Zhang Dandan, Zhou Yuefei, Liu Yang, Wu Shaoze
Department of Neurology, Tangshan Gongren Hospital, Tangshan 063000, Hebei Province, China.
Department of Orthopedics, The First Hospital of China Medical University, Shenyang 110000, Liaoning, China.
J Neurol Sci. 2024 Dec 15;467:123318. doi: 10.1016/j.jns.2024.123318. Epub 2024 Nov 23.
Most studies have focused on the effects of individual environmental risk factors on cognitive function; however, none have evaluated the association between residential environmental quality and cognitive impairment.
Data from the China Health and Retirement Longitudinal Study (CHARLS) were used to include 12,801 participants in a cross-sectional study and 8781 participants in a cohort study. Residential environmental quality was assessed using indicators such as particulate matter, types of household fuel, water sources, indoor temperature, and building types. Based on the residential environment quality score, participants were classified into three groups: comfortable (0-1 points), moderate (2-3 points), and poor (4-6 points). To evaluate the association between residential environmental quality and cognitive scores in the cross-sectional study, as well as the development of mild cognitive impairment (MCI) in the cohort study, ordinary least squares (OLS) regression and logistic regression models were applied.
In the cross-sectional study, cognitive scores and performance across four dimensions-orientation, computation, memory, and drawing-showed a significant decline from the comfortable to the poor residential environment groups. In the fully adjusted OLS regression model, scores across these dimensions were significantly reduced in the moderate and poor groups compared to the comfortable group (P for trend <0.001). The incidence of MCI from 2011 to 2018 was 10.1 %, 16.8 %, and 18.8 % for participants living in comfortable, moderate, and poor environments, respectively, with statistically significant differences among groups (all P < 0.07). Logistic regression analysis revealed an odds ratio of 1.25 (95 % CI: 1.02-1.53) for the moderate group and 1.31 (95 % CI: 1.04-1.65) for the poor group, compared to the comfortable group (P for trend<0.05).
An inferior residential environment is associated with lower cognitive scores and a higher rik of developing MCI in middle-aged and older Chinese adults.
大多数研究都集中在个体环境风险因素对认知功能的影响上;然而,尚无研究评估居住环境质量与认知障碍之间的关联。
利用中国健康与养老追踪调查(CHARLS)的数据,纳入12801名参与者进行横断面研究,8781名参与者进行队列研究。使用颗粒物、家用燃料类型、水源、室内温度和建筑类型等指标评估居住环境质量。根据居住环境质量得分,将参与者分为三组:舒适(0 - 1分)、中等(2 - 3分)和较差(4 - 6分)。为了评估横断面研究中居住环境质量与认知得分之间的关联,以及队列研究中轻度认知障碍(MCI)的发生情况,应用了普通最小二乘法(OLS)回归和逻辑回归模型。
在横断面研究中,从舒适居住环境组到较差居住环境组,认知得分以及在定向、计算、记忆和绘图四个维度上的表现均显著下降。在完全调整的OLS回归模型中,与舒适组相比,中等和较差组在这些维度上的得分显著降低(趋势P<0.001)。2011年至2018年,居住在舒适、中等和较差环境中的参与者发生MCI的发生率分别为10.1%、16.8%和18.8%,组间差异具有统计学意义(所有P<0.07)。逻辑回归分析显示,与舒适组相比,中等组的比值比为1.25(95%CI:1.02 - 1.53),较差组为1.31(95%CI:1.04 - 1.65)(趋势P<0.05)。
较差的居住环境与中国中老年成年人较低的认知得分以及发生MCI的较高风险相关。