Wu Jing, Grande Giulia, Triolo Federico, Pyko Andrei, Sjöberg Linnea, Ljungman Petter, Eneroth Kristina, Bellander Tom, Rizzuto Debora
Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden.
Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden.
Environ Pollut. 2023 Nov 1;336:122394. doi: 10.1016/j.envpol.2023.122394. Epub 2023 Aug 17.
Although emerging research has investigated the relationship between outdoor air pollution and depression risk in older adults, the results remain inconclusive. We aimed to determine the relationship between long-term exposure to ambient air pollution and depression among older adults and explore whether active social engagement may modify this association. At baseline (2001-2004), 2812 depression-free older adults from Swedish National Study on Aging and Care in Kungsholmen (SNAC-K) were included. SNAC-K is a longitudinal population-based cohort in Stockholm, Sweden. Incident depression cases occurred during 2004-2013 were ascertained using the Diagnostic and Statistical Manual of Mental Disorders 4th Edition. Air pollution [particulate matter (PM) and nitrogen oxides (NOx)] at the residency were estimated using dispersion models. Social engagement was measured as active participation in social activities (at least twice/week) or inactive (less than twice/week) in the last 12 months. The hazard ratios (HR) and 95% confidence intervals of depression from air pollution exposure of 3-year moving average before diagnosis (1-μg/m difference in PM and PM, and 10-μg/m difference in NOx) were obtained from Cox models considering greenspace and noise. A product term of air pollutant and social activity was added to test the multiplicative interaction and attributable proportion due to interaction was calculated for assessing additive interaction. We identified 137 (4.9%) incident depression cases. Participants exposed to higher concentrations of PM NOx, and PM had 53% (HR:1.53 [1.22, 1.93]), 26% (HR:1.26 [1.01, 1.58]), and 7% (HR:1.07 [0.98, 1.18]) increased hazard of depression, respectively. These associations were largely attenuated in people with active social engagement (HR for PM: 1.04 [0.70, 1.55]; HR for PM: 0.98 [0.81, 1.18]; and HR for NOx: 1.09 [0.71, 1.66]). Our findings suggest long-term exposure to air pollution may be a risk factor for depression among older adults. An active social engagement might however decrease this risk.
尽管新兴研究已对老年人户外空气污染与抑郁风险之间的关系进行了调查，但结果仍无定论。我们旨在确定老年人长期暴露于环境空气污染与抑郁之间的关系，并探讨积极的社会参与是否可能改变这种关联。在基线期（2001 - 2004年），纳入了来自瑞典斯德哥尔摩孔斯霍尔姆老年与护理全国性研究（SNAC - K）的2812名无抑郁的老年人。SNAC - K是瑞典斯德哥尔摩一个基于人群的纵向队列。2004 - 2013年期间发生的新发抑郁病例根据《精神疾病诊断与统计手册》第4版进行确定。使用扩散模型估算居住地址的空气污染[颗粒物（PM）和氮氧化物（NOx）]。社会参与度通过过去12个月内积极参与社交活动（至少每周两次）或不积极参与（每周少于两次）来衡量。从考虑绿地和噪音的Cox模型中得出诊断前3年移动平均空气污染暴露导致抑郁的风险比（HR）和95%置信区间（PM每立方米相差1微克，以及NOx每立方米相差10微克）。添加空气污染物与社交活动的乘积项以检验相乘交互作用，并计算交互作用导致的归因比例以评估相加交互作用。我们确定了137例（4.9%）新发抑郁病例。暴露于较高浓度PM、NOx和PM的参与者患抑郁症的风险分别增加了53%（HR：1.53 [1.22, 1.93]）、26%（HR：1.26 [1.01, 1.58]）和7%（HR：1.07 [0.98, 1.18]）。在积极参与社会活动的人群中，这些关联在很大程度上减弱了（PM的HR：1.04 [0.70, 1.55]；PM的HR：0.98 [0.81, 1.18]；NOx的HR：1.09 [0.71, 1.66]）。我们的研究结果表明，长期暴露于空气污染可能是老年人患抑郁症的一个风险因素。然而，积极的社会参与可能会降低这种风险。
