Impact of air pollution exposure on the risk of Alzheimer's disease in China: A community-based cohort study

Fan He; Jie Tang; Tao Zhang; Junfen Lin; Fudong Li; Xue Gu; Anthony Chen; Alan Nevill; Ruoling Chen

doi:10.1016/j.envres.2021.112318

Impact of air pollution exposure on the risk of Alzheimer's disease in China: A community-based cohort study

Environ Res. 2022 Apr 1:205:112318. doi: 10.1016/j.envres.2021.112318. Epub 2021 Nov 3.

Authors

Fan He¹, Jie Tang², Tao Zhang¹, Junfen Lin¹, Fudong Li¹, Xue Gu¹, Anthony Chen³, Alan Nevill⁴, Ruoling Chen⁵

Affiliations

¹ Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang, China.
² Faculty of Education, Health and Wellbeing, University of Wolverhampton, UK; Department of Preventive Medicine, School of Public Health, Guangzhou Medical University, Guangzhou, China.
³ Institute of Epidemiology and Health Care, University College London, UK.
⁴ Faculty of Education, Health and Wellbeing, University of Wolverhampton, UK.
⁵ Faculty of Education, Health and Wellbeing, University of Wolverhampton, UK. Electronic address: r.chen@wlv.ac.uk.

PMID: 34742710
DOI: 10.1016/j.envres.2021.112318

Abstract

Alzheimer's disease (AD) is the most common type of dementia. Impact of air pollution (AP) on the risk of AD is unclear. It is unknown which air pollutants are independently associated with AD and whether fish consumption mitigated the association. We carried out a community-based cohort of 6115 participants aged ≥60 years in China to examine the association of PM_2.5, PM₁₀, CO, NO₂, SO₂ and O₃ exposure with AD, and differences in the association between people with low and high consumption of fish. The participants were randomly recruited from six counties in Zhejiang province for health survey to document socio-demographic and disease risk factors in 2014, and were followed up to diagnose AD in 2019. A total of 986 cohort members were diagnosed with AD. Based on the daily mean air pollutants monitored in 2013-2015 in the counties, participants were divided into low, middle and high AP exposure groups for subsequent analysis. The multiple adjusted odds ratio (OR) of AD in participants living with the middle and high levels of PM_2.5 exposure versus the low exposure were 1.50 (95% CI 0.90-2.50) and 3.92 (2.09-7.37). The increased ORs were also with PM₁₀ (1.74, 0.65-4.64; 3.00, 1.22-7.41) and CO (2.86, 1.32-6.20; 1.19, 0.45-3.18), but not with NO₂ (0.63, 0.17-2.27; 0.95, 0.28-3.19), SO₂ (0.44, 0.19-1.001; 1.21, 0.56-2.62), and O₃ (0.38, 0.20-0.74; 0.50, 0.21-1.21). There were no significant interaction effects of AP with fish consumption on AD. However, participants with low consumption of fish appeared to have higher ORs in PM_2.5 exposure (1.80, 1.39-2.33; 5.18, 3.93-6.82) than those high consumption (1.38, 0.78-2.47; 2.89, 1.50-5.59). Our findings of PM_2.5, PM₁₀ and CO exposure significantly increased the risk of AD and the potential mitigating effect of fish consumption on the association provide evidence for developing effective strategies for AD reduction and air pollution control.

Keywords: Air pollutants; Alzheimer's disease; China; Cohort study; Fish intake.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Air Pollutants* / analysis
Air Pollutants* / toxicity
Air Pollution* / adverse effects
Air Pollution* / analysis
Alzheimer Disease* / chemically induced
Alzheimer Disease* / epidemiology
China / epidemiology
Cohort Studies
Environmental Exposure / analysis
Humans
Particulate Matter / analysis
Particulate Matter / toxicity

Substances

Air Pollutants
Particulate Matter