Household use of polluting cooking fuels and late-life cognitive function: a harmonized analysis of India, Mexico, and China
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INTRODUCTION: Exposure to high levels of air pollution is associated with poor health, including worse cognitive function. Whereas many studies of cognition have assessed outdoor air pollution, we evaluate how exposure to air pollution from combustion of polluting household fuels relates with cognitive function using harmonized data from India, Mexico, and China. MATERIALS & METHODS: We analyze adults age 50+ in three nationally representative studies of aging with common data collection methods: the 2017-2019 Longitudinal Aging Study in India (n = 50,532), 2015 Mexican Health and Aging Study (n = 12,883), and 2013 China Health and Retirement Longitudinal Study (n = 12,913). Use of polluting fuels was assessed by self-report of wood, coal, kerosene, crop residue, or dung for cooking. Cognitive function was measured by performance across several cognitive domains and summarized into a total cognition score. We used linear regression, by country, to test how polluting cooking fuel use relates with cognition adjusting for key demographic and socioeconomic factors. RESULTS: Approximately 47%, 12%, and 48% of respondents in India, Mexico, and China, respectively, relied primarily on polluting cooking fuel, which was more common in rural areas. Using polluting cooking fuels was consistently associated with poorer cognitive function in all countries, independent of demographic and socioeconomic characteristics. Adjusted differences in cognitive function between individuals using polluting and clean cooking fuel were equivalent to differences observed between individuals who were 3 years of age apart in Mexico and China and 6 years of age apart in India. Across countries, associations between polluting cooking fuel use and poorer cognition were larger for women. CONCLUSIONS: Results suggest that household air pollution from the use of polluting cooking fuel may play an important role in shaping cognitive outcomes of older adults in countries where reliance on polluting fuels for domestic energy needs still prevails. As these countries continue to age, public health efforts should seek to reduce reliance on these fuels.
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Solid fuel use is associated with higher dementia risk and accelerated cognitive decline among middle-aged and older adults.
“Studies in LMICs have demonstrated that solid fuel use, a proxy for household (indoor) air pollution, is associated with higher dementia risk and accelerated cognitive decline among middle-aged and older adults.(236, 237)”
From Dementia prevention, intervention, and care: 2024 report of the Lancet standing Commission (2024) · cites this paper as [237]
The Conclusions (page unavailable) report that polluting cooking fuel use was associated with poorer cognitive function among older adults in India, Mexico, and China. The Methods describe cognition scores measured at one time point in each country; this paper does not establish higher dementia risk or accelerated cognitive decline. (LLM, conf=0.88)
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Self-citation
- Authors
- Saenz, J. L., Adar, S. D., Zhang, Y. S., Wilkens, J., Chattopadhyay, A., Lee, J., & Wong, R.
- Affiliations
- University of Southern California (US)
- University of Michigan (US)
- University of North Carolina at Chapel Hill (US)
- International Institute for Population Sciences (IN)
- The University of Texas Medical Branch at Galveston (US)
- Corresponding author
- Saenz, Joseph L.
- ORCID
- Venue
- Environment International
- Publisher
- Elsevier BV
- Published
- 2021-11
- Volume
- 156
- Pages
- 106722
- ISSN
- 0160-4120 (ISSN-L)
- PMC
- PMC8380666
- OpenAlex
- W3177015647
- Cited by
- 71
- References
- 53
- Citations by year
- 2026: 9 · 2025: 14 · 2024: 18 · 2023: 11 · 2022: 17 · 2021: 2
- FWCI
- 2.98
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Environment International (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- National Institute on Aging
- National Institute of Child Health and Human Development
- Topics
- Physical Sciences › Environmental Science › Pollution › Energy and Environment Impacts
- Physical Sciences › Environmental Science › Health, Toxicology and Mutagenesis › Air Quality and Health Impacts
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Keywords
- household air pollution, cognitive function, older adults, kerosene, coal, household energy consumption, gender differences, urban-rural differences, Longitudinal Ageing Study in India, Mexican Health and Aging Study, China Health and Retirement Longitudinal Study, cross-national comparison
- MeSH terms
- Aged, China, Cognition, Cooking, Female, Humans, India, Longitudinal Studies, Mexico, Middle Aged, Air Pollution, Indoor
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