Department of Neuropsychiatry, Seoul National University Bundang Hospital, Bundang-gu, Seongnam-si, Gyeonggi-do 13619, Republic of Korea; Institute of Health and Environment, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul 08826, Republic of Korea.
Department of Psychiatry, Gil Medical Center, Gachon University College of Medicine, Incheon 21565, Republic of Korea.
Sci Total Environ. 2019 Jun 10;668:411-418. doi: 10.1016/j.scitotenv.2019.02.447. Epub 2019 Mar 2.
There is a growing concern that air pollution, especially those particles <2.5 μm (PM), could increase the risk of cognitive impairment and mental disorders. However, the relationship between ambient PM and neuropsychiatric symptoms in people with cognitive impairment is still undetermined. This longitudinal study included 645 pairs of cognitively impaired subjects, who had not changed residence within Seoul, and their caregivers from the Clinical Research Center for Dementia of South Korea study cohort between September 2005 and June 2010 (1763 days). Neuropsychiatric symptoms were measured by the Korean version of the Neuropsychiatry Inventory, and caregiver burden was examined by the Neuropsychiatry Inventory Caregiver Distress Scale at the first and second visits at the outpatient clinic. District-specific PM concentrations were constructed over 1 month to 1 year prior to each visit. A log-linear regression using generalized estimating equations to account for repeated measures was used to assess the relationship between PM exposure and neuropsychiatric symptoms or caregiver burden. Aggravated neuropsychiatric symptoms were associated with exposure to high PM levels (adjusted percent change: 16.7% [95% confidence interval (CI), 5.0-29.7] per 8.3 μg/m increase in 1-month moving averages). Increased caregiver burden was associated with high PM exposures only in caregivers for patients with Alzheimer's disease (adjusted percent change: 29.0% [95% CI, 8.1-53.9] per 8.3 μg/m increase in 1-month moving averages). The present results indicate that PM exposure is associated with aggravated neuropsychiatric symptoms and increased caregiver burden in subjects with cognitive impairment. The findings in this study suggest that the role of air pollution deserves great consideration in the aging population with cognitive impairment.
人们越来越担心，空气污染，尤其是那些小于 2.5μm（PM）的颗粒，可能会增加认知障碍和精神障碍的风险。然而，环境 PM 与认知障碍患者的神经精神症状之间的关系仍不确定。本纵向研究纳入了韩国临床痴呆研究中心队列中 645 对认知障碍患者及其照料者，这些患者在 2005 年 9 月至 2010 年 6 月期间（1763 天）没有改变居住地。通过韩国版神经精神病学量表评估神经精神症状，通过神经精神病学量表照料者负担量表在门诊首次和第二次就诊时评估照料者负担。在每次就诊前 1 个月至 1 年内构建特定区域的 PM 浓度。使用广义估计方程来评估 PM 暴露与神经精神症状或照料者负担之间的关系。严重的神经精神症状与高 PM 水平暴露相关（调整后的百分比变化：1 个月移动平均值每增加 8.3μg/m，为 16.7%[95%置信区间（CI），5.0-29.7]）。只有阿尔茨海默病患者的照料者，其高 PM 暴露与增加的照料者负担相关（调整后的百分比变化：1 个月移动平均值每增加 8.3μg/m，为 29.0%[95%CI，8.1-53.9]）。本研究结果表明，PM 暴露与认知障碍患者的神经精神症状加重和照料者负担增加有关。本研究结果表明，在认知障碍的老年人群体中，空气污染的作用值得高度考虑。
