Department of Urology (P-JH), China Medical University and Hospital, Taichung, Taiwan.
Department of Geomatics (C-DW), National Cheng Kung University, Tainan, Taiwan; National Institute of Environmental Health Sciences (C-DW), National Health Research Institutes, Miaoli, Taiwan; Innovation and Development Center of Sustainable Agriculture (C-DW), National Chung Hsing University, Taichung, Taiwan.
Am J Geriatr Psychiatry. 2024 Sep;32(9):1080-1092. doi: 10.1016/j.jagp.2023.12.021. Epub 2023 Dec 29.
Limited research has explored the long-term effect of reduced PM exposure on cognitive function. This study aimed to investigate the effects of time-dependent PM exposure and the interactions of PM and aging on declines in Mini-Mental State Examination (MMSE) scores, in carriers and non-carriers of the APOE-ε4 allele.
Participants aged over 60 were recruited for this cohort study, undergoing MMSE tests twice from the Taiwan Biobank Program from 2008 to 2020. Participants with dementia or baseline MMSE scores <24 were excluded. Annual PM levels were estimated using a hybrid kriging/land use regression model with extreme gradient boosting, treated as a time-dependent variable. Generalized estimating equations were used to assess the impacts of repeated PM on MMSE decline, further stratified by the presence of APOE-ε4 alleles.
After follow-up, 290 participants out of the overall 7,000 community residents in the Biobank dataset demonstrated incidences of MMSE declines (<24), with an average MMSE score decline of 1.11 per year. Participants with ε4/ε4 alleles in the APOE gene had significantly 3.68-fold risks of MMSE decline. High levels of PM across all visits were significantly associated with worsening of scores on the overall MMSE. As annual levels of PM decreased over time, the impact of PM on MMSE decline also slowly diminished.
Long-term PM exposure may be associated with increased risk of MMSE decline, despite improvements in ambient PM levels over time. Validation of these results necessitates a large-scale prospective cohort study with more concise cognitive screening tools.
有限的研究探索了减少 PM 暴露对认知功能的长期影响。本研究旨在调查 PM 暴露的时间依赖性以及 PM 与衰老对载脂蛋白 E-ε4 等位基因携带者和非携带者的简易精神状态检查（MMSE）评分下降的相互作用。
这项队列研究招募了年龄在 60 岁以上的参与者，从 2008 年至 2020 年期间两次接受了 MMSE 测试。排除患有痴呆症或基线 MMSE 评分<24 的参与者。使用混合克里金/土地利用回归模型和极端梯度增强处理，将每年的 PM 水平估计为一个时间依赖性变量。使用广义估计方程来评估重复 PM 对 MMSE 下降的影响，进一步按 APOE-ε4 等位基因的存在进行分层。
在随访后，来自生物库数据集的 7000 名社区居民中有 290 名参与者的 MMSE 下降（<24），平均每年 MMSE 评分下降 1.11。APOE 基因中具有 ε4/ε4 等位基因的参与者发生 MMSE 下降的风险显著增加了 3.68 倍。所有就诊时的高 PM 水平与 MMSE 总分的恶化显著相关。随着时间的推移，PM 年水平的降低，PM 对 MMSE 下降的影响也逐渐减弱。
尽管随着时间的推移环境 PM 水平有所改善，但长期 PM 暴露可能与 MMSE 下降风险增加有关。这些结果需要大规模的前瞻性队列研究和更简洁的认知筛查工具进行验证。
