A national cohort study (2000–2018) of long-term air pollution exposure and incident dementia in older adults in the United States

Liuhua Shi (), Kyle Steenland, Haomin Li, Pengfei Liu, Yuhan Zhang, Robert H. Lyles, Weeberb Requia, Sindana D. Ilango, Howard H. Chang, Thomas Wingo, Rodney J. Weber and Joel Schwartz
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Liuhua Shi: Emory University
Kyle Steenland: Emory University
Haomin Li: Emory University
Yuhan Zhang: Emory University
Robert H. Lyles: Emory University
Sindana D. Ilango: University of Washington
Howard H. Chang: Emory University
Thomas Wingo: Emory University
Rodney J. Weber: Georgia Institute of Technology
Joel Schwartz: Harvard T.H. Chan School of Public Health

Nature Communications, 2021, vol. 12, issue 1, 1-9

Abstract: Abstract Air pollution may increase risk of Alzheimer’s disease and related dementias (ADRD) in the U.S., but the extent of this relationship is unclear. Here, we constructed two national U.S. population-based cohorts of those aged ≥65 from the Medicare Chronic Conditions Warehouse (2000–2018), combined with high-resolution air pollution datasets, to investigate the association of long-term exposure to ambient fine particulate matter (PM2.5), nitrogen dioxide (NO2), and ozone (O3) with dementia and AD incidence, respectively. We identified ~2.0 million incident dementia cases (N = 12,233,371; dementia cohort) and ~0.8 million incident AD cases (N = 12,456,447; AD cohort). Per interquartile range (IQR) increase in the 5-year average PM2.5 (3.2 µg/m3), NO2 (11.6 ppb), and warm-season O3 (5.3 ppb) over the past 5 years prior to diagnosis, the hazard ratios (HRs) were 1.060 (95% confidence interval [CI]: 1.054, 1.066), 1.019 (95% CI: 1.012, 1.026), and 0.990 (95% CI: 0.987, 0.993) for incident dementias, and 1.078 (95% CI: 1.070, 1.086), 1.031 (95% CI: 1.023, 1.039), and 0.982 (95%CI: 0.977, 0.986) for incident AD, respectively, for the three pollutants. For both outcomes, concentration-response relationships for PM2.5 and NO2 were approximately linear. Our study suggests that exposures to PM2.5 and NO2 are associated with incidence of dementia and AD.

Date: 2021
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DOI: 10.1038/s41467-021-27049-2

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