles of cognitive performance may provide insight into neurotoxic effects on the aging brain. OBJECTIVE We examined associations between empirically derived profiles of cognitive performance and residential concentrations of particulate matter of aerodynamic diameter < 2.5 (PM2.5) and nitrogen dioxide (NO2) in older women. METHOD Women (N = 2,142) from the Women's Health Initiative Study of Cognitive Aging completed a neuropsychological assessment measuring attention, visuospatial, language, and episodic memory abilities. Average yearly concentrations of PM2.5 and NO2 were estimated at the participant's addresses for the 3 years prior to the assessment. Latent profile structural equation models identified subgroups of women exhibiting similar profiles across tests. Multinomial regressions examined associations between exposures and latent profile classification, controlling for covariates. RESULT Five latent profiles were identified: low performance across multiple domains (poor multi-domain; n = 282;13%), relatively poor verbal episodic memory (poor memory; n = 216; 10%), average performance across all domains (average multi-domain; n = 974; 45%), superior memory (n = 381; 18%), and superior attention (n = 332; 15%). Using women with average cognitive ability as the referent, higher PM2.5 (per interquartile range [IQR] = 3.64μg/m3) was associated with greater odds of being classified in the poor memory (OR = 1.29; 95% Confidence Interval [CI] = 1.10-1.52) or superior attention (OR = 1.30; 95% CI = 1.10-1.53) profiles. NO2 (per IQR = 9.86 ppb) was associated with higher odds of being classified in the poor memory (OR = 1.38; 95% CI = 1.17-1.63) and lower odds of being classified with superior memory (OR = 0.81; 95% CI = 0.67-0.97). CONCLUSION Exposure to PM2.5 and NO2 are associated with patterns of cognitive performance characterized by worse verbal episodic memory relative to performance in other domains.
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Affiliation(s)
- Andrew J. Petkus
- University of Southern California, Department of Neurology, Los Angeles, CA, USA
| | - Diana Younan
- University of Southern California, Department of Population and Public Health Sciences, Los Angeles, CA, USA
| | - Xinhui Wang
- University of Southern California, Department of Neurology, Los Angeles, CA, USA
| | - Daniel P. Beavers
- Wake Forest School of Medicine, Department of Biostatistics, Winston-Salem, NC, USA
| | - Mark A. Espeland
- Wake Forest School of Medicine, Department of Biostatistics, Winston-Salem, NC, USA
| | - Margaret Gatz
- University of Southern California, Center for Economic and Social Research, Los Angeles, CA, USA
| | - Tara Gruenewald
- Chapman University, Department of Psychology, Orange, CA, USA
| | - Joel D. Kaufman
- University of Washington, Department of Environmental and Occupational Health Sciences, Seattle, WA, USA
| | - Helena C. Chui
- University of Southern California, Department of Neurology, Los Angeles, CA, USA
| | - Joshua Millstein
- University of Southern California, Department of Population and Public Health Sciences, Los Angeles, CA, USA
| | - Stephen R. Rapp
- Wake Forest School of Medicine, Department of Psychiatry and Behavioral Medicine, Winston-Salem, NC, USA
| | - JoAnn E. Manson
- Harvard Medical School, Department of Medicine, Brigham and Women’s Hospital, Boston, MA, USA
| | - Susan M. Resnick
- National Institute on Aging, Laboratory of Behavioral Neuroscience, Baltimore, MD, USA
| | | | - Eric A. Whitsel
- University of North Carolina, Departments of Epidemiology and Medicine, Chapel Hill, NC, USA
| | - Keith Widaman
- University of California, Riverside, Graduate School of Education, Riverside, CA, USA
| | - Jiu-Chiuan Chen
- University of Southern California, Department of Neurology, Los Angeles, CA, USA
- University of Southern California, Department of Population and Public Health Sciences, Los Angeles, CA, USA
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Newby D, Winchester L, Sproviero W, Fernandes M, Wang D, Kormilitzin A, Launer LJ, Nevado-Holgado AJ. Associations Between Brain Volumes and Cognitive Tests with Hypertensive Burden in UK Biobank. J Alzheimers Dis 2021; 84:1373-1389. [PMID: 34690138 PMCID: PMC8673518 DOI: 10.3233/jad-210512] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/13/2021] [Indexed: 12/16/2022]
Abstract
BACKGROUND Mid-life hypertension is an established risk factor for cognitive impairment and dementia and related to greater brain atrophy and poorer cognitive performance. Previous studies often have small sample sizes from older populations that lack utilizing multiple measures to define hypertension such as blood pressure, self-report information, and medication use; furthermore, the impact of the duration of hypertension is less extensively studied. OBJECTIVE To investigate the relationship between hypertension defined using multiple measures and length of hypertension with brain measure and cognition. METHODS Using participants from the UK Biobank MRI visit with blood pressure measurements (n = 31,513), we examined the cross-sectional relationships between hypertension and duration of hypertension with brain volumes and cognitive tests using generalized linear models adjusted for confounding. RESULTS Compared with normotensives, hypertensive participants had smaller brain volumes, larger white matter hyperintensities (WMH), and poorer performance on cognitive tests. For total brain, total grey, and hippocampal volumes, those with greatest duration of hypertension had the smallest brain volumes and the largest WMH, ventricular cerebrospinal fluid volumes. For other subcortical and white matter microstructural regions, there was no clear relationship. There were no significant associations between duration of hypertension and cognitive tests. CONCLUSION Our results show hypertension is associated with poorer brain and cognitive health however, the impact of duration since diagnosis warrants further investigation. This work adds further insights by using multiple measures defining hypertension and analysis on duration of hypertension which is a substantial advance on prior analyses-particularly those in UK Biobank which present otherwise similar analyses on smaller subsets.
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Affiliation(s)
- Danielle Newby
- University of Oxford, Department of Psychiatry, Warneford Hospital, Oxford, UK
| | - Laura Winchester
- University of Oxford, Department of Psychiatry, Warneford Hospital, Oxford, UK
| | - William Sproviero
- University of Oxford, Department of Psychiatry, Warneford Hospital, Oxford, UK
| | - Marco Fernandes
- University of Oxford, Department of Psychiatry, Warneford Hospital, Oxford, UK
| | | | - Andrey Kormilitzin
- University of Oxford, Department of Psychiatry, Warneford Hospital, Oxford, UK
| | | | - Alejo J. Nevado-Holgado
- University of Oxford, Department of Psychiatry, Warneford Hospital, Oxford, UK
- Big Data Institute, University of Oxford, Oxford, UK
- Akrivia Health, Oxford, UK
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Dimakakou E, Johnston HJ, Streftaris G, Cherrie JW. Is Environmental and Occupational Particulate Air Pollution Exposure Related to Type-2 Diabetes and Dementia? A Cross-Sectional Analysis of the UK Biobank. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17249581. [PMID: 33371391 PMCID: PMC7767456 DOI: 10.3390/ijerph17249581] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 12/16/2020] [Accepted: 12/17/2020] [Indexed: 01/02/2023]
Abstract
Human exposure to particulate air pollution (e.g., PM2.5) can lead to adverse health effects, with compelling evidence that it can increase morbidity and mortality from respiratory and cardiovascular disease. More recently, there has also been evidence that long-term environmental exposure to particulate air pollution is associated with type-2 diabetes mellitus (T2DM) and dementia. There are many occupations that may expose workers to airborne particles and that some exposures in the workplace are very similar to environmental particulate pollution. We conducted a cross-sectional analysis of the UK Biobank cohort to verify the association between environmental particulate air pollution (PM2.5) exposure and T2DM and dementia, and to investigate if occupational exposure to particulates that are similar to those found in environmental air pollution could increase the odds of developing these diseases. The UK Biobank dataset comprises of over 500,000 participants from all over the UK. Environmental exposure variables were used from the UK Biobank. To estimate occupational exposure both the UK Biobank’s data and information from a job exposure matrix, specifically developed for UK Biobank (Airborne Chemical Exposure–Job Exposure Matrix (ACE JEM)), were used. The outcome measures were participants with T2DM and dementia. In appropriately adjusted models, environmental exposure to PM2.5 was associated with an odds ratio (OR) of 1.02 (95% CI 1.00 to 1.03) per unit exposure for developing T2DM, while PM2.5 was associated with an odds ratio of 1.06 (95% CI 0.96 to 1.16) per unit exposure for developing dementia. These environmental results align with existing findings in the published literature. Five occupational exposures (dust, fumes, diesel, mineral, and biological dust in the most recent job estimated with the ACE JEM) were investigated and the risks for most exposures for T2DM and for all the exposures for dementia were not significantly increased in the adjusted models. This was confirmed in a subgroup of participants where a full occupational history was available allowed an estimate of workplace exposures. However, when not adjusting for gender, some of the associations become significant, which suggests that there might be a bias between the occupational assessments for men and women. The results of the present study do not provide clear evidence of an association between occupational exposure to particulate matter and T2DM or dementia.
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Affiliation(s)
- Eirini Dimakakou
- School of Engineering and Physical Sciences, Institute of Biological Chemistry, Biophysics and Bioengineering, Heriot-Watt University, Riccarton, Edinburgh EH14-4AS, UK; (H.J.J.); (J.W.C.)
- Correspondence:
| | - Helinor J. Johnston
- School of Engineering and Physical Sciences, Institute of Biological Chemistry, Biophysics and Bioengineering, Heriot-Watt University, Riccarton, Edinburgh EH14-4AS, UK; (H.J.J.); (J.W.C.)
| | - George Streftaris
- Maxwell Institute for Mathematical Sciences, School of Mathematical and Computer Sciences, Heriot-Watt University, Edinburgh EH14-4AS, UK;
| | - John W. Cherrie
- School of Engineering and Physical Sciences, Institute of Biological Chemistry, Biophysics and Bioengineering, Heriot-Watt University, Riccarton, Edinburgh EH14-4AS, UK; (H.J.J.); (J.W.C.)
- Institute of Occupational Medicine (IOM), Riccarton, Edinburgh EH14-4AP, UK
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Chua SYL, Khawaja AP, Dick AD, Morgan J, Dhillon B, Lotery AJ, Strouthidis NG, Reisman C, Peto T, Khaw PT, Foster PJ, Patel PJ. Ambient Air Pollution Associations with Retinal Morphology in the UK Biobank. Invest Ophthalmol Vis Sci 2020; 61:32. [PMID: 32428233 PMCID: PMC7405693 DOI: 10.1167/iovs.61.5.32] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Purpose Because air pollution has been linked to glaucoma and AMD, we characterized the relationship between pollution and retinal structure. Methods We examined data from 51,710 UK Biobank participants aged 40 to 69 years old. Ambient air pollution measures included particulates and nitrogen oxides. SD-OCT imaging measured seven retinal layers: retinal nerve fiber layer, ganglion cell–inner plexiform layer, inner nuclear layer, outer plexiform layer + outer nuclear layer, photoreceptor inner segments, photoreceptor outer segments, and RPE. Multivariable regression was used to evaluate associations between pollutants (per interquartile range increase) and retinal thickness, adjusting for age, sex, race, Townsend deprivation index, body mass index, smoking status, and refractive error. Results Participants exposed to greater particulate matter with an aerodynamic diameter of <2.5 µm (PM2.5) and higher nitrogen oxides were more likely to have thicker retinal nerve fiber layer (β = 0.28 µm; 95% CI, 0.22–0.34; P = 3.3 × 10−20 and β = 0.09 µm; 95% CI, 0.04–0.14; P = 2.4 × 10−4, respectively), and thinner ganglion cell–inner plexiform layer, inner nuclear layer, and outer plexiform layer + outer nuclear layer thicknesses (P < 0.001). Participants resident in areas of higher levels of PM2.5 absorbance were more likely to have thinner retinal nerve fiber layer, inner nuclear layer, and outer plexiform layer + outer nuclear layers (β = –0.16 [95% CI, –0.22 to –0.10; P = 5.7 × 10−8]; β = –0.09 [95% CI, –0.12 to –0.06; P = 2.2 × 10−12]; and β = –0.12 [95% CI, –0.19 to –0.05; P = 8.3 × 10−4], respectively). Conclusions Greater exposure to PM2.5, PM2.5 absorbance, and nitrogen oxides were all associated with apparently adverse retinal structural features.
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Ilango SD, Chen H, Hystad P, van Donkelaar A, Kwong JC, Tu K, Martin RV, Benmarhnia T. The role of cardiovascular disease in the relationship between air pollution and incident dementia: a population-based cohort study. Int J Epidemiol 2020; 49:36-44. [PMID: 31347651 DOI: 10.1093/ije/dyz154] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/09/2019] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Evidence suggests a link between air pollution and dementia. Cardiovascular disease (CVD) may be a potential determinant of dementia. This motivated us to quantify the contribution of CVD to the association between air pollution and dementia. METHODS A cohort of Canadian-born residents of Ontario, who participated in the 1996-2003 Canadian Community Health Surveys, was followed through 2013 or until dementia diagnosis. Exposure to nitrogen dioxide (NO2) and fine particulate matter (PM2.5) was estimated with a 3-year average and 5-year lag before dementia diagnosis. Incident CVD was evaluated as a mediator. We used multi-level Cox proportional and Aalen additive hazard regression models, adjusting for individual- and neighbourhood-level risk factors to estimate associations with NO2 and PM2.5. We estimated the total, direct and indirect effects of air pollution on dementia through cardiovascular disease. RESULTS This study included 34 391 older adults. At baseline, the mean age of this cohort was 59 years. The risk of dementia was moderately higher among those more exposed to NO2 (hazard ratio (HR) 1.10, 95% confidence interval (CI) 0.99-1.19; and 100 additional cases per 100 000 [standard error (SE) <100x10-5]) and PM2.5 [(HR 1.29, 95% CI 0.99-1.64; 200 additional cases per 100 000] [SE 100x10-5]) after adjusting for covariates; however, these estimates are imprecise. A greater proportion of the relationship between PM2.5 and dementia was mediated through CVD than NO2 for both scales. CONCLUSIONS These results suggest some of the association between air pollution and dementia is mediated through CVD, indicating that improving cardiovascular health may prevent dementia in areas with higher exposure to air pollution.
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Affiliation(s)
- Sindana D Ilango
- Graduate School of Public Health, San Diego State University, San Diego, CA, USA.,Department of Family Medicine and Public Health, University of California San Diego, La Jolla, CA, USA
| | - Hong Chen
- Population Studies Division, Environmental Health Science and Research Bureau, Health Canada, Ottawa, ON, Canada.,Public Health Ontario, Toronto, ON, Canada.,ICES, Toronto, ON, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Perry Hystad
- College of Public Health and Human Sciences, Oregon State University, Corvallis, OR, USA
| | - Aaron van Donkelaar
- Department of Physics and Atmospheric Science, Dalhousie University, Halifax, NS, Canada
| | - Jeffrey C Kwong
- Public Health Ontario, Toronto, ON, Canada.,ICES, Toronto, ON, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.,Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada.,Toronto Western Family Health Team, University Health Network, Toronto, ON, Canada
| | - Karen Tu
- Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada.,Toronto Western Family Health Team, University Health Network, Toronto, ON, Canada
| | - Randall V Martin
- Department of Physics and Atmospheric Science, Dalhousie University, Halifax, NS, Canada.,Harvard-Smithsonian Centre for Astrophysics, Cambridge, MA, USA
| | - 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
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Gale SD, Erickson LD, Anderson JE, Brown BL, Hedges DW. Association between exposure to air pollution and prefrontal cortical volume in adults: A cross-sectional study from the UK biobank. ENVIRONMENTAL RESEARCH 2020; 185:109365. [PMID: 32222630 DOI: 10.1016/j.envres.2020.109365] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/17/2019] [Revised: 01/17/2020] [Accepted: 03/08/2020] [Indexed: 05/18/2023]
Abstract
Associated with numerous cognitive and behavioral functions and with several diseases, the prefrontal cortex is vulnerable to environmental insult. Among other factors, toxins in air pollution have been associated with damage to the prefrontal cortex in children and older adults. We used data from the UK Biobank to assess further associations between an array of toxins in air pollution and gray matter in the prefrontal cortex including the left and right frontal poles, left and right superior frontal gyri, left and right frontal medial cortex, left and right orbitofrontal cortex, and left and right frontal opercula, using multivariate models adjusted for covariates that possibly could confound the association between air pollution and volume of prefrontal gray matter. The results showed inverse associations between PM 2.5, PM 10, and nitrogen oxides and prefrontal volume in models adjusted for age, sex, education, socioeconomic status, race-ethnicity, self-rated overall health, body mass index, total brain volume, smoking status, and alcohol use frequency. Education appeared to moderate the association between air pollution and prefrontal volume. The data in these analyses came from regions whose mean PM 2.5 was near the upper limit and whose mean PM 10 was under those recommended by the World Health Organization. These findings suggest that comparatively low levels of air pollution might be associated with reduced volume of the prefrontal cortex.
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Affiliation(s)
- Shawn D Gale
- Department of Psychology, Brigham Young University, Provo, UT, USA; The Neuroscience Center, Brigham Young University, Provo, UT, USA.
| | - Lance D Erickson
- Department of Sociology, Brigham Young University, Provo, UT, USA
| | | | - Bruce L Brown
- Department of Psychology, Brigham Young University, Provo, UT, USA
| | - Dawson W Hedges
- Department of Psychology, Brigham Young University, Provo, UT, USA; The Neuroscience Center, Brigham Young University, Provo, UT, USA
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Crous-Bou M, Gascon M, Gispert JD, Cirach M, Sánchez-Benavides G, Falcon C, Arenaza-Urquijo EM, Gotsens X, Fauria K, Sunyer J, Nieuwenhuijsen MJ, Luis Molinuevo J. Impact of urban environmental exposures on cognitive performance and brain structure of healthy individuals at risk for Alzheimer's dementia. ENVIRONMENT INTERNATIONAL 2020; 138:105546. [PMID: 32151419 DOI: 10.1016/j.envint.2020.105546] [Citation(s) in RCA: 63] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Revised: 01/31/2020] [Accepted: 02/03/2020] [Indexed: 05/07/2023]
Abstract
BACKGROUND Air quality might contribute to incidence of dementia-related disorders, including Alzheimer's dementia (AD). The aim of our study is to evaluate the effect of urban environmental exposures (including exposure to air pollution, noise and green space) on cognitive performance and brain structure of cognitively unimpaired individuals at risk for AD. PARTICIPANTS AND METHODS The ALFA (ALzheimer and FAmilies) study is a prospective cohort of middle-age, cognitively unimpaired subjects, many of them offspring of AD patients. Cognitive performance was measured by the administration of episodic memory and executive function tests (N = 958). Structural brain imaging was performed in a subsample of participants to obtain morphological information of brain areas, specially focused on cortical thickness, known to be affected by AD (N = 228). Land Use Regression models were used to estimate residential exposure to air pollutants. The daily average noise level at the street nearest to each participant's residential address was obtained from noise maps. For each participant residential green exposure indicators, such as surrounding greenness or amount of green, were generated. General linear models were conducted to assess the association between environmental exposures, cognitive performance and brain structure in a cross-sectional analysis. RESULTS No significant associations were observed between urban environmental exposures and the cognitive composite (p > 0.1). Higher exposure to air pollutants, but not noise, was associated with lower cortical thickness in brain regions known to be affected by AD, especially NO2 (β = -16.4; p = 0.05) and PM10 (β = -5.34; p = 0.05). On the other hand, increasing greenness indicators was associated with greater thickness in these same areas (β = 0.08; p = 0.03). CONCLUSION In cognitively unimpaired adults with increased risk for AD, increased exposure to air pollution was suggested to be associated with greater global atrophy and reduced volume and thickness in specific brain areas known to be affected in AD, thus suggesting a potential link between environmental exposures and cerebral vulnerability to AD. Although more research in the field is needed, air pollution reduction is crucial for decreasing the burden of age-related disorders.
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Affiliation(s)
- Marta Crous-Bou
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Barcelona, Spain; CIBER Fragilidad y Envejecimiento Saludable (CIBERFES), Madrid, Spain; IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
| | - Mireia Gascon
- Universitat Pompeu Fabra (UPF), Barcelona, Spain; ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | - Juan Domingo Gispert
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Barcelona, Spain; IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Bioingeniería, Biomateriales y Nanomedicina, Madrid, Spain
| | - Marta Cirach
- Universitat Pompeu Fabra (UPF), Barcelona, Spain; ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | - Gonzalo Sánchez-Benavides
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Barcelona, Spain; CIBER Fragilidad y Envejecimiento Saludable (CIBERFES), Madrid, Spain; IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - Carles Falcon
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Barcelona, Spain; IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain; CIBER Bioingeniería, Biomateriales y Nanomedicina, Madrid, Spain
| | - Eider M Arenaza-Urquijo
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Barcelona, Spain; CIBER Fragilidad y Envejecimiento Saludable (CIBERFES), Madrid, Spain; IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - Xavier Gotsens
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Barcelona, Spain
| | - Karine Fauria
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Barcelona, Spain; CIBER Fragilidad y Envejecimiento Saludable (CIBERFES), Madrid, Spain
| | - Jordi Sunyer
- Universitat Pompeu Fabra (UPF), Barcelona, Spain; ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | - Mark J Nieuwenhuijsen
- Universitat Pompeu Fabra (UPF), Barcelona, Spain; ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | - José Luis Molinuevo
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Barcelona, Spain; CIBER Fragilidad y Envejecimiento Saludable (CIBERFES), Madrid, Spain; IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain.
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Kulick ER, Wellenius GA, Boehme AK, Joyce NR, Schupf N, Kaufman JD, Mayeux R, Sacco RL, Manly JJ, Elkind MSV. Long-term exposure to air pollution and trajectories of cognitive decline among older adults. Neurology 2020; 94:e1782-e1792. [PMID: 32269113 PMCID: PMC7274848 DOI: 10.1212/wnl.0000000000009314] [Citation(s) in RCA: 62] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2018] [Accepted: 11/22/2019] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To evaluate the association between long-term exposure to ambient air pollution and cognitive decline in older adults residing in an urban area. METHODS Data for this study were obtained from 2 prospective cohorts of residents in the northern Manhattan area of New York City: the Washington Heights-Inwood Community Aging Project (WHICAP) and the Northern Manhattan Study (NOMAS). Participants of both cohorts received in-depth neuropsychological testing at enrollment and during follow-up. In each cohort, we used inverse probability weighted linear mixed models to evaluate the cross-sectional and longitudinal associations between markers of average residential ambient air pollution (nitrogen dioxide [NO2], fine particulate matter [PM2.5], and respirable particulate matter [PM10]) levels in the year prior to enrollment and measures of global and domain-specific cognition, adjusting for sociodemographic factors, temporal trends, and censoring. RESULTS Among 5,330 participants in WHICAP, an increase in NO2 was associated with a 0.22 SD lower global cognitive score at enrollment (95% confidence interval [CI], -0.30, -0.14) and 0.06 SD (95% CI, -0.08, -0.04) more rapid decline in cognitive scores between visits. Results were similar for PM2.5 and PM10 and across functional cognitive domains. We found no evidence of an association between pollution and cognitive function in NOMAS. CONCLUSION WHICAP participants living in areas with higher levels of ambient air pollutants have lower cognitive scores at enrollment and more rapid rates of cognitive decline over time. In NOMAS, a smaller cohort with fewer repeat measurements, we found no statistically significant associations. These results add to the evidence regarding the adverse effect of air pollution on cognitive aging and brain health.
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Affiliation(s)
- Erin R Kulick
- From the Department of Epidemiology (E.R.K., G.A.W., N.R.J.), Brown University School of Public Health, Providence, RI; Departments of Neurology (E.R.K., A.K.B., N.S., M.S.V.E.) and Psychiatry (R.M.) and Gertrude H. Sergievsky Center (N.S., R.M., J.J.M., M.S.V.E.), Vagelos College of Physicians and Surgeons, Department of Epidemiology, Mailman School of Public Health (E.R.K., A.K.B., N.S., R.M., J.J.M., M.S.V.E.), and Taub Institute for Research on Alzheimer Disease and the Aging Brain (N.S., R.M., J.J.M.), Columbia University, New York, NY; Departments of Environmental and Occupational Health Sciences, Medicine, and Epidemiology (J.D.K.), University of Washington, Seattle; and Departments of Neurology, Public Health Sciences, and Human Genetics (R.L.S.), Evelyn McKnight Brain Institute, Miller School of Medicine, University of Miami, FL.
| | - Gregory A Wellenius
- From the Department of Epidemiology (E.R.K., G.A.W., N.R.J.), Brown University School of Public Health, Providence, RI; Departments of Neurology (E.R.K., A.K.B., N.S., M.S.V.E.) and Psychiatry (R.M.) and Gertrude H. Sergievsky Center (N.S., R.M., J.J.M., M.S.V.E.), Vagelos College of Physicians and Surgeons, Department of Epidemiology, Mailman School of Public Health (E.R.K., A.K.B., N.S., R.M., J.J.M., M.S.V.E.), and Taub Institute for Research on Alzheimer Disease and the Aging Brain (N.S., R.M., J.J.M.), Columbia University, New York, NY; Departments of Environmental and Occupational Health Sciences, Medicine, and Epidemiology (J.D.K.), University of Washington, Seattle; and Departments of Neurology, Public Health Sciences, and Human Genetics (R.L.S.), Evelyn McKnight Brain Institute, Miller School of Medicine, University of Miami, FL
| | - Amelia K Boehme
- From the Department of Epidemiology (E.R.K., G.A.W., N.R.J.), Brown University School of Public Health, Providence, RI; Departments of Neurology (E.R.K., A.K.B., N.S., M.S.V.E.) and Psychiatry (R.M.) and Gertrude H. Sergievsky Center (N.S., R.M., J.J.M., M.S.V.E.), Vagelos College of Physicians and Surgeons, Department of Epidemiology, Mailman School of Public Health (E.R.K., A.K.B., N.S., R.M., J.J.M., M.S.V.E.), and Taub Institute for Research on Alzheimer Disease and the Aging Brain (N.S., R.M., J.J.M.), Columbia University, New York, NY; Departments of Environmental and Occupational Health Sciences, Medicine, and Epidemiology (J.D.K.), University of Washington, Seattle; and Departments of Neurology, Public Health Sciences, and Human Genetics (R.L.S.), Evelyn McKnight Brain Institute, Miller School of Medicine, University of Miami, FL
| | - Nina R Joyce
- From the Department of Epidemiology (E.R.K., G.A.W., N.R.J.), Brown University School of Public Health, Providence, RI; Departments of Neurology (E.R.K., A.K.B., N.S., M.S.V.E.) and Psychiatry (R.M.) and Gertrude H. Sergievsky Center (N.S., R.M., J.J.M., M.S.V.E.), Vagelos College of Physicians and Surgeons, Department of Epidemiology, Mailman School of Public Health (E.R.K., A.K.B., N.S., R.M., J.J.M., M.S.V.E.), and Taub Institute for Research on Alzheimer Disease and the Aging Brain (N.S., R.M., J.J.M.), Columbia University, New York, NY; Departments of Environmental and Occupational Health Sciences, Medicine, and Epidemiology (J.D.K.), University of Washington, Seattle; and Departments of Neurology, Public Health Sciences, and Human Genetics (R.L.S.), Evelyn McKnight Brain Institute, Miller School of Medicine, University of Miami, FL
| | - Nicole Schupf
- From the Department of Epidemiology (E.R.K., G.A.W., N.R.J.), Brown University School of Public Health, Providence, RI; Departments of Neurology (E.R.K., A.K.B., N.S., M.S.V.E.) and Psychiatry (R.M.) and Gertrude H. Sergievsky Center (N.S., R.M., J.J.M., M.S.V.E.), Vagelos College of Physicians and Surgeons, Department of Epidemiology, Mailman School of Public Health (E.R.K., A.K.B., N.S., R.M., J.J.M., M.S.V.E.), and Taub Institute for Research on Alzheimer Disease and the Aging Brain (N.S., R.M., J.J.M.), Columbia University, New York, NY; Departments of Environmental and Occupational Health Sciences, Medicine, and Epidemiology (J.D.K.), University of Washington, Seattle; and Departments of Neurology, Public Health Sciences, and Human Genetics (R.L.S.), Evelyn McKnight Brain Institute, Miller School of Medicine, University of Miami, FL
| | - Joel D Kaufman
- From the Department of Epidemiology (E.R.K., G.A.W., N.R.J.), Brown University School of Public Health, Providence, RI; Departments of Neurology (E.R.K., A.K.B., N.S., M.S.V.E.) and Psychiatry (R.M.) and Gertrude H. Sergievsky Center (N.S., R.M., J.J.M., M.S.V.E.), Vagelos College of Physicians and Surgeons, Department of Epidemiology, Mailman School of Public Health (E.R.K., A.K.B., N.S., R.M., J.J.M., M.S.V.E.), and Taub Institute for Research on Alzheimer Disease and the Aging Brain (N.S., R.M., J.J.M.), Columbia University, New York, NY; Departments of Environmental and Occupational Health Sciences, Medicine, and Epidemiology (J.D.K.), University of Washington, Seattle; and Departments of Neurology, Public Health Sciences, and Human Genetics (R.L.S.), Evelyn McKnight Brain Institute, Miller School of Medicine, University of Miami, FL
| | - Richard Mayeux
- From the Department of Epidemiology (E.R.K., G.A.W., N.R.J.), Brown University School of Public Health, Providence, RI; Departments of Neurology (E.R.K., A.K.B., N.S., M.S.V.E.) and Psychiatry (R.M.) and Gertrude H. Sergievsky Center (N.S., R.M., J.J.M., M.S.V.E.), Vagelos College of Physicians and Surgeons, Department of Epidemiology, Mailman School of Public Health (E.R.K., A.K.B., N.S., R.M., J.J.M., M.S.V.E.), and Taub Institute for Research on Alzheimer Disease and the Aging Brain (N.S., R.M., J.J.M.), Columbia University, New York, NY; Departments of Environmental and Occupational Health Sciences, Medicine, and Epidemiology (J.D.K.), University of Washington, Seattle; and Departments of Neurology, Public Health Sciences, and Human Genetics (R.L.S.), Evelyn McKnight Brain Institute, Miller School of Medicine, University of Miami, FL
| | - Ralph L Sacco
- From the Department of Epidemiology (E.R.K., G.A.W., N.R.J.), Brown University School of Public Health, Providence, RI; Departments of Neurology (E.R.K., A.K.B., N.S., M.S.V.E.) and Psychiatry (R.M.) and Gertrude H. Sergievsky Center (N.S., R.M., J.J.M., M.S.V.E.), Vagelos College of Physicians and Surgeons, Department of Epidemiology, Mailman School of Public Health (E.R.K., A.K.B., N.S., R.M., J.J.M., M.S.V.E.), and Taub Institute for Research on Alzheimer Disease and the Aging Brain (N.S., R.M., J.J.M.), Columbia University, New York, NY; Departments of Environmental and Occupational Health Sciences, Medicine, and Epidemiology (J.D.K.), University of Washington, Seattle; and Departments of Neurology, Public Health Sciences, and Human Genetics (R.L.S.), Evelyn McKnight Brain Institute, Miller School of Medicine, University of Miami, FL
| | - Jennifer J Manly
- From the Department of Epidemiology (E.R.K., G.A.W., N.R.J.), Brown University School of Public Health, Providence, RI; Departments of Neurology (E.R.K., A.K.B., N.S., M.S.V.E.) and Psychiatry (R.M.) and Gertrude H. Sergievsky Center (N.S., R.M., J.J.M., M.S.V.E.), Vagelos College of Physicians and Surgeons, Department of Epidemiology, Mailman School of Public Health (E.R.K., A.K.B., N.S., R.M., J.J.M., M.S.V.E.), and Taub Institute for Research on Alzheimer Disease and the Aging Brain (N.S., R.M., J.J.M.), Columbia University, New York, NY; Departments of Environmental and Occupational Health Sciences, Medicine, and Epidemiology (J.D.K.), University of Washington, Seattle; and Departments of Neurology, Public Health Sciences, and Human Genetics (R.L.S.), Evelyn McKnight Brain Institute, Miller School of Medicine, University of Miami, FL
| | - Mitchell S V Elkind
- From the Department of Epidemiology (E.R.K., G.A.W., N.R.J.), Brown University School of Public Health, Providence, RI; Departments of Neurology (E.R.K., A.K.B., N.S., M.S.V.E.) and Psychiatry (R.M.) and Gertrude H. Sergievsky Center (N.S., R.M., J.J.M., M.S.V.E.), Vagelos College of Physicians and Surgeons, Department of Epidemiology, Mailman School of Public Health (E.R.K., A.K.B., N.S., R.M., J.J.M., M.S.V.E.), and Taub Institute for Research on Alzheimer Disease and the Aging Brain (N.S., R.M., J.J.M.), Columbia University, New York, NY; Departments of Environmental and Occupational Health Sciences, Medicine, and Epidemiology (J.D.K.), University of Washington, Seattle; and Departments of Neurology, Public Health Sciences, and Human Genetics (R.L.S.), Evelyn McKnight Brain Institute, Miller School of Medicine, University of Miami, FL
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Hedges DW, Erickson LD, Gale SD, Anderson JE, Brown BL. Association between exposure to air pollution and thalamus volume in adults: A cross-sectional study. PLoS One 2020; 15:e0230829. [PMID: 32226035 PMCID: PMC7105117 DOI: 10.1371/journal.pone.0230829] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Accepted: 03/09/2020] [Indexed: 11/18/2022] Open
Abstract
Background Air pollution has been associated with cognitive function and brain volume. While most previous research has examined the association between air pollution and brain volume in cortical structures or total brain volume, less research has investigated associations between exposure to air pollution and subcortical structures, including the thalamus. Further, the few available previous studies investigating associations between air pollution and thalamic volume have shown mixed results. Methods In this study, we evaluated the association between PM2.5, PM2.5–10, PM10, nitrogen dioxide, and nitrogen oxides and volume of the thalamus in adults using the UK Biobank resource, a large community-based sample, while adjusting for multiple covariates that could confound an association between air pollution and thalamic volume. Results In adjusted models, the left but not right thalamus volume was significantly inversely associated with PM2.5–10, although there were no significant associations between PM2.5, PM10, nitrogen dioxide, and nitrogen oxides with either left or right thalamic volumes. In addition, interactions between age and PM2.5–10 and PM10 were inversely associated with thalamic volume, such that thalamic volume in older people appeared more vulnerable to the adverse effects of PM2.5–10 and PM10, and interactions between educational attainment and PM2.5, nitrogen dioxide, and nitrogen oxides and between self-rated health and PM2.5–10 were positively associated with thalamic volume, such that higher educational attainment and better self-rated health appeared protective against the adverse effects of air pollution on the thalamus. Conclusion These findings suggest a possible association between thalamic volume and air pollution particularly in older people and in people with comparatively low educational attainment at levels of air pollution found in the United Kingdom.
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Affiliation(s)
- Dawson W. Hedges
- Department of Psychology, Brigham Young University, Provo, Utah, United States of America
- The Neuroscience Center, Brigham Young University, Provo, Utah, United States of America
- * E-mail:
| | - Lance D. Erickson
- Department of Sociology, Brigham Young University, Provo, Utah, United States of America
| | - Shawn D. Gale
- Department of Psychology, Brigham Young University, Provo, Utah, United States of America
- The Neuroscience Center, Brigham Young University, Provo, Utah, United States of America
| | - Jacqueline E. Anderson
- The Neuroscience Center, Brigham Young University, Provo, Utah, United States of America
| | - Bruce L. Brown
- Department of Psychology, Brigham Young University, Provo, Utah, United States of America
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Erickson LD, Gale SD, Anderson JE, Brown BL, Hedges DW. Association between Exposure to Air Pollution and Total Gray Matter and Total White Matter Volumes in Adults: A Cross-Sectional Study. Brain Sci 2020; 10:E164. [PMID: 32182984 PMCID: PMC7139378 DOI: 10.3390/brainsci10030164] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Revised: 03/04/2020] [Accepted: 03/11/2020] [Indexed: 12/13/2022] Open
Abstract
Total brain gray-matter and white-matter volumes can be indicators of overall brain health. Among the factors associated with gray-matter and white-matter volumes is exposure to air pollution. Using data from the UK Biobank, we sought to determine associations between several components of air pollution-PM2.5, PM2.5-10, PM10, nitrogen dioxide, and nitrogen oxides-and total gray-matter and total white-matter volumes in multivariable regression models in a large sample of adults. We found significant inverse associations between PM2.5 concentration and total white-matter volume and between PM2.5, PM2.5-10, PM10, nitrogen dioxide, and nitrogen oxide concentrations and total gray-matter volume in models adjusted for age, sex, body-mass index, self-assessment of overall health, frequency of alcohol use, smoking status, educational attainment, and income. These findings of pollutant-associated decreases in total gray-matter and total white-matter volumes are in the context of mean PM2.5 concentrations near the upper limit of the World Health Organization's recommendations. Similarly, mean PM10 concentrations were below the recommended upper limit, and nitrogen dioxide concentration was slightly above. Still, there are many areas in the world with much higher concentrations of these pollutants, which could be associated with larger effects. If replicated, these findings suggest that air pollution could be a risk factor for neurodegeneration.
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Affiliation(s)
- Lance D. Erickson
- Department of Sociology, Brigham Young University, Provo, UT 84602, USA;
| | - Shawn D. Gale
- Department of Psychology, Brigham Young University, Provo, UT 84602, USA; (B.L.B.); (D.W.H.)
- The Neuroscience Center, Brigham Young University, Provo, UT 84602, USA;
| | | | - Bruce L. Brown
- Department of Psychology, Brigham Young University, Provo, UT 84602, USA; (B.L.B.); (D.W.H.)
| | - Dawson W. Hedges
- Department of Psychology, Brigham Young University, Provo, UT 84602, USA; (B.L.B.); (D.W.H.)
- The Neuroscience Center, Brigham Young University, Provo, UT 84602, USA;
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Rafiee A, Delgado-Saborit JM, Sly PD, Quémerais B, Hashemi F, Akbari S, Hoseini M. Environmental chronic exposure to metals and effects on attention and executive function in the general population. THE SCIENCE OF THE TOTAL ENVIRONMENT 2020; 705:135911. [PMID: 31838411 DOI: 10.1016/j.scitotenv.2019.135911] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/07/2019] [Revised: 10/16/2019] [Accepted: 12/01/2019] [Indexed: 05/19/2023]
Abstract
Heavy metals are neurotoxic, associated with brain dysfunction, and have been linked with cognitive decline in adults. This study was aimed to characterize chronic exposure to metals (Cd, Be, Co, Hg, Sn, V, Al, Ba, Cr, Cu, Fe, Li, Mn, Ni, Pb, and Zn) and metalloids (As, B, Sb) and assess its impact on cognitive performance of Tehran's residents, capital of Iran. Scalp hair samples gathered from 200 volunteered participants (110 men and 90 women), aged 14-70 years and quantified by inductively coupled plasma atomic emission spectroscopy (ICP-OES). Attention and executive function, two measures of cognitive performance, were characterized using the trail making test (TMT) part A and B, respectively. Mental flexibility was characterized as the Delta TMT B-A scores and cognitive efficiency or dissimulation as the ration between TMT B and A scores. A comprehensive questionnaire was used to gather information on demographic and socioeconomic as well as lifestyle and health status. The highest and lowest mean concentrations were observed for B (325 μg/g) and As (0.29 μg/g), respectively. Results indicated that chronic metal exposure measured in hair changed significantly based on gender and age (p < 0.05). The levels of Cr, Fe, Ni, Si, Hg, Pb and B were significantly higher in males' hair, whereas those of Ag and Ba were greater in females' hair (p < 0.05). The results of the cognitive TMT test were significantly different between gender and age groups (p < 0.05). Moreover, results revealed that As, Hg, Mn, and Pb levels in hair were significantly associated with poorer participants' performance scores in the TMT test (p < 0.05). Age, gender, cigarette smoking, water-pipe smoking, traffic density in the area of residence, and dental amalgam filling were significant factors affecting the TMT test scores. The results suggest that chronic exposure to metals has detrimental effects on attention, executive function, mental flexibility and cognitive efficiency.
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Affiliation(s)
- Ata Rafiee
- Department of Medicine, University of Alberta, Edmonton, AB, Canada.
| | - Juana Maria Delgado-Saborit
- ISGlobal Barcelona Institute for Global Health, Barcelona Biomedical Research Park, Barcelona, Spain; Population Health and Environmental Sciences, Analytical Environmental and Forensic Sciences, King's College London, United Kingdom; Division of Environmental Health & Risk Management, School of Geography, Earth & Environmental Sciences, University of Birmingham, Birmingham, United Kingdom
| | - Peter D Sly
- Children's Health and Environment Program, Child Health Research Centre, The University of Queensland, South Brisbane, Australia
| | | | - Fallah Hashemi
- Department of Environmental Health, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Sadaf Akbari
- Trauma and Injury Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Mohammad Hoseini
- Research Center for Health Sciences, Institute of Health, Department of Environmental Health, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran.
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Shin J, Han SH, Choi J. Exposure to Ambient Air Pollution and Cognitive Impairment in Community-Dwelling Older Adults: The Korean Frailty and Aging Cohort Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16193767. [PMID: 31591354 PMCID: PMC6801547 DOI: 10.3390/ijerph16193767] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Revised: 09/14/2019] [Accepted: 10/04/2019] [Indexed: 01/20/2023]
Abstract
The aim of this study was to investigate the associations between ambient air pollutants and cognitive impairment in Korean older adults. The cognitive function of 2,896 participants aged 70 to 84 years was measured using the Korean version of the mini-mental state examination, the digit span test, the word list learning test, and the frontal assessment battery. After matching the average concentrations of particulate matter (PM) <10 μm in size (PM10) and <2.5 μm (PM2.5), NO2, CO, SO2, and O3 between 2013 and 2017, the association between air pollutants and cognitive scales was analyzed using a linear mixed regression and a multiple logistic regression analysis (after adjusting for age, sex, health related behaviors, socioeconomic status, comorbidity, and meteorological data). Exposure to PM2.5, PM10, NO2, SO2, and CO was associated with cognitive impairment above and beyond age or education level effects. Specifically, PM2.5 was negatively associated with most components of the cognitive scales (interquartile range for PM2.5: 2.0 μg/m3, odds ratio for poor global cognition: 2.28, 95% confidence interval: 1.60-3.26). These associations may be affected by sex, residence area, or alcohol intake. Conclusively, air pollutants, especially PM2.5, were associated with cognitive impairment, including global cognition, attention, memory, and executive function in Korean older adults aged ≥70 years.
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Affiliation(s)
- Jinyoung Shin
- Department of Family Medicine, Research Institute on Healthy aging, Konkuk University School of Medicine, Konkuk University Medical Center, Seoul 05030, Korea.
| | - Seol-Heui Han
- Department of Neurology, Research Institute on Healthy aging, Konkuk University School of Medicine, Konkuk University Medical Center, Seoul 05030, Korea.
| | - Jaekyung Choi
- Department of Family Medicine, Research Institute on Healthy aging, Konkuk University School of Medicine, Konkuk University Medical Center, Seoul 05030, Korea.
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Cornelis MC, Wang Y, Holland T, Agarwal P, Weintraub S, Morris MC. Age and cognitive decline in the UK Biobank. PLoS One 2019; 14:e0213948. [PMID: 30883587 PMCID: PMC6422276 DOI: 10.1371/journal.pone.0213948] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2019] [Accepted: 03/04/2019] [Indexed: 01/09/2023] Open
Abstract
OBJECTIVES Age-related cognitive decline is a well-known phenomenon after age 65 but little is known about earlier changes and prior studies are based on relatively small samples. We investigated the impact of age on cognitive decline in the largest population sample to date including young to old adults. METHOD Between 100,352 and 468,534 participants aged 38-73 years from UK Biobank completed at least one of seven self-administered cognitive functioning tests: prospective memory (PM), pairs matching (Pairs), fluid intelligence (FI), reaction time (RT), symbol digit substitution, trail making A and B. Up to 26,005 participants completed at least one of two follow-up assessments of PM, Pairs, FI and RT. Multivariable regression models examined the association between age (<45[reference], 45-49, 50-54, 55-59, 60-64, 65+) and cognition scores at baseline. Mixed models estimated the impact of age on cognitive decline over follow-up (~5.1 years). RESULTS FI was higher between ages 50 and 64 and lower at 65+ compared to <45 at baseline. Performance on all other baseline tests was lower with older age: with increasing age category, difference in test scores ranged from 2.5 to 7.8%(P<0.0001). Compared to <45 at baseline, RT and Pairs performance declined faster across all older age cohorts (3.0 and 1.2% change, respectively, with increasing age category, P<0.0001). Cross-sectional results yielded 8 to 12-fold higher differences in RT and Pairs with age compared to longitudinal results. CONCLUSIONS Our findings suggest that declines in cognitive abilities <65 are small. The cross-sectional differences in cognition scores for middle to older adult years may be due in part to age cohort effects.
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Affiliation(s)
- Marilyn C. Cornelis
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, United States of America
- * E-mail:
| | - Yamin Wang
- Rush Institute for Healthy Aging, Rush University, Chicago, Illinois, United States of America
| | - Thomas Holland
- Rush Institute for Healthy Aging, Rush University, Chicago, Illinois, United States of America
| | - Puja Agarwal
- Rush Institute for Healthy Aging, Rush University, Chicago, Illinois, United States of America
| | - Sandra Weintraub
- Mesulam Cognitive Neurology and Alzheimer’s Disease Center, Northwestern University Feinberg School of Medicine, Chicago, Illinois, United States of America
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois, United States of America
| | - Martha Clare Morris
- Rush Institute for Healthy Aging, Rush University, Chicago, Illinois, United States of America
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Abstract
PURPOSE OF REVIEW The literature on air pollution and brain health is rapidly expanding and it is a universal finding that greater exposure to air pollution is associated with worse outcomes, whatever the measure of brain health used (clinical dementia, neuroimaging correlates, or cognitive impairment). However, there are a number of important questions which the studies currently published are not able to answer: when in the life course does exposure to air pollution most have the most impact?; which pollutant(s) or components are most important?; and since dementia describes a heterogeneous group of conditions, which is most affected by exposure to air pollution? RECENT FINDINGS We briefly review and discuss the nine articles which have been published so far in 2018, so recently that they were not included in the four review articles also published this year. We highlight the variation in estimates of air pollution used but the consistency in deriving them from residential address (with or without some knowledge of an individual's previous home locations). SUMMARY We are now at the stage when the research agenda needs to be agreed and we believe these three questions should be the focus of future research.
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Abstract
Population-based clinic-pathological studies have established that the most common pathological substrate of dementia in community-dwelling elderly people is mixed, especially Alzheimer's disease (AD) and cerebrovascular ischemic disease (CVID), rather than pure AD. While these could be just two frequent unrelated comorbidities in the elderly, epidemiological research has reinforced the idea that mid-life (age <65 years) vascular risk factors increase the risk of late-onset (age ≥ 65 years) dementia, and specifically AD. By contrast, healthy lifestyle choices such as leisure activities, physical exercise, and Mediterranean diet are considered protective against AD. Remarkably, several large population-based longitudinal epidemiological studies have recently indicated that the incidence and prevalence of dementia might be decreasing in Western countries. Although it remains unclear whether these positive trends are attributable to neuropathologically definite AD versus CVID, based on these epidemiological data it has been estimated that a sizable proportion of AD cases could be preventable. In this review, we discuss the current evidence about modifiable risk factors for AD derived from epidemiological, preclinical, and interventional studies, and analyze the opportunities for therapeutic and preventative interventions.
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Affiliation(s)
- Alberto Serrano-Pozo
- Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - John H. Growdon
- Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
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Affiliation(s)
- Chris J Griffiths
- Barts Institute of Population Health Sciences, Queen Mary University of London, London, UK
| | - Ian S Mudway
- MRC-PHE Centre in Environment and Health, King's College London, London, UK
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