Department of Neurology, Hebei General Hospital, No. 348 Heping West Road, Xinhua District, Shijiazhuang, Hebei Province 050051, China; Department of Neurology, Hebei Medical University, No. 361 Zhongshan East Road, Changan District, Shijiazhuang, Hebei Province 050017, China.
Department of Endocrine, The Second Affiliated Hospital of Air Force Medical University, No.169 Changle West Road, Xi'an, Shaanxi 710032, China.
Public Health. 2022 Nov;212:33-41. doi: 10.1016/j.puhe.2022.08.006. Epub 2022 Oct 3.
This study aimed to analyse the existing evidence on the association between particulate matter 2.5 (PM) and dementia, including two of its subtypes, namely, Alzheimer's disease (AD) and vascular dementia (VaD).
This was a systematic review and meta-analysis.
The PubMed, EMBASE, Cochrane and Web of Science databases were comprehensively searched for articles published between January 1900 and June 2022. All cohort studies that reported the influence of long-term exposure to PM on dementia, together with its subtypes, in adults aged ≥40 years, without any regional restriction were included. A random effects model was used to pool the hazard ratios (HRs) of PM for dementia, AD and VaD. Funnel plots, sensitivity analyses and subgroup analyses were performed to test publication bias and result stability. In addition, an explanation for the heterogeneity of the results was suggested.
In total, 20 articles were selected for review; 18 included results on the long-term effects of PM on dementia, 13 on AD, and eight on VaD. Three group meta-analyses were performed to obtain the HRs and 95% confidence intervals (CIs). The pooled HRs were 1.40 (95% CI 1.23, 1.60) for dementia, 1.47 (95% CI 1.22, 1.78) for AD and 2.00 (95% CI 1.30, 3.08) for VaD per 10.0 μg/m PM increase.
Long-term exposure to PM may increase the risk of dementia, including AD and VaD. These results highlight the need for further study on the detrimental impact of PM and the importance of strategies to mitigate increasing air pollution.
本研究旨在分析 2.5 型颗粒物（PM）与痴呆症之间的现有证据，包括其两种亚型，即阿尔茨海默病（AD）和血管性痴呆（VaD）。
这是一项系统评价和荟萃分析。
全面检索了 1900 年 1 月至 2022 年 6 月期间发表的 PubMed、EMBASE、Cochrane 和 Web of Science 数据库中的文章。所有队列研究均报告了长期暴露于 PM 对≥40 岁成年人痴呆症及其亚型的影响，无任何地区限制。采用随机效应模型对 PM 对痴呆症、AD 和 VaD 的危害比（HRs）进行汇总。绘制漏斗图、进行敏感性分析和亚组分析，以检验发表偏倚和结果稳定性。此外，还对结果的异质性提出了解释。
共选择了 20 篇文章进行综述；18 篇文章报道了 PM 对痴呆症的长期影响，13 篇报道了 AD，8 篇报道了 VaD。进行了三项荟萃分析以获得 HRs 和 95%置信区间（CI）。PM 每增加 10.0μg/m³，汇总的 HRs 为痴呆症 1.40（95%CI 1.23，1.60）、AD 1.47（95%CI 1.22，1.78）和 VaD 2.00（95%CI 1.30，3.08）。
长期暴露于 PM 可能会增加痴呆症的风险，包括 AD 和 VaD。这些结果强调了进一步研究 PM 的有害影响以及采取策略减轻不断增加的空气污染的重要性。
