Residential greenness, air pollution and incident neurodegenerative disease: A cohort study in China

Sci Total Environ. 2023 Jun 20:878:163173. doi: 10.1016/j.scitotenv.2023.163173. Epub 2023 Mar 31.

Abstract

Background: Neurodegenerative disease has a great adverse impact on population's death and disability worldwide. However, the association of air pollution and residential greenness with neurodegenerative disease and their potential mechanisms still remain uncertain.

Methods: We used data from a population-based prospective cohort in Ningbo, China. Exposure to PM2.5, PM10 and NO2 were assessed by land-use regression (LUR) models and residential greenness was estimated by Normalized Difference Vegetation Index (NDVI). Our primary outcomes were all neurodegenerative diseases, Parkinson's disease (PD) and Alzheimer's disease (AD). Cox proportional hazards regression models were used to examine the association of air pollution and residential greenness with risk of incident neurodegenerative disease. Furthermore, we also explored the potential mediation relationship and effect modification between greenness and air pollutants.

Results: During the follow-up period, we identified a total of 617 incident neurodegenerative diseases, 301 PD and 182 AD. In single-exposure models, PM2.5 was positively associated with all outcomes (e.g. AD hazard ratio (HR): 1.41, 95 % confidence interval (CI): 1.09-1.84, per interquartile range (IQR) increment), whereas residential greenness showed protective effects (e.g. neurodegenerative disease, HR: 0.82, 95%CI: 0.75-0.90, per IQR increment for NDVI in 1000 m buffer). NO2 was positively associated with risk of neurodegenerative disease and PM10 was associated with neurodegenerative disease and AD. In two-exposure models, after adjustment for PM2.5, the association for greenness generally attenuated towards null. Moreover, we identified the significant modification effect of greenness on PM2.5 on additive and multiplicative scales.

Conclusion: In this prospective study, we found that exposure to higher residential greenness and lower concentrations of particulate matter were associated with lower risk of neurodegenerative disease, PD and AD. Residential greenness could modify the association of PM2.5 with neurodegenerative disease.

Keywords: Air pollution; Neurodegenerative disease; Prospective cohort study; Residential greenness.

MeSH terms

  • Air Pollutants* / analysis
  • Air Pollution* / analysis
  • China / epidemiology
  • Cohort Studies
  • Environmental Exposure / analysis
  • Humans
  • Neurodegenerative Diseases* / chemically induced
  • Neurodegenerative Diseases* / epidemiology
  • Nitrogen Dioxide / analysis
  • Particulate Matter / analysis
  • Prospective Studies

Substances

  • Nitrogen Dioxide
  • Air Pollutants
  • Particulate Matter