Gardener Hannah, Levin Bonnie, Kannan Kurunthachalam, Rundek Tatjana
Department of Neurology, University of Miami Miller School of Medicine, Miami, Florida, USA.
Wadsworth Center, New York State Department of Health, Empire State Plaza, Albany, New York, USA.
Alzheimers Dement. 2025 May;21(5):e70226. doi: 10.1002/alz.70226.
Per- and polyfluoroalkyl substances (PFAS) are ubiquitous persistent organic pollutants. The neurotoxic and cardiometabolic effects of PFAS are well documented, leading to the hypothesis that exposure increases dementia risk. However, empirical data on PFAS in relation to cognitive impairment and dementia are weak, limited, and inconsistent. This report reviews the literature on PFAS and cognitive impairment and provides a rationale and overview of the PFAS VascCog Longitudinal Study, a new study using the population-based Northern Manhattan Study cohort, to prospectively examine serum concentrations of 13 PFAS in relation to lipids, carotid atherosclerosis, cognitive impairment, and dementia. We hypothesize that PFAS deleteriously impact cognition through a pathway involving hyperlipidemia and atherosclerosis. Rigorous examination of PFAS exposure in relation to dementia is needed to inform public health policies on PFAS-containing products, support regulations to reduce community exposure, and provide new avenues to protect cognitive health and impact dementia at the individual and community levels. HIGHLIGHTS: PFAS exposure increases cardiometabolic risk factors and neurotoxicity. Data on PFAS in relation to cognitive health is limited, weak, and controversial. We hypothesize that PFAS exposure increases dementia risk. We hypothesize a mechanistic pathway involving hyperlipidemia and atherosclerosis. Rigorous study of PFAS exposure and dementia risk can inform public health policy.
全氟和多氟烷基物质（PFAS）是普遍存在的持久性有机污染物。PFAS的神经毒性和心脏代谢影响已有充分记录，由此产生了一种假设，即接触PFAS会增加患痴呆症的风险。然而，关于PFAS与认知障碍和痴呆症关系的实证数据薄弱、有限且不一致。本报告回顾了关于PFAS与认知障碍的文献，并提供了PFAS血管认知纵向研究的基本原理和概述，这是一项利用基于人群的北曼哈顿研究队列进行的新研究，旨在前瞻性地研究13种PFAS的血清浓度与血脂、颈动脉粥样硬化、认知障碍和痴呆症的关系。我们假设PFAS通过涉及高脂血症和动脉粥样硬化的途径对认知产生有害影响。需要对PFAS暴露与痴呆症的关系进行严格审查，以为含PFAS产品的公共卫生政策提供信息，支持减少社区暴露的法规，并提供新途径来保护个体和社区层面的认知健康并影响痴呆症。要点：PFAS暴露会增加心脏代谢风险因素和神经毒性。关于PFAS与认知健康关系的数据有限、薄弱且存在争议。我们假设PFAS暴露会增加患痴呆症的风险。我们假设了一条涉及高脂血症和动脉粥样硬化的机制途径。对PFAS暴露和痴呆症风险的严格研究可为公共卫生政策提供信息。
