空气质量改善与认知功能获益：来自中国清洁空气行动的启示。
Air quality improvement and cognitive function benefit: Insight from clean air action in China.
机构信息
Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, China.
Department of Cardiology, Hypertension Research Laboratory, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, China.
出版信息
Environ Res. 2022 Nov;214(Pt 4):114200. doi: 10.1016/j.envres.2022.114200. Epub 2022 Aug 27.
INTRODUCTION
Epidemiological evidence suggests associations between long-term exposure to air pollution and accelerated cognitive decline. China implemented a strict clean air action plan in 2013; however, it is unclear whether the improvement of air quality has alleviated cognitive impairment in the population.
METHODS
From the China Health and Retirement Longitudinal Study, 8536 Chinese adults were enrolled in 2011 and followed up in 2015. Satellite-based spatiotemporal models were used to estimate exposure to air pollutants (including particles with diameters ≤1.0 μm [PM], ≤2.5 μm [PM], ≤10 μm [PM], nitrogen dioxide [NO], and ozone [O]). Cognitive function was evaluated using a structured questionnaire in three dimensions: episodic memory, orientation and attention, and visuoconstruction. The associations between changes in the levels of air pollutants and cognitive function were elucidated by a logistic model. The Bayesian Kernel Machine Regression (BKMR) model was applied to evaluate the cumulative effect of air pollutants.
RESULTS
The mean (standard deviation) age of all participants was 58.6 (8.7) years. The odds ratio (95% confidence interval) between the highest and the lowest quartile of PM exposure reduction for cognitive impairment was 0.46 (0.41, 0.53) after adjusting for confounders. Similar protective effects of cognitive function were observed with the decrease in the level of PM (0.34 [0.30, 0.39]), PM (0.54 [0.48, 0.62]), and NO (0.59 [0.51, 0.67]), while the reduction in O appeared to be less related to changes in cognitive function (OR: 0.97 [0.85, 1.10]). The protective association of PM reduction was stronger in males than in females. Decreased in PM dominate the cognitive function benefit relative to PM, PM, NO.
CONCLUSIONS
The implementation of the clean air action plan led to a significant reduction in PM, PM, PM, and NO, which could slow the decline of cognitive function, while a reduction in O may not.
简介
流行病学证据表明，长期暴露于空气污染与认知能力加速下降之间存在关联。中国于 2013 年实施了严格的清洁空气行动计划；然而，空气质量的改善是否减轻了人群的认知障碍尚不清楚。
方法
我们从中国健康与退休纵向研究中招募了 8536 名中国成年人，他们于 2011 年入组，并于 2015 年进行了随访。我们使用基于卫星的时空模型来估计空气污染物（包括直径≤1.0μm[PM₁₀]、≤2.5μm[PM₂.₅]、≤10μm[PM₁₀]、二氧化氮[NO]和臭氧[O₃]）的暴露水平。我们使用结构化问卷从三个维度评估认知功能：情景记忆、定向和注意力以及视空间构建。使用逻辑模型阐明了空气污染物水平变化与认知功能之间的关联。应用贝叶斯核机器回归（BKMR）模型评估空气污染物的累积效应。
结果
所有参与者的平均（标准差）年龄为 58.6（8.7）岁。调整混杂因素后，PM 暴露降低最高四分位数与最低四分位比值（95%置信区间）为认知障碍的 0.46（0.41，0.53）。PM 水平降低（0.34 [0.30，0.39]）、PM（0.54 [0.48，0.62]）和 NO（0.59 [0.51，0.67]）也观察到类似的认知功能保护作用，而 O 的减少似乎与认知功能变化的关系较小（比值比：0.97 [0.85，1.10]）。PM 降低的保护关联在男性中强于女性。与 PM、PM、PM 相比，PM 的降低主导认知功能获益。
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