National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China.
Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, China.
Environ Health Perspect. 2020 Jun;128(6):67013. doi: 10.1289/EHP5304. Epub 2020 Jun 18.
Research on the relationship between long-term exposure to particulate matter with aerodynamic diameter () and poor cognitive function is lacking in developing countries, especially in highly polluted areas.
We evaluated associations of long-term exposure to with poor cognitive function in a diverse, national sample of older adults in China.
This analysis included data on 13,324 older adults (5,879 who were 65-79 years of age, 3,052 who were 80-89 years of age, 2,634 who were 90-99 years of age, and 1,759 who were of age) with normal cognitive function at baseline from March 2002 to September 2014, with 64,648 person-years of follow-up. We used a geographic information system analysis to estimate the annual average satellite-derived concentration for the geocoded location of the participants' baseline residences. Poor cognitive function was defined as a score of less than 18 on the Chinese version of the Mini-Mental State Examination (MMSE). Competing risk models were performed to explore the association of with poor cognitive function.
Each increase in was associated with a 5.1% increased risk of poor cognitive function [adjusted hazard ratio (HR): 1.051; 95% confidence interval (CI): 1.023, 1.079]. Compared to the lowest quartile of (), adjusted values were 1.20 (95% CI: 1.09, 1.33), 1.27 (95% CI: 1.15, 1.41), and 1.21 (95% CI: 1.09, 1.34) for the second (), third (), and fourth () quartiles of , respectively ( for trend ). Subgroup analyses suggested stronger associations between and poor cognitive impairment in men than women. The association was positive in the 65- to 79- and age group but not significant and positive in the other two age groups with similar results.
was identified as a risk factor for poor cognitive function in Chinese older adults. Improving air quality may reduce the future population burden of poor cognitive function, especially in areas with high air pollution. https://doi.org/10.1289/EHP5304.
在发展中国家，尤其是在污染严重的地区，关于长期暴露于空气动力学直径为 2.5 微米及以下的颗粒物（ ）与认知功能不良之间关系的研究较为匮乏。
我们评估了在中国一个多样化的、全国性的老年人群体中，长期暴露于 与认知功能不良之间的关联。
本分析纳入了 13324 名认知功能正常的老年人的数据（65-79 岁 5879 人，80-89 岁 3052 人，90-99 岁 2634 人， 岁及以上 1759 人），这些参与者的基线居住地址经地理信息系统分析后，估计出了其每年平均的卫星衍生 浓度。认知功能不良定义为中文版简易精神状态检查（MMSE）得分<18。使用竞争风险模型来探讨 与认知功能不良之间的关联。
每增加 ，认知功能不良的风险就会增加 5.1%（调整后的危险比[HR]：1.051；95%置信区间[CI]：1.023，1.079）。与 浓度最低的四分位数（）相比， 浓度分别为 1.20（95%CI：1.09，1.33）、1.27（95%CI：1.15，1.41）和 1.21（95%CI：1.09，1.34）的第二（）、第三（）和第四（）四分位数（ 趋势检验）。亚组分析表明， 与男性认知功能障碍之间的关联强于女性。这种关联在 65-79 岁和 80-89 岁年龄组中是显著的，但在其他两个年龄组中不显著，且呈阳性。
被确定为中国老年人认知功能不良的一个风险因素。改善空气质量可能会降低未来认知功能不良的人群负担，尤其是在空气污染严重的地区。
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