Short-term associations between warm-season ambient temperature and emergency department visits for Alzheimer's disease and related dementia in five US states

Yuzi Zhang; Stefanie T Ebelt; Liuhua Shi; Noah C Scovronick; Rohan R D'Souza; Kyle Steenland; Howard H Chang

doi:10.1016/j.envres.2022.115176

Short-term associations between warm-season ambient temperature and emergency department visits for Alzheimer's disease and related dementia in five US states

Environ Res. 2023 Mar 1:220:115176. doi: 10.1016/j.envres.2022.115176. Epub 2022 Dec 28.

Authors

Yuzi Zhang¹, Stefanie T Ebelt², Liuhua Shi², Noah C Scovronick², Rohan R D'Souza³, Kyle Steenland², Howard H Chang³

Affiliations

¹ Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, GA, USA. Electronic address: yuzi.zhang@emory.edu.
² Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, 30322, USA.
³ Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, GA, USA.

Abstract

Background: Ambient temperatures are projected to increase in the future due to climate change. Alzheimer's disease (AD) and Alzheimer's disease-related dementia (ADRD) affect millions of individuals and represent substantial health burdens in the US. High temperature may be a risk factor for AD/ADRD outcomes with several recent studies reporting associations between temperature and AD mortality. However, the link between heat and AD morbidity is poorly understood.

Methods: We examined short-term associations between warm-season daily ambient temperature and AD/ADRD emergency department (ED) visits for individuals aged 45 years or above during the warm season (May to October) for up to 14 years (2005-2018) in five US states: California, Missouri, North Carolina, New Jersey, and New York. Daily ZIP code-level maximum, average and minimum temperature exposures were derived from 1 km gridded Daymet products. Associations are assessed using a time-stratified case-crossover design using conditional logistic regression.

Results: We found consistent positive short-term effects of ambient temperature among 3.4 million AD/ADRD ED visits across five states. An increase of the 3-day cumulative temperature exposure of daily average temperature from the 50th to the 95th percentile was associated with a pooled odds ratio of 1.042 (95% CI: 1.034, 1.051) for AD/ADRD ED visits. We observed evidence of the association being stronger for patients 65-74 years of age and for ED visits that led to hospital admissions. Temperature associations were also stronger among AD/ADRD ED visits compared to ED visits for other reasons, particularly among patients aged 65-74 years.

Conclusion: People with AD/ADRD may represent a vulnerable population affected by short-term exposure to high temperature. Our results support the development of targeted strategies to reduce heat-related AD/ADRD morbidity in the context of global warming.

Keywords: Alzheimer's disease; Alzheimer's disease-related dementia; Emergency department visits; Heat; Temperature.

Publication types

Research Support, N.I.H., Extramural

MeSH terms

Aged
Alzheimer Disease* / epidemiology
Emergency Service, Hospital
Hot Temperature
Humans
Seasons
Temperature

Abstract

Publication types

MeSH terms

Grants and funding