Department of Environmental Health and Epidemiology, Institute for Research in Environmental Health (NIREH), Bhopal, Madhya Pradesh, India.
Department of Biostatistics and Bioinformatics, Institute for Research in Environmental Health (NIREH), Bhopal, Madhya Pradesh, India.
Neurol India. 2022 May-Jun;70(3):1004-1019. doi: 10.4103/0028-3886.349654.
There are prevailing inconsistencies in epidemiological research about air pollution being a risk factor for dementia.
We performed meta-analyses to calculate the pooled estimates of the risk of developing dementia due to air pollution exposure.
We performed a systematic search in PubMed, Google Scholar, The Cochrane Library, and J-GATEPLUS databases for peer-reviewed epidemiological studies reporting the risk of developing all-cause dementia, cognitive decline, Alzheimer's disease (AD), and vascular dementia (VaD) due to exposure to particulate matter with an aerodynamic diameter less than 2.5 μm (PM) and less than 10 μm (PM), ozone (O), carbon monoxide (CO), nitrogen dioxide (NO), nitrogen oxides (NO) and sulfur dioxide (SO) from the beginning until December 2020. Meta-analysis was performed by adopting the random-effects model using Meta-XL.
In all-cause dementia, the pooled hazard ratio (HR) for PM and NO exposure was 1.03 [(95%CI: 1.01-1.06; I = 99% (P < 0.001)] and 1.00 [(95%CI: 1.00-1.01; I = 96% (P < 0.001)], respectively. The pooled HR for NO was 1.00 [(95%CI: 1.00-1.01; I = 61% (P = 0.05)]. In AD, the pooled HRs for PM and O was 1.08 (95%CI: 1.01-1.15; I = 99% (P < 0.001)]) and 1.02 (95%CI: 0.96-1.08; I = 100% (P < 0.001)], respectively. In VaD, the pooled HR for PM exposure was 1.03 (95%CI: 1.01-1.06; I = 91% (P < 0.001)]. In NO/NO, the results were found to be equivocal. Meta-analysis could not be performed in cognitive decline because of wide variations in assessments methods.
The present study showed exposure to PM as a risk factor for all-cause dementia, AD, and VaD and exposure to O as a possible risk factor for AD. These findings can be used for policy measures and further research.
流行病学研究中普遍存在空气污染是痴呆症风险因素的不一致性。
我们进行荟萃分析，计算由于空气污染暴露而导致痴呆的风险的汇总估计值。
我们在 PubMed、Google Scholar、The Cochrane Library 和 J-GATEPLUS 数据库中进行了系统搜索，以查找报道由于暴露于空气动力学直径小于 2.5 μm（PM）和小于 10 μm（PM）的颗粒物、臭氧（O）、一氧化碳（CO）、二氧化氮（NO）、氮氧化物（NO）和二氧化硫（SO）而导致所有原因痴呆、认知能力下降、阿尔茨海默病（AD）和血管性痴呆（VaD）的风险的同行评审的流行病学研究。采用 Meta-XL 采用随机效应模型进行荟萃分析。
在所有原因痴呆中，PM 和 NO 暴露的汇总危害比（HR）分别为 1.03 [（95%CI：1.01-1.06；I = 99%（P < 0.001））和 1.00 [（95%CI：1.00-1.01；I = 96%（P < 0.001）]。NO 的汇总 HR 为 1.00 [（95%CI：1.00-1.01；I = 61%（P = 0.05）]。在 AD 中，PM 和 O 的汇总 HR 分别为 1.08（95%CI：1.01-1.15；I = 99%（P < 0.001））和 1.02（95%CI：0.96-1.08；I = 100%（P < 0.001）]）。在 VaD 中，PM 暴露的汇总 HR 为 1.03 [（95%CI：1.01-1.06；I = 91%（P < 0.001）]。在 NO/NO 中，结果尚无定论。由于评估方法的广泛差异，无法对认知能力下降进行荟萃分析。
本研究表明，PM 暴露是所有原因痴呆、AD 和 VaD 的危险因素，O 暴露是 AD 的可能危险因素。这些发现可用于政策措施和进一步的研究。
