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The association between ambient air pollution and cognitive impairment in community‐dwelling older adults: Six‐year cohort study TIGER
Author(s) -
Tsao ShuPing,
Chen JenHau,
Yu HwaLung,
Chiou JengMin,
Chen TaFu,
Lai LiangChuan,
Chen YenChing
Publication year - 2020
Publication title -
alzheimer's and dementia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 6.713
H-Index - 118
eISSN - 1552-5279
pISSN - 1552-5260
DOI - 10.1002/alz.041433
Subject(s) - cognition , environmental health , montreal cognitive assessment , psychology , medicine , cognitive impairment , psychiatry
Background Ambient air pollution exposure has been related to cognitive impairment. Several studies have started to explore the association of particulate matter and nitrogen oxides with cognitive impairment, studies evaluated the effect of long‐term exposure to ozone(O 3 ), carbon monoxide (CO) and sulfur dioxide (SO 2 ) are sparse. Method This study is part of the ongoing Taiwan Initiative for Geriatric Epidemiological Research (TIGER). A total of 605 participants (Age 65+) were recruited from a teaching hospital in northern Taiwan in 2011 and followed up biennially. After exclusion and loss to follow‐up over 6 years, a total of 292 participants were included for analyses. Global cognition was assessed by Montreal Cognitive Assessment‐Taiwanese version; domain‐specific cognition (logical memory, attention, verbal fluency, and executive function) were assessed by a battery of neuropsychological tests. The data of three air pollutants (O 3 , CO and SO 2 ) were obtained from 27 monitor stations of Taiwan Environmental Protection Administration (EPA) between 1993 and 2010. Air pollutants were tertiled into low, moderate, and high levels. Spatial‐Time Analysis Rendering with Bayesian Maximum Entropy was utilized to establish the spatial‐temporal model. Logistic regression model was utilized to assess the association of exposure to air pollutants and global or domain‐specific cognition over 6 years adjusting for important covariates. Result The 17‐year average level was 39.40ppb for 8‐hour O 3 , 1.47ppm for 8‐hour CO, and 4.70ppb for daily SO 2 , which were below the EPA standards. Exposure to high‐level O 3 (>40.83 ppb) was associated with poor executive function [adjusted odds ratio (aOR)=2.14, 95% confidence interval (CI)=1.05‐4.35] compared with low‐level O 3 . No significant association was observed between O 3 or CO and global cognition or other cognitive domains. SO 2 were not associated with cognitive function over 6 years. Conclusion Long‐term (17 years) exposure to O 3 , CO and SO 2 lower than the EPA standards showed significant association with cognitive domains in a 6‐year cohort of community‐dwelling older adults. Future revisions of air standards may need to consider epidemiologic studies exploring the relation between exposure to these air pollutants and cognitive impairment.