From the Department of Epidemiology (E.R.K., G.A.W., N.R.J.), Brown University School of Public Health, Providence, RI; Departments of Neurology (E.R.K., A.K.B., N.S., M.S.V.E.) and Psychiatry (R.M.) and Gertrude H. Sergievsky Center (N.S., R.M., J.J.M., M.S.V.E.), Vagelos College of Physicians and Surgeons, Department of Epidemiology, Mailman School of Public Health (E.R.K., A.K.B., N.S., R.M., J.J.M., M.S.V.E.), and Taub Institute for Research on Alzheimer Disease and the Aging Brain (N.S., R.M., J.J.M.), Columbia University, New York, NY; Departments of Environmental and Occupational Health Sciences, Medicine, and Epidemiology (J.D.K.), University of Washington, Seattle; and Departments of Neurology, Public Health Sciences, and Human Genetics (R.L.S.), Evelyn McKnight Brain Institute, Miller School of Medicine, University of Miami, FL.
Neurology. 2020 Apr 28;94(17):e1782-e1792. doi: 10.1212/WNL.0000000000009314. Epub 2020 Apr 8.
To evaluate the association between long-term exposure to ambient air pollution and cognitive decline in older adults residing in an urban area.
Data for this study were obtained from 2 prospective cohorts of residents in the northern Manhattan area of New York City: the Washington Heights-Inwood Community Aging Project (WHICAP) and the Northern Manhattan Study (NOMAS). Participants of both cohorts received in-depth neuropsychological testing at enrollment and during follow-up. In each cohort, we used inverse probability weighted linear mixed models to evaluate the cross-sectional and longitudinal associations between markers of average residential ambient air pollution (nitrogen dioxide [NO], fine particulate matter [PM], and respirable particulate matter [PM]) levels in the year prior to enrollment and measures of global and domain-specific cognition, adjusting for sociodemographic factors, temporal trends, and censoring.
Among 5,330 participants in WHICAP, an increase in NO was associated with a 0.22 SD lower global cognitive score at enrollment (95% confidence interval [CI], -0.30, -0.14) and 0.06 SD (95% CI, -0.08, -0.04) more rapid decline in cognitive scores between visits. Results were similar for PM and PM and across functional cognitive domains. We found no evidence of an association between pollution and cognitive function in NOMAS.
WHICAP participants living in areas with higher levels of ambient air pollutants have lower cognitive scores at enrollment and more rapid rates of cognitive decline over time. In NOMAS, a smaller cohort with fewer repeat measurements, we found no statistically significant associations. These results add to the evidence regarding the adverse effect of air pollution on cognitive aging and brain health.
评估居住在城市地区的老年人长期暴露于环境空气污染与认知能力下降之间的关联。
本研究的数据来自纽约市北部曼哈顿地区的两个前瞻性队列研究：华盛顿高地-因伍德社区老龄化项目（WHICAP）和北部曼哈顿研究（NOMAS）。两个队列的参与者在入组时和随访期间都接受了深入的神经心理学测试。在每个队列中，我们使用逆概率加权线性混合模型来评估入组前一年的平均居住环境空气污染标志物（二氧化氮[NO]、细颗粒物[PM]和可吸入颗粒物[PM]）水平与全球和特定领域认知测量之间的横断面和纵向关联，调整社会人口统计学因素、时间趋势和删失。
在 WHICAP 的 5330 名参与者中，NO 增加与入组时全球认知评分降低 0.22 个标准差（95%置信区间[CI]，-0.30，-0.14）以及认知评分在两次就诊之间的下降速度加快 0.06 个标准差（95%CI，-0.08，-0.04）有关。PM 和 PM 以及各功能认知域的结果均相似。我们在 NOMAS 中没有发现污染与认知功能之间存在关联的证据。
居住在环境空气污染水平较高地区的 WHICAP 参与者在入组时的认知评分较低，并且随着时间的推移认知下降速度更快。在 NOMAS 中，我们发现一个规模较小的队列，重复测量次数较少，没有统计学上显著的关联。这些结果增加了关于空气污染对认知老化和大脑健康的不利影响的证据。
