Department of Preventive Medicine, University of São Paulo Medical School, São Paulo, SP, Brazil.
Center for Clinical and Epidemiological Research, University of São Paulo, São Paulo, SP, Brazil; Division of Geriatrics, University of São Paulo Medical School, São Paulo, SP, Brazil.
Environ Res. 2020 Dec;191:110208. doi: 10.1016/j.envres.2020.110208. Epub 2020 Sep 14.
Despite the knowledge about the deleterious effects of air pollutants and their influence on mortality and morbidity due to respiratory and cardiovascular diseases, little is known about the relationship between atmospheric pollutants and neurological diseases. Recently, studies from high-income countries have suggested an association between exposures to air pollutants with cognitive impairment. Thus, we investigated the association of air pollution with cognitive performance in the participants of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil).
Cognitive function was evaluated using the word list, the verbal fluency, and the trail making tests (TMT). Pollutant exposure was evaluated indirectly using the distance-weighted traffic density (DWTD) of participants' residence and workplace. We investigated the cross-sectional association between DWTD and cognitive test scores using adjusted linear regression models for sociodemographic and clinical variables.
3050 were included (mean age = 52.1 ± 9.2 years old, 56.5% women, and 63.6% white). In the simple linear regression models, participants in the higher tertile of combined DWTD (residence and workplace) presented better cognitive performance in all tests when compared to participants in the lower tertile. The DWTD was not associated with cognitive performance in adjusted linear models especially when adjusted for socioeconomic variables (age, sex, education, and race). We found similar results when we investigated the association of cognitive performance with DTWD near participants' workplace and residence separately.
Air pollutants were not associated with worse cognitive performance in a large sample of middle-aged and older adults.
尽管人们已经了解到空气污染物的有害影响及其对呼吸系统和心血管疾病导致的死亡率和发病率的影响，但对于大气污染物与神经退行性疾病之间的关系却知之甚少。最近，高收入国家的研究表明，暴露于空气污染物与认知障碍之间存在关联。因此，我们在巴西成年人健康纵向研究（ELSA-Brasil）参与者中调查了空气污染与认知表现之间的关系。
使用词汇表、语言流畅性和连线测试（TMT）评估认知功能。使用参与者居住地和工作场所的距离加权交通密度（DWTD）间接评估污染物暴露情况。我们使用调整后的线性回归模型，针对社会人口统计学和临床变量，调查了 DWTD 与认知测试分数之间的横断面关联。
共纳入 3050 名参与者（平均年龄为 52.1 ± 9.2 岁，56.5%为女性，63.6%为白人）。在简单线性回归模型中，与低 tertile 组相比，居住地和工作场所 DWTD 较高 tertile 的参与者在所有测试中的认知表现均更好。在调整后的线性模型中，DWTD 与认知表现之间没有关联，尤其是在调整了社会经济变量（年龄、性别、教育程度和种族）后。当我们分别调查认知表现与参与者工作场所和居住地附近的 DTWD 之间的关联时，我们发现了类似的结果。
在一个较大的中年和老年人样本中，空气污染物与认知表现不佳之间没有关联。
