长期暴露于环境空气污染、APOE-ε4 状态与纽约北部老年人群认知衰退的队列研究。
Long-term exposure to ambient air pollution, APOE-ε4 status, and cognitive decline in a cohort of older adults in northern Manhattan.
机构信息
Department of Epidemiology, Brown University School of Public Health, Providence, RI, USA; Department of Neurology, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA; Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA.
Department of Neurology, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA; Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA; Gertrude H Sergievsky Center, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA.
出版信息
Environ Int. 2020 Mar;136:105440. doi: 10.1016/j.envint.2019.105440. Epub 2020 Jan 8.
BACKGROUND
There is mounting evidence that long-term exposure to air pollution is related to accelerated cognitive decline in aging populations. Factors that influence individual susceptibility remain largely unknown, but may involve the apolipoprotein E genotype E4 (APOE-ε4) allele.
OBJECTIVES
We assessed whether the association between long-term exposure to ambient air pollution and cognitive decline differed by APOE-ε4 status and cognitive risk factors.
METHODS
The Washington Heights Inwood Community Aging Project (WHICAP) is a prospective study of aging and dementia. Neuropsychological testing and medical examinations occur every 18-24 months. We used mixed-effects models to evaluate whether the association between markers of ambient air pollution (nitrogen dioxide [NO]), fine [PM], and coarse [PM] particulate matter) and the rate of decline in global and domain-specific cognition differed across strata defined by APOE-ε4 genotypes and cognitive risk factors, adjusting for sociodemographic factors and temporal trends.
RESULTS
Among 4821 participants with an average of 6 years follow-up, higher concentrations of ambient air pollution were associated with more rapid cognitive decline. This association was more pronounced among APOE-ε4 carriers (p < 0.001). A one interquartile range increase in NO was associated with an additional decline of 0.09 standard deviations (SD) (95%CI -0.1, -0.06) in global cognition across biennial visits among APOE-ε4 positive individuals and a 0.07 SD (95%CI -0.09, -0.05) decline among APOE-ε4 negative individuals. Results for PM PM and cognitive domains were similar. The association between air pollutants and rate of cognitive decline also varied across strata of race-ethnicity with the association strongest among White non-Hispanic participants.
CONCLUSIONS
These results add to the body of evidence on the adverse impact of ambient air pollution on cognitive aging and brain health and provide new insights into the genetic and behavioral factors that may impact individual susceptibility.
背景
越来越多的证据表明，长期暴露于空气污染与老龄化人群认知能力下降加速有关。影响个体易感性的因素在很大程度上尚不清楚，但可能涉及载脂蛋白 E 基因型 E4（APOE-ε4）等位基因。
目的
我们评估了长期暴露于环境空气污染与认知能力下降之间的关联是否因 APOE-ε4 状态和认知危险因素而异。
方法
华盛顿高地-因伍德社区老龄化项目（WHICAP）是一项针对衰老和痴呆的前瞻性研究。神经心理学测试和体检每 18-24 个月进行一次。我们使用混合效应模型来评估环境空气污染标志物（二氧化氮[NO]、细颗粒物[PM]和粗颗粒物[PM]）与全球和特定领域认知下降率之间的关联是否因 APOE-ε4 基因型和认知危险因素的不同而有所不同，同时调整了社会人口因素和时间趋势。
结果
在 4821 名平均随访 6 年的参与者中，较高浓度的环境空气污染与认知能力下降较快相关。这种关联在 APOE-ε4 携带者中更为明显（p<0.001）。在 APOE-ε4 阳性个体中，NO 每增加一个四分位距，与两年一次的全球认知测试中额外下降 0.09 个标准差（95%置信区间为-0.1，-0.06）相关，而在 APOE-ε4 阴性个体中则下降 0.07 个标准差（95%置信区间为-0.09，-0.05）。PM 和认知领域的结果相似。空气污染物与认知下降率之间的关联也因种族-族裔的不同而有所不同，其中与白种非西班牙裔参与者的关联最强。
结论
这些结果增加了环境空气污染对认知老化和大脑健康的不良影响的证据，并为可能影响个体易感性的遗传和行为因素提供了新的见解。
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