Guo Cui, Wu Dongze, Yang Jun, Lu Xingcheng, Chen Xiang Yan, Ma Jun, Lin Changqing, Lau Alexis K H, Jin Yingzhao, Li Ruiyun, He Shenjing
Department of Urban Planning and Design, the University of Hong Kong, 8/F, Knowles Building, Pokfulam Road, Hong Kong SAR, China.
Department of Rheumatology and Immunology, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China.
BMC Public Health. 2025 Jan 29;25(1):371. doi: 10.1186/s12889-025-21600-2.
Emerging research found air pollution may be associated with incident Alzheimer's disease (AD) and other dementias. However, few studies have examined these associations at the global scale. This study aimed to assess the dynamic associations between ambient air pollution and the burden of AD and other dementias worldwide.
This study synthesised 149 countries/territories between 1990 and 2019. These data include age-standardised mortality rate (ASMR) and disability-adjusted life-years (DALYs) of AD and other dementias, ambient air pollution (fine particulate matter [PM], NO and O concentration) and a series of covariates were from various source. Average annual percentage changes (AAPCs) were calculated to investigate the temporal variations. Linear mixed models were adopted to assess the associations with single- and multi-pollutant separately. The associations between air pollution changes and the AD and other dementias were also examined using linear regression models. Stratified analyses by Global North-South divide and human development index were performed to explore the potential inequity in air pollution impacts.
During 1990-2019, the global ASMR, DALYs and O increased by 0.11%, 0.09%, and 0.17% per year, respectively. In contrast, PM and NO decreased by 0.33% and 0.14% per year, respectively. Each 10 µg/m increase in PM was associated with a 0.118 (95% confidence interval [CI]: 0.060 - 0.175) higher ASMR and 0.966 (95%CI: 0.321 - 1.611) higher DALYs after adjusting for all the covariates. The ASMR increased by 0.112 and the DALYs increased by 1.068 for each 10 µg/m increase in O. The NO-dementia associations were relatively weak. Stronger O-dementia associations were found in the Global South than those in the Global North.
The burden of dementia is expected to increase globally, given the continuously expansion of the ageing population. Air pollution was found to be significantly associated with a higher burden of AD and dementia. As a persistent challenge in urban cities, air pollution demands strict regulatory control.
新兴研究发现空气污染可能与阿尔茨海默病（AD）及其他痴呆症的发病有关。然而，很少有研究在全球范围内考察这些关联。本研究旨在评估全球环境空气污染与AD及其他痴呆症负担之间的动态关联。
本研究综合了1990年至2019年期间的149个国家/地区的数据。这些数据包括AD及其他痴呆症的年龄标准化死亡率（ASMR）和伤残调整生命年（DALYs）、环境空气污染（细颗粒物[PM]、NO和O浓度），以及一系列来自不同来源的协变量。计算年均百分比变化（AAPCs）以研究时间变化趋势。采用线性混合模型分别评估与单一污染物和多种污染物的关联。还使用线性回归模型检验空气污染变化与AD及其他痴呆症之间的关联。按全球南北划分和人类发展指数进行分层分析，以探讨空气污染影响方面的潜在不平等。
在1990 - 2019年期间，全球ASMR、DALYs和O浓度分别以每年0.11%、0.09%和0.17%的速度增长。相比之下，PM和NO浓度分别以每年0.33%和0.14%的速度下降。在调整所有协变量后，PM每增加10 μg/m³，ASMR升高0.118（95%置信区间[CI]：0.060 - 0.175），DALYs升高0.966（95%CI：0.321 - 1.611）。O每增加10 μg/m³，ASMR升高0.112，DALYs升高1.068。NO与痴呆症的关联相对较弱。在全球南方发现的O与痴呆症的关联比全球北方更强。
鉴于老年人口的持续增长，预计全球痴呆症负担将会增加。研究发现空气污染与更高的AD和痴呆症负担显著相关。作为城市地区持续存在的挑战，空气污染需要严格的监管控制。
