Cantuaria Manuella Lech, Waldorff Frans Boch, Wermuth Lene, Pedersen Ellen Raben, Poulsen Aslak Harbo, Thacher Jesse Daniel, Raaschou-Nielsen Ole, Ketzel Matthias, Khan Jibran, Valencia Victor H, Schmidt Jesper Hvass, Sørensen Mette
The Mærsk McKinney Møller Institute, University of Southern Denmark, Odense, Denmark
Diet, Genes and Environment, Danish Cancer Society Research Center, Copenhagen, Denmark.
BMJ. 2021 Sep 8;374:n1954. doi: 10.1136/bmj.n1954.
To investigate the association between long term residential exposure to road traffic and railway noise and risk of incident dementia.
Nationwide prospective register based cohort study.
Denmark.
1 938 994 adults aged ≥60 years living in Denmark between 1 January 2004 and 31 December 2017.
Incident cases of all cause dementia and dementia subtypes (Alzheimer's disease, vascular dementia, and Parkinson's disease related dementia), identified from national hospital and prescription registries.
The study population included 103 500 participants with incident dementia, and of those, 31 219 received a diagnosis of Alzheimer's disease, 8664 of vascular dementia, and 2192 of Parkinson's disease related dementia. Using Cox regression models, 10 year mean exposure to road traffic and railway noise at the most (Lmax) and least (Lmin) exposed façades of buildings were associated with a higher risk of all cause dementia. These associations showed a general pattern of higher hazard ratios with higher noise exposure, but with a levelling off or even small declines in risk at higher noise levels. In subtype analyses, both road traffic noise and railway noise were associated with a higher risk of Alzheimer's disease, with hazard ratios of 1.16 (95% confidence interval 1.11 to 1.22) for road Lmax ≥65 dB compared with <45 dB, 1.27 (1.22 to 1.34) for road Lmin ≥55 dB compared with <40 dB, 1.16 (1.10 to 1.23) for railway Lmax ≥60 dB compared with <40 dB, and 1.24 (1.17 to 1.30) for railway Lmin ≥50 dB compared with <40 dB. Road traffic, but not railway, noise was associated with an increased risk of vascular dementia. Results indicated associations between road traffic Lmin and Parkinson's disease related dementia.
This nationwide cohort study found transportation noise to be associated with a higher risk of all cause dementia and dementia subtypes, especially Alzheimer's disease.
调查长期居住在道路交通和铁路噪声环境中与痴呆症发病风险之间的关联。
基于全国前瞻性登记的队列研究。
丹麦。
2004年1月1日至2017年12月31日期间居住在丹麦的1938994名年龄≥60岁的成年人。
从国家医院和处方登记处确定的全因痴呆症及痴呆症亚型（阿尔茨海默病、血管性痴呆和帕金森病相关痴呆）的发病病例。
研究人群包括103500名痴呆症发病参与者，其中31219人被诊断为阿尔茨海默病，8664人被诊断为血管性痴呆，2192人被诊断为帕金森病相关痴呆。使用Cox回归模型，建筑物暴露程度最高（Lmax）和最低（Lmin）的立面上10年道路交通和铁路噪声的平均暴露与全因痴呆症风险较高相关。这些关联呈现出一般模式，即噪声暴露越高，风险比越高，但在较高噪声水平下风险趋于平稳甚至略有下降。在亚型分析中，道路交通噪声和铁路噪声均与阿尔茨海默病风险较高相关，道路Lmax≥65dB与<45dB相比，风险比为1.16（95%置信区间1.11至1.22）；道路Lmin≥55dB与<40dB相比，风险比为1.27（1.22至1.34）；铁路Lmax≥60dB与<40dB相比，风险比为1.16（1.10至1.23）；铁路Lmin≥50dB与<40dB相比，风险比为1.24（1.17至1.30）。道路交通噪声而非铁路噪声与血管性痴呆风险增加相关。结果表明道路Lmin与帕金森病相关痴呆之间存在关联。
这项全国性队列研究发现交通噪声与全因痴呆症及痴呆症亚型风险较高相关，尤其是阿尔茨海默病。
