Long-term air pollution exposure and cognitive impairment risk in Chinese middle-aged and older adults

IF 3.8 3区医学 Q2 NEUROSCIENCES

Neurotoxicology Pub Date : 2026-01-01 Epub Date: 2025-12-11 DOI:10.1016/j.neuro.2025.103364

Shengqiang Xie , Shichao Su , Wenxuan Li , Yanteng Li , Fangbin Hao , Gang Cheng , Jianning Zhang

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引用次数: 0

Abstract

This prospective cohort study quantified the longitudinal associations between long-term exposure to multiple air pollutants and cognitive impairment risk among China's middle-aged and older adults. Leveraging data from 10,584 participants in the China Health and Retirement Longitudinal Study (2011–2020), we assessed high-resolution (1-km) annual exposures to particulate matter (PM₁, PM_2.5, PM₁₀), nitrogen dioxide (NO₂), and ozone (O₃) using satellite-based models. Cognitive impairment was defined through education-stratified Chinese Mini-Mental State Examination thresholds. Time-varying Cox proportional hazards models revealed significant dose-response relationships: per 10-μg/m³ increase, PM₁ (HR=1.078, 95 % CI:1.022–1.136), PM_2.5 (HR=1.042, 1.015–1.070), PM₁₀ (HR=1.038, 1.022–1.054), and NO₂ (HR=1.129, 1.061–1.200) elevated cognitive impairment risk, while O₃ showed no association (HR=0.878, 0.743–1.038). Three-year exposure windows intensified effects for NO₂ (HR=1.053) and PM₁ (HR=1.034). Multi-pollutant models demonstrated PM₁₀'s exceptional robustness (e.g., PM₁₀+NO₂ HR=1.055), whereas NO₂ attenuated finer particulate associations. Critical vulnerability emerged among adults with education below junior high (PM₁ HR=1.30), rural residents (PM₁₀ HR=1.21), those aged 60–69 years (peak PM₁ HR=1.28), and uninsured individuals (PM₁ HR=1.22). Strictly linear exposure-response relationships (all Pnonlinear>0.05) indicated no safe thresholds. These findings advocate prioritizing control of PM₁₀ (particles ≤10 μm) alongside mitigation of traffic-related pollutants, while implementing targeted interventions for vulnerable educationally disadvantaged and rural populations to mitigate dementia burden.

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中国中老年人长期空气污染暴露与认知障碍风险

这项前瞻性队列研究量化了中国中老年人长期暴露于多种空气污染物与认知障碍风险之间的纵向关联。利用中国健康与退休纵向研究（2011-2020）的10,584名参与者的数据，我们使用基于卫星的模型评估了高分辨率（1公里）每年暴露于颗粒物（PM1、PM2.5、PM10）、二氧化氮（NO2）和臭氧（O3）的情况。认知障碍的定义是通过教育分层的中国简易精神状态考试阈值。时变Cox比例风险模型显示出显著的剂量-反应关系：每增加10-μg/m³，PM1 （HR=1.078, 95% CI:1.022-1.136）、PM2.5 （HR=1.042, 1.015-1.070）、PM10 （HR=1.038, 1.022-1.054）和NO2 （HR=1.129, 1.061-1.200）会增加认知功能障碍的风险，而O3没有相关性（HR=0.878, 0.743-1.038）。3年暴露窗强化了NO2 （HR=1.053）和PM1 （HR=1.034）的效应。多污染物模型表明，PM10具有特殊的稳健性（例如，PM10+NO2的HR=1.055），而NO2则减弱了细颗粒物的关联。受教育程度在初中以下的成年人（PM1 HR=1.30）、农村居民（PM10 HR=1.21）、60-69岁人群（峰值PM1 HR=1.28）和无保险个体（PM1 HR=1.22）中出现了严重脆弱性。严格的线性暴露-反应关系（p < 0.05）表明没有安全阈值。这些研究结果主张优先控制PM10（颗粒≤10 μm），同时减少交通相关污染物，同时对弱势教育群体和农村人口实施有针对性的干预措施，以减轻痴呆症负担。

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来源期刊

Neurotoxicology 医学-毒理学

CiteScore

6.80

自引率

5.90%

发文量

161

审稿时长

70 days

期刊介绍： NeuroToxicology specializes in publishing the best peer-reviewed original research papers dealing with the effects of toxic substances on the nervous system of humans and experimental animals of all ages. The Journal emphasizes papers dealing with the neurotoxic effects of environmentally significant chemical hazards, manufactured drugs and naturally occurring compounds.