Zhu Qingyang, Lyu Yuebin, Huang Keyong, Zhou Jinhui, Wang Wenhao, Steenland Kyle, Chang Howard H, Ebelt Stefanie, Shi Xiaoming, Liu Yang
Gangarosa Department of Environmental Health Rollins School of Public Health Emory University Atlanta GA USA.
China CDC Key Laboratory of Environment and Population Health Chinese Center for Disease Control and Prevention National Institute of Environmental Health Beijing China.
Geohealth. 2025 Jan 6;9(1):e2024GH001023. doi: 10.1029/2024GH001023. eCollection 2025 Jan.
Cognitive impairment and dementia have long been recognized as growing public health threats. Studies have found that air pollution is a potential risk factor for dementia, but the literature remains inconclusive. This study aimed to evaluate the association between three major air pollutants (i.e., PM, O, and NO) and cognitive impairment among the Chinese elderly population. Study participants were selected from the Chinese Longitudinal Health Longevity Survey (CLHLS) after 2005. We define cognitive impairment as a Chinese Mini-Mental-State Exam (CMMSE) score <24. The associations of air pollution with cognitive impairment and CMMSE score were evaluated with a logistic regression model and a linear mixed-effect model with random intercepts, respectively. A total of 3,887 participants were enrolled in this study. Of the 2,882 participants who completed at least one follow-up visit, 931 eventually developed cognitive impairment. In single-pollutant models, we found that yearly average PM and NO as well as warm season O, were positively associated with cognitive impairment. NO remained positively associated with cognitive impairment in the multi-pollutant model. The linear mixed-effect models revealed that warm season O and yearly average NO were significantly associated with decreased CMMSE scores. Our research has established a positive association between cognitive impairment and air pollution in China. These findings underscore the imperative for the next iteration of China's Air Pollution Prevention and Control Action Plan to broaden its focus to encompass gaseous air pollutants since mitigating single air pollutant is insufficient to protect the aging population.
认知障碍和痴呆症长期以来一直被认为是日益严重的公共卫生威胁。研究发现空气污染是痴呆症的一个潜在风险因素，但文献尚无定论。本研究旨在评估三种主要空气污染物（即颗粒物、臭氧和二氧化氮）与中国老年人群认知障碍之间的关联。研究参与者选自2005年后的中国老年健康长寿纵向调查（CLHLS）。我们将认知障碍定义为中国简易精神状态检查表（CMMSE）得分<24。分别采用逻辑回归模型和具有随机截距的线性混合效应模型评估空气污染与认知障碍及CMMSE得分之间的关联。本研究共纳入3887名参与者。在完成至少一次随访的2882名参与者中，931人最终出现认知障碍。在单污染物模型中，我们发现年平均颗粒物和二氧化氮以及暖季臭氧与认知障碍呈正相关。在多污染物模型中，二氧化氮与认知障碍仍呈正相关。线性混合效应模型显示，暖季臭氧和年平均二氧化氮与CMMSE得分降低显著相关。我们的研究证实了中国认知障碍与空气污染之间存在正相关。这些发现强调，中国《大气污染防治行动计划》的下一阶段必须扩大关注范围，将气态空气污染物纳入其中，因为仅减轻单一空气污染物不足以保护老年人群。
