Wu Yao, Wen Bo, Gasevic Danijela, Xu Rongbin, Yang Zhengyu, Yu Pei, Liu Yanming, Zhou Guowei, Zhang Yan, Song Jiangning, Liu Hong, Li Shanshan, Guo Yuming
Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia.
Centre for Global Health, Usher Institute, The University of Edinburgh, Teviot Place, Edinburgh EH8 9AG, United Kingdom.
Environ Health (Wash). 2025 Mar 13;3(6):680-689. doi: 10.1021/envhealth.4c00241. eCollection 2025 Jun 20.
Flooding has become more frequent and severe worldwide, leading to an increased burden of psychiatric disorders (e.g., depression and anxiety). Psychiatric disorders are associated with an increased risk of subsequent dementia. However, the associations among floods, psychiatric disorders, and dementia are still unclear. Using a population cohort from the UK Biobank, we aimed to investigate the mediating role of psychiatric disorders on the associations between floods and dementia. In this study, cumulative exposure to floods over an eight-year period preceding the study baseline was assessed for each participant at residential addresses. Multivariable Cox proportional hazards regression was used to study the associations of flooding exposure with psychiatric disorders and dementia. Stratified analyses and mediation analyses were conducted to examine whether psychiatric disorders mediate the relationship between floods and dementia. During a median follow-up of 12.3 years (interquartile range: 11.6-13.0), 0.9% (2,028) of participants developed dementia and 9.5% (21,629) were diagnosed with psychiatric disorders. The flooding exposure was associated with an 8.0% increased risk of incident dementia (Hazard Ratio [HR]: 1.080, 95% CI: 1.023-1.141). The flood-dementia association was observed to be partially mediated by several subtypes of psychiatric disorders (overall proportion of mediation: 75.7%), with psychotic disorder accounting for 49.7% (indirect effect HR: 1.039, 95% confidence interval: 1.015-1.064) of flood-related dementia, followed by stress-related disorder (proportion of mediation: 18.1%), and depression (proportion of mediation: 3.9%). This study provides evidence of an increased risk of dementia associated with exposure to floods, with psychiatric disorders playing a crucial mediating role in the flood-related dementia pathway. These findings suggest that flooding exposure is a critical risk factor for dementia, and targeted interventions addressing postdisaster mental health may be crucial for dementia prevention in affected populations.
洪水在全球范围内变得更加频繁和严重，导致精神障碍（如抑郁症和焦虑症）的负担加重。精神障碍与随后患痴呆症的风险增加有关。然而，洪水、精神障碍和痴呆症之间的关联仍不明确。我们利用英国生物银行的人群队列，旨在研究精神障碍在洪水与痴呆症关联中的中介作用。在本研究中，在研究基线前的八年期间，对每个参与者居住地址的洪水累积暴露情况进行了评估。采用多变量Cox比例风险回归来研究洪水暴露与精神障碍和痴呆症的关联。进行分层分析和中介分析，以检验精神障碍是否介导洪水与痴呆症之间的关系。在中位随访12.3年（四分位间距：11.6 - 13.0）期间，0.9%（2028名）参与者患上痴呆症，9.5%（21629名）被诊断患有精神障碍。洪水暴露与痴呆症发病风险增加8.0%相关（风险比[HR]：1.080，95%置信区间：1.023 - 1.141）。观察到洪水与痴呆症的关联部分由几种精神障碍亚型介导（总体中介比例：75.7%），其中精神分裂症占与洪水相关痴呆症的49.7%（间接效应HR：1.039，95%置信区间：1.015 - 1.064），其次是应激相关障碍（中介比例：18.1%）和抑郁症（中介比例：3.9%）。本研究提供了证据，表明暴露于洪水会增加患痴呆症的风险，精神障碍在与洪水相关的痴呆症途径中起着关键的中介作用。这些发现表明，洪水暴露是痴呆症的一个关键风险因素，针对灾后心理健康的有针对性干预措施对于受影响人群预防痴呆症可能至关重要。
