Weng Xueqiong, Liang Huanzhu, Tan Yuxuan, Chen Jingmin, Fei Qiaoyuan, Liu Shan, Guo Xinrong, Wen Lin, Wu Yingying, Jing Chunxia
Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, No. 601 Huangpu Ave West, Guangzhou, 510632, Guangdong, China.
Guangdong Key Laboratory of Environmental Exposure and Health, Jinan University, Guangzhou, 510632, Guangdong, China.
Environ Sci Pollut Res Int. 2022 May;29(21):32093-32104. doi: 10.1007/s11356-021-17789-5. Epub 2022 Jan 11.
The relationship between perfluoroalkyl and polyfluoroalkyl substances (PFAS) and cognitive function are inconsistent, and the mixed effects of PFAS on cognitive function are still unclear. We aimed to evaluate the joint effects of PFAS on cognitive function assessed using four tests as follows: the Consortium to Establish a Registry for Alzheimer's Disease Immediate Recall Test (IRT), Delayed Recall Test (DRT), the Animal Fluency Test (AFT), and the Digit Symbol Substitution Test (DSST) in the US elderly. A total of 777 individuals aged ≥ 60 from the National Health and Nutrition Examination Survey (NHANES) 2011-2014 were included in this study. Multivariable logistic regression and Bayesian kernel machine regression (BKMR) were constructed to estimate the overall and the individual effects of PFAS exposure on cognitive function. There were 21.36%, 22.65%, 21.62%, and 21.24% participants with cognitive decline in IRT, DRT, AFT, and DSST, respectively. After multivariable adjustment, perfluorooctanoic acid (PFOA) was inversely associated with cognitive decline in IRT, DRT, and AFT, while no significant association was observed between any other PFAS and cognitive decline. Compared with the lowest quartile, the adjusted odds ratio of cognitive decline with a 95% confidence interval (CI) for the highest quartile of PFOA was 0.33 (95% CI: 0.15-0.69) in IRT, 0.50 (0.26-0.96) in DRT, and 0.45 (0.21-0.95) in AFT. In BKMR analysis, the overall effect of mixtures was significantly protective on cognitive decline in IRT, of which PFOA made the greatest contribution. The consistent protective effect in DRT and DSST was observed when all the chemicals were at their 50th percentile or below it. No significant interaction was observed among PFAS for cognitive function. These findings suggested that PFAS mixture at a low level of current exposure of the US population may have a protective effect on cognitive function.
全氟烷基和多氟烷基物质（PFAS）与认知功能之间的关系并不一致，PFAS对认知功能的混合影响仍不明确。我们旨在评估PFAS对认知功能的联合影响，认知功能通过以下四项测试进行评估：美国老年人中的阿尔茨海默病注册协会即时回忆测试（IRT）、延迟回忆测试（DRT）、动物流畅性测试（AFT）和数字符号替换测试（DSST）。本研究纳入了2011 - 2014年国家健康与营养检查调查（NHANES）中777名年龄≥60岁的个体。构建多变量逻辑回归和贝叶斯核机器回归（BKMR）来估计PFAS暴露对认知功能的总体和个体影响。在IRT、DRT、AFT和DSST中，分别有21.36%、22.65%、21.62%和21.24%的参与者存在认知功能下降。多变量调整后，全氟辛酸（PFOA）与IRT、DRT和AFT中的认知功能下降呈负相关，而未观察到其他任何PFAS与认知功能下降之间存在显著关联。与最低四分位数相比，PFOA最高四分位数的认知功能下降调整比值比及95%置信区间（CI）在IRT中为0.33（95% CI: 0.15 - 0.69），在DRT中为0.50（0.26 - 0.96）, 在AFT中为0.45（0.21 - 0.95）。在BKMR分析中，混合物的总体效应在IRT中对认知功能下降具有显著保护作用，其中PFOA贡献最大。当所有化学物质处于其第50百分位数或以下时，在DRT和DSST中观察到一致的保护作用。未观察到PFAS之间对认知功能有显著相互作用。这些发现表明，美国人群当前低水平暴露的PFAS混合物可能对认知功能有保护作用。
