TY - JOUR
T1 - Association of air pollution with dementia
T2 - a systematic review with meta-analysis including new cohort data from China
AU - Tang, Jie
AU - Chen, Anthony
AU - He, Fan
AU - Shipley, Martin
AU - Nevill, Alan
AU - Coe, Hugh
AU - Hu, Zhi
AU - Zhang, Tao
AU - Kan, Haidong
AU - Brunner, Eric
AU - Tao, Xuguang
AU - Chen, Ruoling
N1 - Publisher Copyright:
© 2023
PY - 2023/4/15
Y1 - 2023/4/15
N2 - It remains unclear whether a total exposure to air pollution (AP) is associated with an increased risk of dementia. Little is known on the association in low- and middle-income countries. Two cohort studies in China (in Anhui cohort 1402 older adults aged ≥ 60 followed up for 10 years; in Zhejiang cohort 6115 older adults followed up for 5 years) were conducted to examine particulate matter - PM2.5 associated with all dementia and air quality index (AQI) with Alzheimer's disease, respectively. A systematic literature review and meta-analysis was performed following worldwide literature searched until May 20, 2020 to identify 15 population-based cohort studies examining the association of AP with dementia (or any specific type of dementia) through PubMed, MEDLINE, PsycINFO, SocINDEX, CINHAL, and CNKI. The cohort studies in China showed a significantly increased relative risk (RR) of dementia in relation to AP exposure; in Anhui cohort the adjusted RR was 2.14 (95% CI 1.00–4.56) in people with PM2.5 exposure at ≥ 64.5 μg/m3 versus <63.5 μg/m3 and in Zhejiang cohort the adjusted RR was 2.28 (1.07–4.87) in AQI>90 versus ≤ 80. The systematic review revealed that all 15 studies were undertaken in high income countries/regions, with inconsistent findings. While they had reasonably good overall quality of studies, seven studies did not adjust smoking in analysis and 13 did not account for depression. Pooling all eligible data demonstrated that dementia risk increased with the total AP exposure (1.13, 1.08–1.19). Data analysis of air pollutants showed that the RR significantly increased with PM2.5 (1.06, 1.03–1.10 in 2nd tertile exposure; 1.13, 1.07–1.19 in 3rd tertile versus 1st tertile), PM10 (1.05, 0.86–1.29; 1.62, 0.60–4.36), carbon monoxide (1.69, 0.72–3.93; 1.52, 1.35–1.71), nitrogen dioxide (1.06, 1.03–1.09; 1.18, 1.10–1.28) and nitrogen oxides (1.09, 1.04–1.15; 1.26, 1.13–1.41), but not ozone. Controlling air pollution and targeting on specific pollutants would reduce dementia globally.
AB - It remains unclear whether a total exposure to air pollution (AP) is associated with an increased risk of dementia. Little is known on the association in low- and middle-income countries. Two cohort studies in China (in Anhui cohort 1402 older adults aged ≥ 60 followed up for 10 years; in Zhejiang cohort 6115 older adults followed up for 5 years) were conducted to examine particulate matter - PM2.5 associated with all dementia and air quality index (AQI) with Alzheimer's disease, respectively. A systematic literature review and meta-analysis was performed following worldwide literature searched until May 20, 2020 to identify 15 population-based cohort studies examining the association of AP with dementia (or any specific type of dementia) through PubMed, MEDLINE, PsycINFO, SocINDEX, CINHAL, and CNKI. The cohort studies in China showed a significantly increased relative risk (RR) of dementia in relation to AP exposure; in Anhui cohort the adjusted RR was 2.14 (95% CI 1.00–4.56) in people with PM2.5 exposure at ≥ 64.5 μg/m3 versus <63.5 μg/m3 and in Zhejiang cohort the adjusted RR was 2.28 (1.07–4.87) in AQI>90 versus ≤ 80. The systematic review revealed that all 15 studies were undertaken in high income countries/regions, with inconsistent findings. While they had reasonably good overall quality of studies, seven studies did not adjust smoking in analysis and 13 did not account for depression. Pooling all eligible data demonstrated that dementia risk increased with the total AP exposure (1.13, 1.08–1.19). Data analysis of air pollutants showed that the RR significantly increased with PM2.5 (1.06, 1.03–1.10 in 2nd tertile exposure; 1.13, 1.07–1.19 in 3rd tertile versus 1st tertile), PM10 (1.05, 0.86–1.29; 1.62, 0.60–4.36), carbon monoxide (1.69, 0.72–3.93; 1.52, 1.35–1.71), nitrogen dioxide (1.06, 1.03–1.09; 1.18, 1.10–1.28) and nitrogen oxides (1.09, 1.04–1.15; 1.26, 1.13–1.41), but not ozone. Controlling air pollution and targeting on specific pollutants would reduce dementia globally.
KW - Air pollution
KW - Carbon monoxide
KW - Dementia
KW - Nitrogen oxide
KW - Particulate matters
KW - Sulfur dioxide
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U2 - 10.1016/j.envres.2022.115048
DO - 10.1016/j.envres.2022.115048
M3 - Article
C2 - 36529331
AN - SCOPUS:85147586644
SN - 0013-9351
VL - 223
JO - Environmental research
JF - Environmental research
M1 - 115048
ER -