Wu Haisheng, Lin Zengxian, Zhang Chunren, Jiang Yuxing, Bai Liming, Zheng Jiazhen, Wei Suosu, Deng Chunxia
School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region of China.
Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China.
Environ Pollut. 2025 Sep 15;381:126603. doi: 10.1016/j.envpol.2025.126603. Epub 2025 Jun 3.
Population aging exacerbates the health threat stemming from inequalities in access to cleaner fuels, yet household air pollution (HAP) from the use of polluting fuels and its association with biological aging and subsequent dementia risk remain underexplored. We aimed to explore potential pathways linking household fuel use to aging and incident dementia, via a cohort study of 8,561 Chinese adults aged 45-80. The household fuel use trajectories during the baseline period (2011-2015) were investigated, and biological age was assessed in 2015 using the Klemera Doubal method along with 11 clinical biomarkers. Dementia cases were documented during the follow-up period (2015-2020). Cox proportional hazards models were employed to estimate the association between household fuel use and dementia risk, while assessing the mediation effects of biological age acceleration. Additionally, potential benefits of leisure engagement were examined. A total of 580 (6.8 %) participants developed incident dementia. Compared to consistent use of cleaner fuels, consistent solid fuel use and switching from cleaner to solid fuels were significantly associated with an acceleration of 0.14 (95 % CI: 0.08, 0.19) and 0.15 (95 % CI: 0.05, 0.24) years of biological age, respectively; consistent use of solid fuels was significantly associated with an evaluated risk of dementia (HR = 1.32, 95 % CI: 1.06, 1.64). Accelerated biological age (as a continuous variable) and being biologically older (as a binary variable) partially mediated 6.7 % and 5.3 % of dementia risk associated with consistent solid fuel use. Moreover, leisure engagement was independently associated with an attenuation of 0.13 (95 % CI: 0.08, 0.19) years of biological age, with little evidence of interaction with household fuel use on either additive or multiplicative scales. Accelerated biological age may be an intermediate factor in dementia pathogenesis linked to household solid fuel combustion. Our findings emphasize that expanding access to cleaner fuels might contribute to relieving both biological aging and dementia burden.
人口老龄化加剧了因获取清洁燃料机会不平等而产生的健康威胁，但使用污染性燃料导致的家庭空气污染（HAP）及其与生物衰老和随后痴呆风险的关联仍未得到充分研究。我们旨在通过对8561名年龄在45 - 80岁的中国成年人进行队列研究，探索家庭燃料使用与衰老及新发痴呆之间的潜在途径。调查了基线期（2011 - 2015年）的家庭燃料使用轨迹，并于2015年使用克莱梅拉·杜巴尔方法以及11种临床生物标志物评估了生物年龄。在随访期（2015 - 2020年）记录了痴呆病例。采用Cox比例风险模型估计家庭燃料使用与痴呆风险之间的关联，同时评估生物年龄加速的中介效应。此外，还研究了休闲活动的潜在益处。共有580名（6.8%）参与者发生了新发痴呆。与持续使用清洁燃料相比，持续使用固体燃料以及从清洁燃料转换为固体燃料分别与生物年龄加速0.14（95%CI：0.08，0.19）年和0.15（95%CI：0.05，0.24）年显著相关；持续使用固体燃料与痴呆评估风险显著相关（HR = 1.32，95%CI：1.06，1.64）。生物年龄加速（作为连续变量）和生物年龄较大（作为二元变量）分别部分介导了与持续使用固体燃料相关的痴呆风险的6.7%和5.3%。此外，休闲活动独立地与生物年龄衰减0.13（95%CI：0.08，0.19）年相关，几乎没有证据表明在相加或相乘尺度上与家庭燃料使用存在相互作用。生物年龄加速可能是与家庭固体燃料燃烧相关的痴呆发病机制中的一个中间因素。我们的研究结果强调，扩大清洁燃料的获取机会可能有助于减轻生物衰老和痴呆负担。
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