Jones Aaron, Ali Muhammad Usman, Mayhew Alexandra, Aryal Komal, Correia Rebecca H, Dash Darly, Manis Derek R, Rehman Atiya, O'Connell Megan E, Taler Vanessa, Costa Andrew P, Hogan David B, Wolfson Christina, Raina Parminder, Griffith Lauren
Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada; McMaster Institute for Research on Aging, Hamilton, Ontario, Canada.
Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada.
Environ Res. 2025 Apr 1;270:121007. doi: 10.1016/j.envres.2025.121007. Epub 2025 Jan 29.
Mitigation of environmental risk factors for neurocognitive disorders could reduce the number of incident cases. We sought to synthesize the literature on environmental risk factors for dementia and mild cognitive impairment.
We conducted an umbrella review and meta-analysis. Multiple databases were systematically searched to identify systematic reviews and meta-analyses of longitudinal studies examining environmental risk factors for dementia or mild cognitive impairment. We used random effects multi-level, meta-analytic models to synthesize risk ratios for each risk factor while accounting for overlap in the studies within reviews. As a secondary objective, we examined risk factors for two common phenotypes of dementia: Alzheimer's disease dementia and vascular dementia.
A total of 19 reviews containing 37 meta-analyses were included umbrella review. We found 9 factors where exposure was associated with higher risks of all-cause dementia: fine particulate matter, particulate matter, nitrogen dioxide, nitrogen oxides, carbon monoxide, shift work, night shift work, chronic noise, and extremely-low frequency magnetic fields. Neighbourhood greenness was associated with a lower risk of all-cause dementia. In a narrative review, we found that exposure to sulfur dioxide, proximity to roadways, ionizing radiation, aluminum, solvents, pesticides, and environmental tobacco smoke were also associated with dementia. We also found that fine particulate matter, extremely-low frequency magnetic fields, sulfur dioxide, chronic noise, and pesticides were related to Alzheimer's disease dementia. Fine particulate matter, particulate matter, and chronic noise were related to vascular dementia. No systematic review reported on mild cognitive impairment.
Achieving stronger air quality targets has the potential to reduce population-level dementia risk. Neighbourhood (i.e., greenness and chronic noise) and occupational (i.e., shift work) characteristics are associated with dementia and are viable public health intervention points. Additional research should examine the relationship between other environmental risk factors and mild cognitive impairment and specific types of dementia.
减轻神经认知障碍的环境风险因素可减少发病病例数。我们试图综合有关痴呆症和轻度认知障碍环境风险因素的文献。
我们进行了一项综合综述和荟萃分析。系统检索多个数据库，以识别对纵向研究进行的系统综述和荟萃分析，这些研究考察了痴呆症或轻度认知障碍的环境风险因素。我们使用随机效应多层次荟萃分析模型，在考虑综述内研究重叠的情况下，综合每个风险因素的风险比。作为次要目标，我们研究了痴呆症两种常见表型的风险因素：阿尔茨海默病痴呆症和血管性痴呆症。
综合综述共纳入19篇包含37项荟萃分析的综述。我们发现9种暴露因素与全因痴呆症风险较高相关：细颗粒物、颗粒物、二氧化氮、氮氧化物、一氧化碳、轮班工作、夜班工作、慢性噪声和极低频磁场。社区绿化与全因痴呆症风险较低相关。在一项叙述性综述中，我们发现接触二氧化硫、靠近道路、电离辐射、铝、溶剂、农药和环境烟草烟雾也与痴呆症有关。我们还发现细颗粒物、极低频磁场、二氧化硫、慢性噪声和农药与阿尔茨海默病痴呆症有关。细颗粒物、颗粒物和慢性噪声与血管性痴呆症有关。没有系统综述报道轻度认知障碍。
实现更强的空气质量目标有可能降低人群层面的痴呆症风险。社区（即绿化和慢性噪声）和职业（即轮班工作）特征与痴呆症有关，是可行的公共卫生干预点。进一步的研究应考察其他环境风险因素与轻度认知障碍以及特定类型痴呆症之间的关系。
