Preventive medicine最新文献

{"title":"Barriers to healthcare utilization among adults engaging in heavy drinking: Results from the all of us research program","authors":"Melissa Pearman Fenton ,&nbsp;Kaitlyn Swacil ,&nbsp;Catherine Woodstock Striley ,&nbsp;Linda Bauer Cottler ,&nbsp;Milton Eder ,&nbsp;Irvin PeDro Cohen ,&nbsp;Catalina Lopez-Quintero","doi":"10.1016/j.ypmed.2025.108356","DOIUrl":"10.1016/j.ypmed.2025.108356","url":null,"abstract":"<div><h3>Objective</h3><div>We examined sociodemographic factors associated with barriers to healthcare utilization (HCU) among a national sample of adults engaging in heavy drinking behavior (HDB).</div></div><div><h3>Methods</h3><div>A sample of 3257 participants from the <em>All of Us</em> program (2018–2022 Controlled Tier Dataset-v7) who reported HDB (i.e., six or more drinks on one occasion, at least weekly) was selected to examine the associations between socio-demographic factors and barriers to HCU (i.e., structural, competing social roles, attitudinal, and financial barriers). Multiple logistic regressions estimated adjusted Odds Ratios (aOR) for the associations of interest.</div></div><div><h3>Results</h3><div>Financial barriers (23.64 %) were the most common of the four barriers, followed by attitudinal (18.27 %), competing social roles (15.66 %), and structural (13.36 %) barriers. Females were more likely than males to report competing social roles (or = 1.56, 95 %CI = 1.28,1.90), attitudinal (aOR = 1.41, 95 %CI = 1.17,1.70), and financial (or = 1.41, 95 %CI = 1.19,1.68) barriers. Lower income (aOR = 6.71, 95 %CI = 4.77,9.56), and Non-Hispanic Black/African Americans (aOR = 1.39, 95 %CI = 1.04,1.85) showed higher odds of reporting structural barriers.</div></div><div><h3>Conclusions</h3><div>As many as one in four individuals who engage in HDB experience at least one HCU barrier, particularly women, those with low-incomes, and Non-Hispanic Black/African Americans. The findings highlight the need for implementation of evidence-based strategies among the identified populations to reduce HCU barriers, and ultimately, alcohol-related disparities.</div></div>","PeriodicalId":20339,"journal":{"name":"Preventive medicine","volume":"198 ","pages":"Article 108356"},"PeriodicalIF":4.3,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144604233","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Travel distance to the general practitioner and women's participation in cervical cancer screening in Denmark – A population-based cohort study, 2017","authors":"Rikke Bjerring Plenborg,&nbsp;Annette Kjær Ersbøll,&nbsp;Kristine Bihrmann","doi":"10.1016/j.ypmed.2025.108355","DOIUrl":"10.1016/j.ypmed.2025.108355","url":null,"abstract":"<div><h3>Objectives</h3><div>Previous studies found disparities in utilization of cervical cancer screening programs. Geographical distance to the screening location may affect women's participation. The aim of this study was to investigate the association between travel distance from residence to general practitioner, and invited women's participation in a national screening program for cervical cancer.</div></div><div><h3>Methods</h3><div>Data were obtained from Danish national registers including all women invited to the screening program in 2017 (<em>n</em> = 341,708). Travel distance from residence to the general practitioner was calculated based on geocoded addresses and the road network. Multilevel logistic regression was used to calculate odds ratios (ORs) of participation with 95 % confidence intervals (CI).</div></div><div><h3>Results</h3><div>Based on 271,959 women with complete information, screening participation decreased from 67.7 % among women with a travel distance of 1.0–4.9 km to 61.1 % among women with ≥15.0 km. Adjusted for ethnicity, education, and age, women with ≥15.0 km to the general practitioner had 22 % lower odds of participation compared to those living 1.0–4.9 km away (OR = 0.78, 95 %CI [0.75;0.81]). Women with &lt;1.0 km to the general practitioner had 10 % lower odds of participation (OR = 0.90, 95 %CI [0.88;0.93]). Sensitivity analysis indicated an exposure-response relationship when distance was ≥5 km, implying lower odds of participation with increasing distance above 5 km.</div></div><div><h3>Conclusion</h3><div>Travel distance to the general practitioner was associated with participation in screening. Future initiatives should promote equal access to preventive health services focusing on women having a long travel distance to their general practitioner, as well as those living very close to their general practitioner.</div></div>","PeriodicalId":20339,"journal":{"name":"Preventive medicine","volume":"198 ","pages":"Article 108355"},"PeriodicalIF":4.3,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144596779","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"E-cigarette use frequency mediates effects in three randomized controlled trials of reduced nicotine cigarettes with tobacco vs preferred flavor E-cigarettes in high-risk populations in the U.S.","authors":"Elias M Klemperer, Michael J DeSarno, Jennifer W Tidey, Diann E Gaalema, Katya A Nolder, Marc Jerome P Feinstein, Rhiannon C Wiley, Stephen T Higgins","doi":"10.1016/j.ypmed.2025.108353","DOIUrl":"10.1016/j.ypmed.2025.108353","url":null,"abstract":"<p><strong>Objectives: </strong>The U.S. Food and Drug Administration is authorized to implement a nicotine-reducing standard to decrease smoking. Three recent trials found switching to very low nicotine content (VLNC) cigarettes produced the greatest reduction in cigarettes/day and 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL, a tobacco-specific carcinogen) among adults from high-risk populations when participants also received preferred- vs tobacco-flavored e-cigarettes. This pooled secondary analysis investigates e-cigarette use frequency as a mechanism driving these effects.</p><p><strong>Methods: </strong>Participants (U.S. adults with affective disorders, adults with opioid use disorder, and reproductive-age females with ≤high-school education) were randomized to 16 weeks of VLNC cigarettes with preferred-flavored e-cigarettes selected from eight options (VLNC+PF; n = 84) or VLNC cigarettes with tobacco-flavored e-cigarettes (VLNC+TF; n = 74) from October 2020-November 2023. General linear models explored whether e-cigarette use frequency (days/week) between Weeks 1-15 mediated effects on Week-16 cigarettes/day and NNAL.</p><p><strong>Results: </strong>Participants were 40.4 (mean) years old (SD = 11.5), 69.0 % female, 81.0 % white, and smoked 17.3 (mean) cigarettes/day (SD = 9.0) at baseline. The VLNC+PF condition reported more e-cigarette use days/week (LSmean[SEM]): 4.3[±0.4]) than the VLNC+TF condition (LSMean[SEM]: 3.4[±0.5]; F[1151] = 3.9, p < .05) across weeks 1-15. More e-cigarette use days/week predicted greater reductions in mean cigarettes/day (β[SE]: -0.32[±0.05)]; F[1106] = 50.5, p < .01) and NNAL (β[SE]: -0.14[±0.04]; F[1,92] = 12.2, p < .01) at Week-16. E-cigarette use frequency fully mediated the effects of condition on cigarettes/day and partially mediated effects on NNAL.</p><p><strong>Conclusions: </strong>Greater frequency of e-cigarette use was a mechanism by which preferred-flavor e-cigarettes led to reductions in smoking and tobacco-toxicant exposure, demonstrating the potential for appealing e-cigarettes to reduce harm among high-risk populations who smoke.</p>","PeriodicalId":20339,"journal":{"name":"Preventive medicine","volume":" ","pages":"108353"},"PeriodicalIF":4.3,"publicationDate":"2025-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12291598/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144592024","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pilot randomized clinical trial examining use of very low nicotine content cigarettes during pregnancy in the United States.","authors":"Sarah H Heil, Loren S Kock, Roxanne F Harfmann, Kristin B Ashford, Janine Barnett, Andrea McCubbin, Michael J DeSarno, Stephen T Higgins","doi":"10.1016/j.ypmed.2025.108351","DOIUrl":"10.1016/j.ypmed.2025.108351","url":null,"abstract":"<p><strong>Objective: </strong>Randomized controlled trials have shown that reducing the nicotine content of cigarettes decreases the number of cigarettes smoked per day (CPD) without engendering compensatory smoking. The present study examined whether those effects extend to smoking during pregnancy.</p><p><strong>Methods: </strong>Pregnant participants (≤25 weeks gestational age) in the U.S. with less than an Associate's degree and not planning to quit smoking were randomly assigned to smoke their usual brand (UB) cigarettes or very low nicotine content (VLNC) cigarettes (0.4 mg nicotine/g of tobacco) for 12 weeks. The primary outcome was total CPD at 12 weeks.</p><p><strong>Results: </strong>Baseline characteristics did not differ between conditions (14 UB, 16 VLNC), but smoking-related variables were indicative of heavy smoking and moderate-high nicotine dependence. Mean (±SE) total CPD at 12 weeks among completers (11 UB, 12 VLNC) did not differ between conditions (18.4 ± 2.3 and 16.3 ± 2.6, respectively), nor did it vary over time. VLNC cigarette use did not lead to compensatory smoking, greater withdrawal or craving, or any severe or serious adverse events, and birth outcomes were within normal ranges on average.</p><p><strong>Conclusions: </strong>Results suggest this sample of pregnant participants did not realize the same benefits of VLNC cigarettes that other not-pregnant samples have, although there was also no evidence of harm in the form of compensatory smoking or other adverse events. The sample's smoking characteristics suggest they were especially resistant to changing their smoking and it remains possible that those with more representative smoking patterns during pregnancy will respond to VLNC cigarettes as other populations have.</p><p><strong>Clinicaltrials: </strong>govID:NCT04033237.</p>","PeriodicalId":20339,"journal":{"name":"Preventive medicine","volume":" ","pages":"108351"},"PeriodicalIF":4.3,"publicationDate":"2025-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144584650","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relationship between an adult-use Cannabis law and Cannabis use by type in a cohort of New Jersey young adults","authors":"Allison M. Glasser ,&nbsp;Andrea C. Villanti ,&nbsp;Daniel A. Gundersen ,&nbsp;Kevin R.J. Schroth ,&nbsp;Mary Hrywna","doi":"10.1016/j.ypmed.2025.108354","DOIUrl":"10.1016/j.ypmed.2025.108354","url":null,"abstract":"<div><h3>Objectives</h3><div>Limited research has evaluated the impact of cannabis policies on young adult cannabis use, after full implementation (retail outlets opened), nor on cannabis product type. This study examined the relationship between adult-use cannabis retail sales in New Jersey (United States) and young adult cannabis use by type.</div></div><div><h3>Methods</h3><div>Data on New Jersey young adults (18–23 years) were from the Policy Communication and Evaluation (PACE) New Jersey Study. Generalized estimating equations models estimated differences in prevalence of ever and past 30-day use of cannabis and sub-types before (Waves 1–3 [March–November 2021], <em>n</em> = 1439) and after (Wave 4 [June–July 2022], <em>n</em> = 1127) adult-use retail sales began.</div></div><div><h3>Results</h3><div>Ever cannabis use among New Jersey young adults was higher in the post-retail sales period than pre-sales (58.1 % vs. 48.9 %, <em>p</em> &lt; 0.01). The odds of ever cannabis use were 42 % higher (95 % CI = 32 %–54 %) in the post-retail period. Ever use of dried herb (post vs. pre: 44.4 % vs. 38.5 %, <em>p</em> &lt; 0.01), drinks (7.0 % vs. 4.8 %, p &lt; 0.01), edibles (45.9 % vs. 35.6 %, p &lt; 0.01), and topicals (6.4 % vs. 4.6 %, <em>p</em> &lt; 0.05), and past 30-day edible use (11.8 % vs. 9.0 %, <em>p</em> = 0.01) were higher post-retail; use of other product types did not differ.</div></div><div><h3>Conclusions</h3><div>Cannabis use overall and among certain subtypes (e.g., edibles) increased among New Jersey young adults in the three months after adult-use cannabis retail sales began, demonstrating that increased access to legal cannabis for sale may encourage use. Continued monitoring is needed over longer follow-up periods in New Jersey and other states legalizing cannabis.</div></div>","PeriodicalId":20339,"journal":{"name":"Preventive medicine","volume":"198 ","pages":"Article 108354"},"PeriodicalIF":4.3,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144576038","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term intensity and volume of biking, swimming, and tennis: Associations with mortality risk in US older men","authors":"Albert Ko ,&nbsp;Yiwen Zhang ,&nbsp;Edward Giovannucci","doi":"10.1016/j.ypmed.2025.108350","DOIUrl":"10.1016/j.ypmed.2025.108350","url":null,"abstract":"<div><h3>Objectives</h3><div>To study the association of intensity and volume of individual physical activities with mortality risk among US older males.</div></div><div><h3>Methods</h3><div>We prospectively followed 10,218 men in Health Professionals Follow-up Study (2012−2022) who were free of diabetes, cardiovascular disease or cancer at baseline. Intensity of biking, swimming and tennis was assessed using biennial questionnaires and categorized into two intensity groups: low intensity, medium/high intensity. Cumulative averaged physical activity volume was classified based on tertiles: low volume, medium/high volume. We examined joint associations of physical activity intensity and volume with mortality using multivariable-adjusted Cox proportional hazards regression models to estimate hazard ratios (HRs) and 95 % CI.</div></div><div><h3>Results</h3><div>During 89,168 person-years of follow-up (mean [SD] age at baseline, 73.8 [6.9] years [range, 65–102 years]), 2303 deaths were documented. Medium/high intensity performed at medium/high volume was suggestively associated with reduced mortality risk for biking (HR: 0.83 [95 % CI: 0.73, 0.94]), swimming (HR: 0.81 [95 % CI: 0.63, 1.03]), and tennis (HR: 0.83 [95 % CI: 0.65, 1.05]), compared with non-participation in these activities, respectively. Further, specific levels of intensity and volume in biking (medium/high intensity and low volume: HR 0.89 [95 % CI: 0.76, 1.05]), swimming (low intensity and low volume: HR 0.77 [95 % CI: 0.57, 1.06]), and tennis (low intensity and medium/high volume: HR 0.49 [95 % CI: 0.23, 1.01]) were suggestively associated with reduced mortality risk compared with non-participants.</div></div><div><h3>Conclusions</h3><div>Both physical activity intensity and volume inform on mortality risk for biking, tennis and swimming, highlighting the necessity of examining both factors in future research.</div></div>","PeriodicalId":20339,"journal":{"name":"Preventive medicine","volume":"198 ","pages":"Article 108350"},"PeriodicalIF":4.3,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144567711","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corrigendum to “Associations of healthy lifestyle and three latent socioeconomic status patterns with physical multimorbidity among middle-aged and older adults in China” [Preventive Medicine, Volume 175, 2023 Oct; 107693]","authors":"Chengnan Guo ,&nbsp;Zhenqiu Liu ,&nbsp;Hong Fan ,&nbsp;Haili Wang ,&nbsp;Xin Zhang ,&nbsp;Changjia Fan ,&nbsp;Yi Li ,&nbsp;Xinyu Han ,&nbsp;Tiejun Zhang","doi":"10.1016/j.ypmed.2025.108337","DOIUrl":"10.1016/j.ypmed.2025.108337","url":null,"abstract":"","PeriodicalId":20339,"journal":{"name":"Preventive medicine","volume":"198 ","pages":"Article 108337"},"PeriodicalIF":4.3,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144560935","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of ‘weekend warrior’ physical activity pattern and erectile dysfunction: A large cross-sectional study in Brazil","authors":"Eduardo Rossato de Victo ,&nbsp;Rafael Mathias Pitta ,&nbsp;Luana de Lima Queiroga ,&nbsp;Gerson Ferrari ,&nbsp;Claudio Farias-Valenzuela ,&nbsp;Paloma Ferrero-Hernández ,&nbsp;Oskar Kaufmann ,&nbsp;Nelson Wolosker","doi":"10.1016/j.ypmed.2025.108352","DOIUrl":"10.1016/j.ypmed.2025.108352","url":null,"abstract":"<div><h3>Objective</h3><div>To examine the association between the weekend warrior physical activity pattern and erectile dysfunction, including analyses stratified by age group and obesity.</div></div><div><h3>Methods</h3><div>Data from 15,655 men aged &gt;40 screened at a Brazilian hospital (2008–2022) were analyzed. Physical activity was assessed using the International Physical Activity Questionnaire. Participants were grouped into three physical activity patterns: not meeting recommendations (defined as &lt;150 min/week of moderate-to-vigorous physical activity), weekend warrior (defined as ≥150 min/week on one or two days), and regularly active (defined as ≥150 min/week on three or more days). Erectile dysfunction was assessed using the International Index of Erectile Function score (&lt;22 indicating erectile dysfunction). Logistic regression tested the association between erectile dysfunction and physical activity patterns using unadjusted and adjusted models (adjusted for age, lifestyle and clinical conditions).</div></div><div><h3>Results</h3><div>Erectile dysfunction prevalence was 22.4 %. The weekend warrior pattern was initially associated with erectile dysfunction, but this association lost significance after adjustment. The regularly active pattern remained associated with lower erectile dysfunction likelihood in adjusted model (OR: 0.90; 95 %CI: 0.82–0.99). Among adults, this association persisted (OR: 0.90; 95 %CI: 0.82–0.99). In non-obese individuals, the regularly active pattern was also associated with lower erectile dysfunction likelihood (OR: 0.88; 95 %CI: 0.79–0.98), while in obese individuals, the association was significant only in the unadjusted model.</div></div><div><h3>Conclusion</h3><div>The weekend warrior pattern did not show significance in adjusted models, while the regularly active pattern is associated with a lower likelihood of erectile dysfunction, particularly among adults and non-obese individuals.</div></div>","PeriodicalId":20339,"journal":{"name":"Preventive medicine","volume":"198 ","pages":"Article 108352"},"PeriodicalIF":4.3,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144565100","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Atherosclerotic cardiovascular disease measures in foreign-born Latino patients by country of birth compared with U.S.-born Latinos","authors":"Nakai Corral ,&nbsp;N.D. Jorge Kaufmann ,&nbsp;Miguel Marino ,&nbsp;Jennifer A. Lucas ,&nbsp;Steffani R. Bailey ,&nbsp;Dave Boston ,&nbsp;Sophia Giebultowicz ,&nbsp;John Heintzman","doi":"10.1016/j.ypmed.2025.108349","DOIUrl":"10.1016/j.ypmed.2025.108349","url":null,"abstract":"<div><h3>Objective</h3><div>The burden of atherosclerotic cardiovascular disease (ASCVD) may differ based on the country of birth in Latinos, therefore, we aimed to examine differences in the utilization of ASCVD screening services, which have not been studied using large healthcare datasets.</div></div><div><h3>Methods</h3><div>Data included electronic health record (EHR) data from a multistate network of United States (U.S.) community health centers from 2014 to 2020. The study population (<em>N</em> = 49,177) was foreign-born Latinos (from ten different Latin countries) and U.S.-born Latino patients aged 40–83 years seeking care at 149 U.S. community health centers across 14 states. To compare the prevalence of documented medical record data necessary for ASCVD risk calculation, we performed a cross-sectional anlaysis, using logistic regression, adjusted for demographic and health services utilization factors.</div></div><div><h3>Results</h3><div>The adjusted odds ratio (aOR) comparing foreign-born to U.S.-born Latinos was 1.17 (95 % CI = 1.01, 1.35). When stratifying by country of birth, patients from specific countries had higher odds of documented data when compared to their U.S.-born counterparts (Dominican Republic: aOR = 1.13, 95 % CI = 1.03, 1.24; El Salvador: aOR = 1.26, 95 % CI = 1.08, 1.47; Guatemala: aOR = 1.17, 95 % CI = 1.02, 1.34; Mexico: aOR = 1.19, 95 % CI = 1.01, 1.41).</div></div><div><h3>Conclusions</h3><div>Foreign-born Latinos from El Salvador, Guatemala, the Dominican Republic, and Mexico are more likely to have documented information in their EHR necessary to assess cardiovascular risk. These findings underscore the clinical importance of data disaggregation in Latino patients as specific national birthplace may be associated with the adequacy of cardiovascular screening.</div></div>","PeriodicalId":20339,"journal":{"name":"Preventive medicine","volume":"198 ","pages":"Article 108349"},"PeriodicalIF":4.3,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144565101","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The longitudinal relationships between the built and natural environment, air pollution, noise and dementia: results from two UK-based cohort studies","authors":"Yu-Tzu Wu ,&nbsp;Sean Beevers ,&nbsp;Benjamin Barratt ,&nbsp;Carol Brayne ,&nbsp;Ester Cerin ,&nbsp;Rachel Franklin ,&nbsp;Victoria Houlden ,&nbsp;Bob Woods ,&nbsp;Eman Zied Abozied ,&nbsp;Matthew Prina ,&nbsp;Fiona Matthews","doi":"10.1016/j.ypmed.2025.108348","DOIUrl":"10.1016/j.ypmed.2025.108348","url":null,"abstract":"<div><h3>Objective</h3><div>Recent epidemiological studies have investigated a variety of environmental risk factors for dementia. However, most existing studies have focused on single environmental factors and reported mixed results. The aim of this study is to examine the interrelationships between multiple environment factors and their joint associations with cognitive health in later life.</div></div><div><h3>Methods</h3><div>This study was based on the Cognitive Function and Ageing Study II and Wales, two population-based cohort studies of 11,055 people aged ≥65 across five urban and rural areas in the UK. Using geospatial data, a wide range of environmental variables were generated for the participants and integrated into five domains through a latent approach, including the built environment, natural environment, noise, air pollution and deprivation. Multistate modelling was used to investigate their longitudinal associations with dementia and death adjusting for individual sociodemographic factors.</div></div><div><h3>Results</h3><div>The effect sizes of joint associations between the built environment (HR: 1.00; 95 %CI: 0.66, 1.52), natural environment (HR: 0.95; 95 %CI: 0.66, 1.36), air pollution (HR: 0.91; 95 %CI: 0.78, 1.07), deprivation (HR: 1.02; 95 %CI: 0.96, 1.09) and incident dementia were generally small. The strongest association was found in noise, where a high level of exposure was associated with an increased risk of incident dementia (HR: 1.22; 95 %CI: 0.97, 1.54). However, the confidence intervals were wide.</div></div><div><h3>Conclusions</h3><div>The joint associations between multiple environmental factors and incident dementia were found to be modest. Given mixed results in this field, future research should address methodological challenges and enhance evidence for population-level interventions on dementia risk factors.</div></div>","PeriodicalId":20339,"journal":{"name":"Preventive medicine","volume":"198 ","pages":"Article 108348"},"PeriodicalIF":4.3,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144549640","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}