Abstract
Introduction: Growing evidence implicates air pollution as a risk factor for dementia, but prior work is limited by challenges in diagnostic accuracy and assessing exposures in the decades prior to disease development. We evaluated the impact of long-term fine particulate matter (PM2.5) exposures on incident dementia (all-cause, Alzheimer's disease [AD], and vascular dementia [VaD]) in older adults. Methods: A panel of neurologists adjudicated dementia cases based on extensive neuropsychological testing and magnetic resonance imaging. We applied validated fine-scale air pollutant models to reconstructed residential histories to assess exposures. Results: An interquartile range increase in 20-year PM2.5 was associated with a 20% higher risk of dementia (95% confidence interval [CI]: 5%, 37%) and an increased risk of mixed VaD/AD but not AD alone. Discussion: Our findings suggest that air pollutant exposures over decades contribute to dementia and that effects of current exposures may be experienced years into the future.
| Original language | English |
|---|---|
| Pages (from-to) | 549-559 |
| Number of pages | 11 |
| Journal | Alzheimer's and Dementia |
| Volume | 19 |
| Issue number | 2 |
| DOIs | |
| State | Published - Feb 2023 |
Funding
Funding to support the effort for this submission for Drs. Semmens, Fitzpatrick, Adam, Hajat, and Kaufman and Ms. Leary and Ms. Park was provided to the authors’ respective institutions by the NIA (RF1AG057033). Support for Dr. Ilango's effort was provided by the University of Washington Biostatistics, Epidemiologic, and Bioinformatic Training in Environmental Health grant (NIEHS, 5T32ES015459) to her institution. In addition to the funding support listed above, Dr. Semmens received support from the National Institutes of Health Office of the Director Environmental Influences on Child Health Outcomes IDeA States Pediatric Clinical Trials Network (8UG1OD024952), the National Institute for Occupational Safety and Health (5R21OH011385), and grants from the NIGMS American Indian‐Alaska Native Clinical and Translational Research Program. Dr. Fitzpatrick received support from the National Institutes of Health (NIH D43 TW011596, U19 AG057377, U01HL130114, NHLBI‐HC‐9515, R01AG058969, R01AG059727) and US Centers for Disease Control and Prevention (BAA75D301_20_R‐68024, CDC SIP02). Dr. Hajat received support from the NIA (R01AG060011) and the NIEHS (R00 ES023498). Dr. Kaufman received support from several NIH grants, one from the US EPA, one subcontract on a grant from the US Department of Defense to Michigan State University, and one subcontract on a grant from the Global Alliance for Clean Cookstoves (UN Foundation) to the University of California, Berkeley. Except where noted, all of the above were paid to the authors’ respective institutions. We are grateful to the study volunteers who made this work possible. This research was supported by the National Institute on Aging (NIA RF1AG057033); the National Center for Complementary and Integrative Health [(NCCIH) previously the National Center for Complementary and Alternative Medicine (NCCAM)], and the Office of Dietary Supplements (U01 AT000162); National Heart, Lung, and Blood Institute (NHLBI); the University of Pittsburgh Alzheimer's Disease Research Center (P50AG05133); the Roena Kulynych Center for Memory and Cognition Research; the National Institute of Neurological Disorders and Stroke; the National Institute of General Medical Sciences (NIGMS, P20GM130418); the National Institute of Environmental Health Sciences (NIEHS, 5T32ES015459-08); and the US Environmental Protection Agency (US EPA). Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the NCCIH, the National Institutes of Health, or the US EPA. The funders of this study had no role in data collection, analysis, interpretation, presentation of study findings, or the decision to submit the article for publication. Dr. DeKosky received royalty payments from UpToDate for Dementia. Dr. Lopez received consulting fees from Grifols and Biogen. Dr. Hajat received consulting fees from the Pew Charitable Trusts and honoraria for NIH grant review. Dr. DeKosky received payment for expert testimony from Blood, Hurst, & O'Reardon, LLP. Travel support was provided to Dr. Semmens, Ms. Leary, and Dr. Adam from NIH grants to respective author institutions. Dr. DeKosky received payments for serving on the medical advisory boards or data safety and monitoring boards for Acumen Pharmaceuticals, Biogen, Cognition Therapeutics, Prevail Pharmaceuticals, and Vaccinex. Dr. Kaufman participated on an external advisory board to NIH‐funded trial: Household Air Pollution Intervention Network. Dr. Adam served as an unpaid member on the Society for Epidemiologic Research Student & Post‐Doc Committee Board, and Dr. Kaufman served as an unpaid Executive Council Member of the International Society for Epidemiology. Dr. DeKosky holds stock options for Acumen Pharmaceuticals. Dr. DeKosky received payment for serving as an Associate Editor for . No other disclosures were reported. Neurotherapeutics We are grateful to the study volunteers who made this work possible. This research was supported by the National Institute on Aging (NIA RF1AG057033); the National Center for Complementary and Integrative Health [(NCCIH) previously the National Center for Complementary and Alternative Medicine (NCCAM)], and the Office of Dietary Supplements (U01 AT000162); National Heart, Lung, and Blood Institute (NHLBI); the University of Pittsburgh Alzheimer's Disease Research Center (P50AG05133); the Roena Kulynych Center for Memory and Cognition Research; the National Institute of Neurological Disorders and Stroke; the National Institute of General Medical Sciences (NIGMS, P20GM130418); the National Institute of Environmental Health Sciences (NIEHS, 5T32ES015459‐08); and the US Environmental Protection Agency (US EPA). Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the NCCIH, the National Institutes of Health, or the US EPA. The funders of this study had no role in data collection, analysis, interpretation, presentation of study findings, or the decision to submit the article for publication.
| Funders | Funder number |
|---|---|
| University of Washington | |
| D43 TW011596, NHLBI‐HC‐9515, U19 AG057377, R01AG059727, R01AG058969, 8UG1OD024952, U01HL130114 | |
| Centers for Disease Control and Prevention | CDC SIP02, BAA75D301_20_R‐68024 |
| R01AG060011, RF1AG057033, R00 ES023498 | |
| P20GM130418 | |
| U01 AT000162 | |
| 5T32ES015459‐08 | |
| National Institute for Occupational Safety and Health | 5R21OH011385 |
| The Pew Charitable Trusts | |
| University of California at Berkeley | |
| Michigan State University | |
| P50AG05133 |
Keywords
- Alzheimer's disease
- air pollution
- dementia
- longitudinal cohort study
- vascular dementia
- Humans
- Alzheimer Disease/epidemiology
- Dementia, Vascular/epidemiology
- Air Pollution/adverse effects
- Ginkgo biloba
- Air Pollutants/adverse effects
- Particulate Matter/adverse effects
- Aged
