认知表现和长期暴露于室外空气污染:来自英国老龄化纵向研究(ELSA-HCAP)的统一认知评估方案子研究的结果

Giorgio DI GESSA, Mikaela Bloomberg, Rina So, Shaun Scholes, Thomas Byrne, Jinkook Lee, Sara D Adar, Paola Zaninotto
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摘要

虽然空气污染与较差的认知表现有关,但这些关系是否因认知领域而异,以及哪些空气污染来源对认知特别有害,目前仍未得到充分研究。本研究考察了老年人在三个领域的认知得分与8-10年暴露于空气污染物(二氧化氮、总PM2.5和不同排放源的PM2.5)之间的关系。方法我们使用的数据来自2018年英国老龄化纵向研究的统一认知评估方案子研究(N= 1127)。估算了2008/10-2017年每种污染物的室外浓度,并使用均值和基于组的轨迹进行了总结。线性回归模型用于评估长期空气污染暴露与记忆、执行功能、语言和整体认知功能之间的关系,并对关键的个人和社区混杂因素进行了调整。结果空气污染轨迹与认知之间呈倒j型关系,暴露于最高NO2和总PM2.5水平的受访者的全球认知表现较差[β=-0.241;95%CI=(-0.46,-0.02), β=-0.334;[95%CI=(-0.55,-0.12)]比暴露在平均污染水平下的人要多。在执行功能和记忆(仅限PM2.5)方面也发现了类似的关联,而在语言方面发现了更令人信服的剂量反应证据。工业和住宅燃烧以及生物燃料、煤炭、石油和天然气燃烧产生的较高排放与较差的语言分数有关。结论:空气污染及其来源与认知表现存在特定领域的关联,在语言方面观察到的证据最为一致。继续努力减少空气污染,特别是在空气污染水平最高的地方,可能有利于认知表现。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Cognitive Performance and Long-term Exposure to Outdoor Air Pollution: Findings from the Harmonised Cognitive Assessment Protocol Sub-Study of the English Longitudinal Study of Ageing (ELSA-HCAP)
Background Although air pollution is associated with worse cognitive performance, whether these relationships differ by cognitive domain and which sources of air pollution are particularly detrimental to cognition remains understudied. This study examined associations between cognitive scores across three domains in older adults and 8-10 years of exposure to air pollutants (NO2, total PM2.5, and PM2.5 from different emission sources). Methods We used data from the 2018 Harmonized Cognitive Assessment Protocol sub-study of the English Longitudinal Study of Ageing (N=1,127). Outdoor concentrations of each pollutant were estimated for 2008/10-2017 and summarised using means and group-based trajectories. Linear regression models were used to assess long-term air pollution exposure relationships with memory, executive function, language, and global cognitive function after adjustment for key individual and neighbourhood-level confounders. Results Associations between air pollution trajectories and cognition are mostly inverted j-shaped, with respondents exposed to the highest residential levels of NO2 and total PM2.5 having worse performance for global cognition [β=-0.241; 95%CI=(-0.46,-0.02) and β=-0.334; 95%CI=(-0.55,-0.12) respectively] than those exposed to average levels of pollution. Similar associations were also found for executive function and memory (PM2.5 only), whereas more compelling dose-response evidence was found for language. Higher emissions from industry and residential combustion, as well as biofuel, coal, oil and natural gas combustion, were associated with worse language scores. Conclusions Air pollution and its sources have domain-specific associations with cognitive performance, with most consistent evidence observed for language. Continued efforts to reduce air pollution, particularly where levels are the highest, might benefit cognitive performance.
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