Yang Weixuan, Yang Yadi, Cao Wenjing, Xie Qianru, Wei Miaomiao, Wang Sufang, Wang Qu-Nan, Tao Fangbiao, Sheng Jie
Department of Hygiene Inspection and Quarantine, School of Public Health, Anhui Medical University, Hefei, Anhui 230032, China.
School of Public Health, Anhui Medical University, Hefei, Anhui 230032, China.
Ecotoxicol Environ Saf. 2025 Sep 15;303:118941. doi: 10.1016/j.ecoenv.2025.118941. Epub 2025 Aug 26.
Cognitive decline among older adults has become an increasingly serious public health issue. Metal exposure may contribute to neurodegenerative processes; however, the combined effects of multiple metals and the potential moderating role of sleep quality on cognitive function remain unclear.
To examine the associations between combined exposure to six metal elements-molybdenum (Mo), vanadium (V), nickel (Ni), strontium (Sr), arsenic (As), and cadmium (Cd)-in whole blood and cognitive function among community-dwelling older adults, and to assess whether these associations are modified by sleep quality.
A total of 1273 older adults participated in the study. The concentrations of metal elements in whole blood were determined using Inductively coupled plasma mass spectrometer (ICP-MS). Cognitive performance was evaluated with the Mini-Mental State Examination (MMSE), while sleep quality was measured using the Pittsburgh Sleep Quality Index (PSQI). Associations between individual metals and cognitive function were examined through multivariable linear regression. The combined impact of metal mixtures was analyzed using Bayesian kernel machine regression (BKMR) and weighted quantile sum (WQS) models. Additionally, interaction effects involving sleep quality were explored.
Elevated levels of Mo, V, Ni, Sr, and Cd were significantly associated with lower MMSE scores. Significant interactions were observed between V and sleep quality and between Sr and sleep quality, suggesting that poor sleep may exacerbate the neurotoxic effects of metal exposure.
Exposure to various metal elements has been linked to reduced cognitive function in older adults, with the magnitude of this association varying by sleep quality. These results highlight the need to consider both environmental metal exposure and sleep health in efforts to prevent cognitive deterioration. To establish causal relationships and clarify underlying pathways, longitudinal research incorporating objective assessments of sleep is warranted.
老年人认知功能下降已成为日益严重的公共卫生问题。金属暴露可能会促进神经退行性变过程；然而，多种金属的联合作用以及睡眠质量对认知功能的潜在调节作用仍不明确。
研究社区居住的老年人全血中钼（Mo）、钒（V）、镍（Ni）、锶（Sr）、砷（As）和镉（Cd）六种金属元素的联合暴露与认知功能之间的关联，并评估这些关联是否会因睡眠质量而改变。
共有1273名老年人参与了本研究。使用电感耦合等离子体质谱仪（ICP-MS）测定全血中金属元素的浓度。用简易精神状态检查表（MMSE）评估认知表现，同时使用匹兹堡睡眠质量指数（PSQI）测量睡眠质量。通过多变量线性回归研究个体金属与认知功能之间的关联。使用贝叶斯核机器回归（BKMR）和加权分位数和（WQS）模型分析金属混合物的联合影响。此外，还探讨了涉及睡眠质量的交互作用。
Mo、V、Ni、Sr和Cd水平升高与较低的MMSE评分显著相关。观察到V与睡眠质量之间以及Sr与睡眠质量之间存在显著的交互作用，表明睡眠质量差可能会加剧金属暴露的神经毒性作用。
接触各种金属元素与老年人认知功能下降有关，这种关联的程度因睡眠质量而异。这些结果凸显了在预防认知衰退的努力中，需要同时考虑环境金属暴露和睡眠健康。为了建立因果关系并阐明潜在途径，有必要进行纳入睡眠客观评估的纵向研究。
