Liu Tingting, Shi Chunxiang, Wei Jing, Xu Ruijun, Li Yingxin, Wang Rui, Lu Wenfeng, Liu Likun, Zhong Chenghui, Zhong Zihua, Zheng Yi, Wang Tingting, Hou Sihan, Lv Ziquan, Huang Suli, Chen Gongbo, Zhou Yun, Sun Hong, Liu Yuewei
Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China.
Meteorological Data Laboratory, National Meteorological Information Center, Beijing, China.
Int J Epidemiol. 2024 Feb 1;53(1). doi: 10.1093/ije/dyad119.
The effect of exposure to extreme temperature events (ETEs) on dementia mortality remains largely unknown. We aimed to quantify the association of ETE exposure with dementia mortality.
We conducted a population-based, case-crossover study among 57 791 dementia deaths in Jiangsu province, China, during 2015-20. Daily mean temperatures were extracted from a validated grid dataset at each subject's residential address, and grid-specific exposures to heat wave and cold spell were assessed with a combination of their intensity and duration. We applied conditional logistic regression models to investigate cumulative and lag effects for ETE exposures.
Exposure to ETE with each of all 24 definitions was associated with an increased odds of dementia mortality, which was higher when exposed to heat wave. Exposure to heat wave (daily mean temperature ≥95th percentile, duration ≥3 days (d); P95_3d) and cold spell (≤5th percentile, duration ≥3 d; P5_3d) was associated with a 75% (95% CI: 61%, 90%) and 30% (19%, 43%) increase in odds of dementia mortality, respectively. Definitions with higher intensity were generally associated with a higher odds of dementia mortality. We estimated that 6.14% of dementia deaths were attributable to exposure to heat wave (P90_2d) and cold spell (P10_2d). No effect modifications were observed by sex or age, except that the association for heat wave was stronger among women.
Exposure to both heat wave and cold spell was associated with an increased odds of dementia mortality. Our findings highlight that reducing individual ETE exposures may be helpful in preventing deaths from dementia, especially among women in summer.
暴露于极端温度事件(ETEs)对痴呆症死亡率的影响在很大程度上仍不清楚。我们旨在量化暴露于ETEs与痴呆症死亡率之间的关联。
我们在中国江苏省2015 - 2020年期间的57791例痴呆症死亡病例中开展了一项基于人群的病例交叉研究。从经过验证的网格数据集中提取每个受试者居住地址的日平均温度,并结合强度和持续时间评估特定网格的热浪和寒潮暴露情况。我们应用条件逻辑回归模型来研究ETEs暴露的累积效应和滞后效应。
所有24种定义的ETEs暴露均与痴呆症死亡率增加的几率相关,热浪暴露时几率更高。暴露于热浪(日平均温度≥第95百分位数,持续时间≥3天(d);P95_3d)和寒潮(≤第5百分位数,持续时间≥3 d;P5_3d)分别与痴呆症死亡几率增加75%(95%置信区间:61%,90%)和30%(19%,43%)相关。强度较高的定义通常与痴呆症死亡率增加的几率更高相关。我们估计6.14%的痴呆症死亡可归因于热浪(P90_2d)和寒潮(P10_2d)暴露。未观察到性别或年龄的效应修正,除了热浪的关联在女性中更强。
暴露于热浪和寒潮均与痴呆症死亡率增加的几率相关。我们的研究结果强调,减少个体ETEs暴露可能有助于预防痴呆症死亡,尤其是在夏季的女性中。