Department of Neurology, University of Southern California, Los Angeles, California, USA.
Department of Population and Public Health Sciences, University of Southern California, Los Angeles, California, USA.
Environ Health Perspect. 2021 Sep;129(9):97009. doi: 10.1289/EHP7668. Epub 2021 Sep 13.
Episodic memory decline varies by age and underlying neuropathology. Whether ambient air pollution contributes to the heterogeneity of episodic memory decline in older populations remains unclear.
We estimated associations between air pollution exposures and episodic memory decline according to pollutant, exposure time window, age, and latent class subgroups defined by episodic memory trajectories.
Participants were from the Women's Health Initiative Memory Study-Epidemiology of Cognitive Health Outcomes. Older women (; 74-92 years of age) completed annual (2008-2018) episodic memory assessments using the telephone-based California Verbal Learning Test (CVLT). We estimated 3-y average fine particulate matter [PM with an aerodynamic diameter of ()] and nitrogen dioxide () exposures at baseline and 10 y earlier (recent and remote exposures, respectively), using regionalized national universal kriging. Separate latent class mixed models were used to estimate associations between interquartile range increases in exposures and CVLT trajectories in women and , adjusting for covariates.
Two latent classes were identified for women (), "slow-decliners" { [95% confidence interval (CI): , ] and "fast-decliners" [ (95% CI: , )]}. In the slow-decliner class, but not the fast-decliner class, exposures were associated with a greater decline in CVLT scores over time, with a stronger association for recent vs. remote exposures [ (95% CI: , ) per and (95% CI: , 0.01) per , respectively]. Among women (), the largest latent class comprised "steady-decliners" [ (95% CI: , )], whereas the second class, "cognitively resilient", had no decline in CVLT on average. was not associated with episodic memory decline in either class. A increase in recent was associated with nonsignificant acceleration of episodic memory decline in the -y-old fast-decliner class [ (95% CI: , 0.04)], and in the cognitively resilient class [ (95% CI: , 0.03)] and steady-decliner class [ (95% CI: , 0.05)]. Associations with recent exposure in women were stronger and statistically significant when 267 women with incident probable dementia were excluded [e.g., (95% CI: , ) for the cognitively resilient class]. In contrast with changes in CVLT over time, there were no associations between exposures and CVLT scores during follow-up in any subgroup.
In a community-dwelling U.S. population of older women, associations between late-life exposure to ambient air pollution and episodic memory decline varied by age-related cognitive trajectories, exposure time windows, and pollutants. https://doi.org/10.1289/EHP7668.
间歇性记忆衰退随年龄和潜在神经病理学的变化而变化。环境空气污染是否会导致老年人群间歇性记忆衰退的异质性仍不清楚。
我们根据污染物、暴露时间窗、年龄以及根据间歇性记忆轨迹定义的潜在类别亚组，估计了空气污染暴露与间歇性记忆衰退之间的关联。
参与者来自妇女健康倡议记忆研究-认知健康结果的流行病学。老年女性（74-92 岁）使用基于电话的加利福尼亚词语学习测试（CVLT）每年（2008-2018 年）进行间歇性记忆评估。我们使用区域化国家通用克里金法，分别估算了基线和 10 年前（最近和远程暴露）的 3 年平均细颗粒物（ [空气动力学直径为 ()]）和二氧化氮（ ）暴露量。分别使用单独的潜在类别混合模型，在调整协变量后，估计了女性中暴露量增加 1/4 分位数与 CVLT 轨迹之间的关联。[95%置信区间（CI）： ， ]和“快速衰退者”[（95%CI： ， ）]）。在缓慢衰退者类别中，但在快速衰退者类别中，最近的 暴露与 CVLT 评分随时间的下降有关，最近暴露与远程暴露的关联更强[每增加 （95%CI： ， ）和每增加 （95%CI： ， 0.01），分别]。在女性中（ ），最大的潜在类别包括“稳定下降者”[（95%CI： ， ）]，而第二个类别“认知弹性”的 CVLT 平均没有下降。在任何一个类别中， 都与间歇性记忆衰退无关。最近的 增加与 -y 岁快速衰退者类别的间歇性记忆衰退的非显著加速有关[（95%CI： ， 0.04）]，以及认知弹性类别的间歇性记忆衰退[（95%CI： ， 0.03）]和稳定下降者类别的间歇性记忆衰退[（95%CI： ， 0.05）]。当排除 267 名新发可能痴呆的女性时，最近 暴露与女性中与时间相关的 CVLT 变化之间的关联更强且具有统计学意义[例如，在认知弹性类别中， （95%CI： ， ）]。与随时间变化的 CVLT 相比，在任何亚组中，暴露与随访期间的 CVLT 评分之间均无关联。
在一个美国社区居住的老年女性人群中，与晚年环境空气污染相关的暴露与间歇性记忆衰退之间的关联因与年龄相关的认知轨迹、暴露时间窗和污染物而异。https://doi.org/10.1289/EHP7668.
