Département de Génie d'imagerie médicale et de radiobiologie, École Polytechnique d'Abomey-Calavi, University of Abomey-Calavi, P.O. Box 2009, Cotonou, Abomey-Calavi, Republic of Benin.
Centre d'excellence sur le vieillissement de Québec, CHU de Québec-Université Laval Research Center, and Centre de recherche sur les soins et les services de première ligne de l'Université Laval, Québec, Canada.
Environ Health. 2019 Jun 14;18(1):57. doi: 10.1186/s12940-019-0494-2.
Little attention has been paid to neurotoxicants on the risk of dementia. Exposure to known neurotoxicants such as polychlorinated biphenyls (PCBs) and organochlorine (OC) pesticides is suspected to have adverse cognitive effects in older populations.
To assess whether plasma concentrations of PCBs and OC pesticides are associated with the risk of cognitive decline, Alzheimer's disease (AD) and of all-cause dementia in the Canadian older population.
Analyses were based on data from the Canadian Study of Health and Aging, a 3-phase, 10-year population-based study of individuals aged 65+ years. Analyses included 669 clinically assessed subjects, of which 156 developed dementia including 108 incident cases of AD. Subjects were screened at each phase with the 100-point Modified Mini-Mental State Examination (3MS), a measurement of global cognitive function. Statistical analyses included Cox proportional hazards model when the outcome was dementia or AD, and a repeated-measure mixed model when the outcome was the 3MS score.
No association of PCB and OC pesticides with the risk of dementia and AD was observed. Elevated concentrations of PCB congeners nos 118, 153, 156, 163, and OC pesticides 1,1,1-trichloro-2,2-bis(p-chlorophenyl)ethane (p,p'-DDT) and its metabolite 1,1-dichloro-2,2-bis(p-chlorophenyl)ethylene (p,p'-DDE) were significantly associated with cognitive decline as assessed with the 3MS. A posteriori analyses suggested that only p,p'-DDE was significantly related to a higher cognitive decline in time based on the 3MS among incident cases of dementia compared to subjects remaining nondemented.
PCB and OC pesticide plasma concentrations were not related to the incident diagnosis of neither dementia, nor AD. Using the 3MS scores as the outcome, higher concentrations of four PCB congeners and two OC pesticides were associated with lower cognitive performances in subjects. The association of p,p'-DDE with cognitive decline in time in incident cases of dementia merits further investigation.
人们对神经毒素对痴呆风险的关注甚少。已知的神经毒素，如多氯联苯（PCBs）和有机氯（OC）农药，接触后可能对老年人群的认知功能产生不良影响。
评估加拿大老年人群血浆中 PCBs 和 OC 农药的浓度是否与认知能力下降、阿尔茨海默病（AD）和所有原因痴呆的风险相关。
分析基于加拿大健康老龄化研究的数据，这是一项为期 10 年的 3 阶段、基于人群的研究，对象为 65 岁以上的个体。分析包括 669 名经过临床评估的受试者，其中 156 人患有痴呆症，包括 108 例 AD 新发病例。受试者在每个阶段都接受了 100 分的改良迷你精神状态检查（3MS）的筛查，这是一项衡量整体认知功能的测试。当结果为痴呆症或 AD 时，使用 Cox 比例风险模型进行统计分析，当结果为 3MS 评分时，使用重复测量混合模型进行分析。
未观察到 PCBs 和 OC 农药与痴呆症和 AD 风险之间的关联。PCB 同系物 nos 118、153、156、163 和 OC 农药 1,1,1-三氯-2,2-双（对氯苯基）乙烷（p,p'-DDT）及其代谢物 1,1-二氯-2,2-双（对氯苯基）乙烯（p,p'-DDE）浓度升高与 3MS 评估的认知能力下降显著相关。事后分析表明，只有 p,p'-DDE 与痴呆症新发病例的认知下降时间相关，与未痴呆的受试者相比，认知下降速度更快。
PCBs 和 OC 农药的血浆浓度与痴呆症或 AD 的新发诊断均无相关性。使用 3MS 评分作为结果，四种 PCB 同系物和两种 OC 农药的浓度越高，受试者的认知表现越低。p,p'-DDE 与痴呆症新发病例认知下降时间的关联值得进一步研究。
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