Comparison of Particulate Air Pollution From Different Emission Sources and Incident Dementia in the US

被引:54
作者
Zhang, Boya [1 ,2 ]
Weuve, Jennifer [3 ]
Langa, Kenneth M. [4 ,5 ,6 ,7 ]
D'Souza, Jennifer [2 ]
Szpiro, Adam [8 ]
Faul, Jessica [4 ]
de Leon, Carlos Mendes [9 ]
Gao, Jiaqi [2 ]
Kaufman, Joel D. [10 ,11 ,12 ]
Sheppard, Lianne [8 ,11 ]
Lee, Jinkook [13 ]
Kobayashi, Lindsay C. [2 ]
Hirth, Richard [14 ,15 ]
Adar, Sara D. [2 ]
机构
[1] Univ Michigan, Sch Publ Hlth, Dept Epidemiol, 1415 Washington Hts, Ann Arbor, MI 48109 USA
[2] Univ Michigan, Sch Publ Hlth, Dept Epidemiol, Ann Arbor, MI USA
[3] Boston Univ, Sch Publ Hlth, Dept Epidemiol, Boston, MA USA
[4] Univ Michigan, Inst Social Res, Ann Arbor, MI USA
[5] Univ Michigan, Med Sch, Ann Arbor, MI USA
[6] Univ Michigan, Inst Healthcare Policy & Innovat, Ann Arbor, MI USA
[7] Vet Affairs Ctr Clin Management Res, Ann Arbor, MI USA
[8] Univ Washington, Dept Biostat, Seattle, WA USA
[9] Georgetown Univ, Dept Oncol, Washington, DC USA
[10] Univ Washington, Dept Epidemiol, Seattle, WA USA
[11] Univ Washington, Dept Environm & Occupat Hlth Sci, Seattle, WA USA
[12] Univ Washington, Dept Med, Seattle, WA USA
[13] Univ Southern Calif, Ctr Econ & Social Res, Los Angeles, CA USA
[14] Univ Michigan, Sch Publ Hlth, Dept Hlth Management & Policy, Ann Arbor, MI USA
[15] Univ Michigan, Dept Internal Med, Ann Arbor, MI USA
关键词
ORGANOCHLORINE PESTICIDES; HEALTH IMPACTS; EXPOSURE; RETIREMENT; COHORT; CELLS;
D O I
10.1001/jamainternmed.2023.3300
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
IMPORTANCE Emerging evidence indicates that exposure to fine particulate matter (PM2.5) air pollution may increase dementia risk in older adults. Although this evidence suggests opportunities for intervention, little is known about the relative importance of PM2.5 from different emission sources. OBJECTIVE To examine associations of long-term exposure of total and source-specific PM2.5 with incident dementia in older adults. DESIGN, SETTING, AND PARTICIPANTS The Environmental Predictors of Cognitive Health and Aging study used biennial survey data from January 1, 1998, to December 31, 2016, for participants in the Health and Retirement Study, which is a nationally representative, population-based cohort study in the US. The present cohort study included all participants older than 50 years who were without dementia at baseline and had available exposure, outcome, and demographic data between 1998 and 2016 (N = 27 857). Analyses were performed from January 31 toMay 1, 2022. EXPOSURES The 10-year mean total PM2.5 and PM2.5 from 9 emission sources at participant residences for each month during follow-up using spatiotemporal and chemical transport models. MAIN OUTCOMES AND MEASURES The main outcomewas incident dementia as classified by a validated algorithm incorporating respondent-based cognitive testing and proxy respondent reports. Adjusted hazard ratios (HRs) were estimated for incident dementia per IQR of residential PM2.5 concentrations using time-varying, weighted Cox proportional hazards regression models with adjustment for the individual- and area-level risk factors. RESULTS Among 27 857 participants (mean [SD] age, 61 [10] years; 15 747 [56.5%] female), 4105 (15%) developed dementia during a mean (SD) follow-up of 10.2 [5.6] years. Higher concentrations of total PM2.5 were associated with greater rates of incident dementia (HR, 1.08 per IQR; 95% CI, 1.01-1.17). In single pollutant models, PM2.5 from all sources, except dust, were associated with increased rates of dementia, with the strongest associations for agriculture, traffic, coal combustion, and wildfires. After control for PM2.5 from all other sources and copollutants, only PM2.5 from agriculture (HR, 1.13; 95% CI, 1.01-1.27) and wildfires (HR, 1.05; 95% CI, 1.02-1.08) were robustly associated with greater rates of dementia. CONCLUSION AND RELEVANCE In this cohort study, higher residential PM2.5 levels, especially from agriculture and wildfires, were associated with higher rates of incident dementia, providing further evidence supporting PM2.5 reduction as a population-based approach to promote healthy cognitive aging. These findings also indicate that intervening on key emission sources might have value, although more research is needed to confirm these findings.
引用
收藏
页码:1080 / 1089
页数:10
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