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Cited by 186Air Quality and Health ImpactsDementia and Cognitive Impairment ResearchHealth, Environment, Cognitive Aging

Ambient air pollution and clinical dementia: systematic review and meta-analysis

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Wilker, Elissa H, Osman, Marwa, Weisskopf, Marc G·2023·BMJ
DOI 10.1136/bmj-2022-071620PMC PMC10498344
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Abstract

Abstract Objective To investigate the role of air pollutants in risk of dementia, considering differences by study factors that could influence findings. Design Systematic review and meta-analysis. Data sources EMBASE, PubMed, Web of Science, Psycinfo, and OVID Medline from database inception through July 2022. Eligibility criteria for selecting studies Studies that included adults (≥18 years), a longitudinal follow-up, considered US Environmental Protection Agency criteria air pollutants and proxies of traffic pollution, averaged exposure over a year or more, and reported associations between ambient pollutants and clinical dementia. Two authors independently extracted data using a predefined data extraction form and assessed risk of bias using the Risk of Bias In Non-randomised Studies of Exposures (ROBINS-E) tool. A meta-analysis with Knapp-Hartung standard errors was done when at least three studies for a given pollutant used comparable approaches. Results 2080 records identified 51 studies for inclusion. Most studies were at high risk of bias, although in many cases bias was towards the null. 14 studies could be meta-analysed for particulate matter <2.5 µm in diameter (PM 2.5 ). The overall hazard ratio per 2 μg/m 3 PM 2.5 was 1.04 (95% confidence interval 0.99 to 1.09). The hazard ratio among seven studies that used active case ascertainment was 1.42 (1.00 to 2.02) and among seven studies that used passive case ascertainment was 1.03 (0.98 to 1.07). The overall hazard ratio per 10 μg/m 3 nitrogen dioxide was 1.02 ((0.98 to 1.06); nine studies) and per 10 μg/m 3 nitrogen oxide was 1.05 ((0.98 to 1.13); five studies). Ozone had no clear association with dementia (hazard ratio per 5 μg/m 3 was 1.00 (0.98 to 1.05); four studies). Conclusion PM 2.5 might be a risk factor for dementia, as well as nitrogen dioxide and nitrogen oxide, although with more limited data. The meta-analysed hazard ratios are subject to limitations that require interpretation with caution. Outcome ascertainment approaches differ across studies and each exposure assessment approach likely is only a proxy for causally relevant exposure in relation to clinical dementia outcomes. Studies that evaluate critical periods of exposure and pollutants other than PM 2.5 , and studies that actively assess all participants for outcomes are needed. Nonetheless, our results can provide current best estimates for use in burden of disease and regulatory setting efforts. Systematic review registration PROSPERO CRD42021277083.

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  • Each 2 μg/m3 increment in PM2.5 is associated with a 17% increase in dementia risk (HR 1.17, 95% CI 0.96-1.43).

    “A conservative pooled estimate, obtained from a meta-analysis of five studies that used active case ascertainment of high quality studies, reported a 17% increase in dementia risk per 2 µg/m 3 increment in PM2.5, although confidence intervals were wide and included the null (HR 1.17, 0.96- 1.43).(231)”

    From Dementia prevention, intervention, and care: 2024 report of the Lancet standing Commission (2024) · cites this paper as [231]

    The Results (Quantitative synthesis) report HR 1.17 (95% CI 0.96–1.43) per 2 μg/m³ PM2.5 among three active-ascertainment studies, supporting the estimate and the statement that its interval includes the null. The citing sentence incorrectly says that estimate pooled five studies; the paper reports a different estimate, HR 1.45 (0.93–2.27), for five such studies. (LLM, conf=0.91)

    Experimental — accuracy not yet measured

  • Pooled HRs for nitrogen dioxide, nitrogen oxides, and ozone are not statistically significant.

    “Pooled HRs were reported from five studies each of nitrogen dioxide (HR per 10μg/m 3 1.0,; 0.98 1.06) and nitrogen oxides (HR per 10 μg/m 3 1.05, 0.98 1.13), and four of ozone (HR per 5 μg/m 3 1.00, 0.98 -1.05), none of which were statistically significant.”

    From Dementia prevention, intervention, and care: 2024 report of the Lancet standing Commission (2024) · cites this paper as [231]

    The Results (Quantitative synthesis) give pooled confidence intervals that include 1 for nitrogen dioxide, nitrogen oxides, and ozone, supporting the claim that none is statistically significant. The citing sentence also says five studies contributed to the nitrogen dioxide estimate, but the paper’s Abstract (Results) reports nine; it reports five for nitrogen oxides and four for ozone. (LLM, conf=0.88)

    Experimental — accuracy not yet measured

  • Multidomain interventions including group components suggest small cognitive benefits (Cohen's d = 0.13; MMSE difference 0.99 points) for highly intensive interventions.

    “Studies of multidomain interventions which included group components suggested small cognitive benefits (Cohen's d = 0.13 (228) and mean mini-mental state examination (MMSE) difference 0.99 points) for highly intensive interventions.”

    From Dementia prevention, intervention, and care: 2024 report of the Lancet standing Commission (2024) · cites this paper as [228]

    The Results (Quantitative synthesis; page unavailable) report associations between ambient air-pollution exposure and clinical dementia, not cognitive effects of multidomain interventions. Searches for group components, Cohen’s d = 0.13, an MMSE difference of 0.99 points, and highly intensive interventions found no passage addressing the claim. (LLM, conf=0.78)

    Experimental — accuracy not yet measured

  • There was high certainty of a small benefit on overall cognition (MD 0.03, 0.01-0.06) in 3 RCTs with n=4,617 over 18-36 months.

    “There was high certainty of a small benefit on overall cognition (3 RCTs; composite z score mean difference (MD) 0.03, 0.01- 0.06, n = 4,617, over 18-36 months), (228, 261, 262)”

    From Dementia prevention, intervention, and care: 2024 report of the Lancet standing Commission (2024) · cites this paper as [228]

    The Results (Quantitative synthesis; page unavailable) report associations between air-pollution exposure and clinical dementia using hazard ratios. Neither the supplied passages nor searches for the composite z-score estimate and randomized trials found the claimed cognition benefit, three RCTs, sample size, or follow-up period in our copy. (LLM, conf=0.76)

    Experimental — accuracy not yet measured

  • The FINGERS study reported that effects of the intervention on cognitive function were the same across socio-economic categories (within a relatively affluent cohort).

    “The FINGERS study(228) did not report ethnicity or dementia incidence but reported that effects of the intervention on cognitive function were the same across socio-economic categories (albeit within a relatively affluent cohort).”

    From Dementia prevention, intervention, and care: 2024 report of the Lancet standing Commission (2024) · cites this paper as [228]

    The Results (Quantitative synthesis) and Discussion (Principal findings; page numbers unavailable) address air-pollution exposure and dementia, not the FINGERS intervention. Searches for FINGERS, cognitive intervention effects, and socioeconomic categories found no passage reporting the claimed comparison or describing the cohort as relatively affluent. (LLM, conf=0.76)

    Experimental — accuracy not yet measured

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Research works printed but not linked: 84

  1. [2]Brauer M Casadei B Harrington RA Kovacs R Sliwa K WHF Air Pollution Expert Group. Taking a stand against air pollution-the impact on cardiovascular disease: a joint opinion from the World Heart Federation, American College of Cardiology, American Heart Association, and the European Society of Cardiology. Circulation 2021; 143: e800- 4. 10.1161/CIRCULATIONAHA.120.052666. 33506685 · DOI
  2. [3]Rajagopalan S Brauer M Bhatnagar A American Heart Association Council on Lifestyle and Cardiometabolic Health; Council on Arteriosclerosis, Thrombosis and Vascular Biology; Council on Clinical Cardiology; Council on Cardiovascular and Stroke Nursing; and Stroke Council. Personal-level protective actions against particulate matter air pollution exposure: a scientific statement from the American Heart Association. Circulation 2020; 142: e411- 31. 10.1161/CIR.0000000000000931. 33150789 · DOI
  3. [4]Ljungman PL Mittleman MA. Ambient air pollution and stroke. Stroke 2014; 45: 3734- 41. 10.1161/STROKEAHA.114.003130. 25300971 PMC4276028 · DOI
  4. [5]Power MC Adar SD Yanosky JD Weuve J. Exposure to air pollution as a potential contributor to cognitive function, cognitive decline, brain imaging, and dementia: A systematic review of epidemiologic research. Neurotoxicology 2016; 56: 235- 53. 10.1016/j.neuro.2016.06.004. 27328897 PMC5048530 · DOI · Paper page
  5. [7]Dominici F Peng RD Zeger SL White RH Samet JM. Particulate air pollution and mortality in the United States: did the risks change from 1987 to 2000? Am J Epidemiol 2007; 166: 880- 8. 10.1093/aje/kwm222 17728271 · DOI
  6. [8]Laden F Schwartz J Speizer FE Dockery DW. Reduction in fine particulate air pollution and mortality: Extended follow-up of the Harvard Six Cities study. Am J Respir Crit Care Med 2006; 173: 667- 72. 10.1164/rccm.200503-443OC 16424447 PMC2662950 · DOI
  7. [10]Peters R Ee N Peters J Booth A Mudway I Anstey KJ. Air pollution and dementia: a systematic review. J Alzheimers Dis 2019; 70(s1): S145- 63. 10.3233/JAD-180631. 30775976 PMC6700631 · DOI · Paper page
  8. [13]DerSimonian R Laird N. Meta-analysis in clinical trials. Control Clin Trials 1986; 7: 177- 88. 10.1016/0197-2456(86)90046-2. 3802833 · DOI · Paper page
  9. [15]Röver C Knapp G Friede T. Hartung-Knapp-Sidik-Jonkman approach and its modification for random-effects meta-analysis with few studies. BMC Med Res Methodol 2015; 15: 99. 10.1186/s12874-015-0091-1. 26573817 PMC4647507 · DOI · Paper page
  10. [17]Oudin A Segersson D Adolfsson R Forsberg B. Association between air pollution from residential wood burning and dementia incidence in a longitudinal study in Northern Sweden. PLoS One 2018; 13: e0198283. 10.1371/journal.pone.0198283. 29897947 PMC5999109 · DOI · Paper page
  11. [18]Andersson J Oudin A Sundström A Forsberg B Adolfsson R Nordin M. Road traffic noise, air pollution, and risk of dementia - results from the Betula project. Environ Res 2018; 166: 334- 9. 10.1016/j.envres.2018.06.008. 29909174 · DOI
  12. [19]Oudin A Andersson J Sundström A. Traffic-related air pollution as a risk factor for dementia: no clear modifying effects of aPOEɛ4 in the Betula cohort. J Alzheimers Dis 2019; 71: 733- 40. 10.3233/JAD-181037. 31450491 · DOI
  13. [20]Åström DO Adolfsson R Segersson D Forsberg B Oudin A. Local contrasts in concentration of ambient particulate air pollution (pm2.5) and incidence of alzheimer’s disease and dementia: results from the Betula cohort in Northern Sweden. J Alzheimers Dis 2021; 81: 83- 5. 10.3233/JAD-201538. 33749652 PMC8203233 · DOI
  14. [21]Cacciottolo M Wang X Driscoll I. Particulate air pollutants, APOE alleles and their contributions to cognitive impairment in older women and to amyloidogenesis in experimental models. Transl Psychiatry 2017; 7: e1022. 10.1038/tp.2016.280. 28140404 PMC5299391 · DOI
  15. [22]Chen C Whitsel EA Espeland MA. B vitamin intakes modify the association between particulate air pollutants and incidence of all-cause dementia: findings from the Women’s Health Initiative Memory Study. Alzheimers Dement 2022; 18: 2188- 98. 10.1002/alz.12515. 35103387 PMC9339592 · DOI
  16. [23]Wang X Younan D Millstein J. Association of improved air quality with lower dementia risk in older women. Proc Natl Acad Sci U S A 2022; 119: e2107833119. 10.1073/pnas.2107833119. 34983871 PMC8764698 · DOI · Paper page
  17. [24]Younan D Wang X Gruenewald T. Racial/ethnic disparities in Alzheimer’s disease risk: role of exposure to ambient fine particles. J Gerontol A Biol Sci Med Sci 2022; 77: 977- 85. 10.1093/gerona/glab231. 34383042 PMC9071399 · DOI
  18. [26]Paul KC Haan M Yu Y. Traffic-related air pollution and incident dementia: direct and indirect pathways through metabolic dysfunction. J Alzheimers Dis 2020; 76: 1477- 91. 10.3233/JAD-200320. 32651321 PMC7591265 · DOI
  19. [27]Yu Y Haan M Paul KC. Metabolic dysfunction modifies the influence of traffic-related air pollution and noise exposure on late-life dementia and cognitive impairment: a cohort study of older Mexican-Americans. Environ Epidemiol 2020; 4: e122. 10.1097/EE9.0000000000000122. 33778355 PMC7941776 · DOI
  20. [28]Letellier N Gutierrez LA Duchesne J. Air quality improvement and incident dementia: Effects of observed and hypothetical reductions in air pollutant using parametric g-computation. Alzheimers Dement 2022; 18: 2509- 17. 10.1002/alz.12606. 35142029 · DOI · Paper page
  21. [29]Mortamais M Gutierrez LA de Hoogh K. Long-term exposure to ambient air pollution and risk of dementia: Results of the prospective Three-City Study. Environ Int 2021; 148: 106376. 10.1016/j.envint.2020.106376. 33484961 · DOI
  22. [30]Semmens EO Leary CS Fitzpatrick AL. Air pollution and dementia in older adults in the Ginkgo Evaluation of Memory Study. Alzheimers Dement 2023; 19: 549- 59. 10.1002/alz.12654. 35436383 PMC9576823 · DOI
  23. [31]Shaffer RM Blanco MN Li G. Fine particulate matter and dementia incidence in the adult changes in thought study. Environ Health Perspect 2021; 129: 87001. 10.1289/EHP9018. 34347531 PMC8336685 · DOI
  24. [32]Sullivan KJ Ran X Wu F. Ambient fine particulate matter exposure and incident mild cognitive impairment and dementia. J Am Geriatr Soc 2021; 69: 2185- 94. 10.1111/jgs.17188. 33904156 PMC8373708 · DOI
  25. [34]Chang KH Chang MY Muo CH Wu TN Chen CY Kao CH. Increased risk of dementia in patients exposed to nitrogen dioxide and carbon monoxide: a population-based retrospective cohort study. PLoS One 2014; 9: e103078. 10.1371/journal.pone.0103078. 25115939 PMC4130523 · DOI
  26. [35]Jung CR Lin YT Hwang BF. Ozone, particulate matter, and newly diagnosed Alzheimer’s disease: a population-based cohort study in Taiwan. J Alzheimers Dis 2015; 44: 573- 84. 10.3233/JAD-140855. 25310992 · DOI · Paper page
  27. [36]Kioumourtzoglou MA Schwartz JD Weisskopf MG. Long-term PM2.5 Exposure and Neurological Hospital Admissions in the Northeastern United States. Environ Health Perspect 2016; 124: 23- 9. 10.1289/ehp.1408973. 25978701 PMC4710596 · DOI
  28. [37]Chen H Kwong JC Copes R. Exposure to ambient air pollution and the incidence of dementia: A population-based cohort study. Environ Int 2017; 108: 271- 7. 10.1016/j.envint.2017.08.020. 28917207 · DOI · Paper page
  29. [38]Chen H Kwong JC Copes R. Living near major roads and the incidence of dementia, Parkinson’s disease, and multiple sclerosis: a population-based cohort study. Lancet 2017; 389: 718- 26. 10.1016/S0140-6736(16)32399-6. 28063597 · DOI · Paper page
  30. [39]Carey IM Anderson HR Atkinson RW. Are noise and air pollution related to the incidence of dementia? A cohort study in London, England. BMJ Open 2018; 8: e022404. 10.1136/bmjopen-2018-022404. 30206085 PMC6144407 · DOI · Paper page
  31. [40]Bishop KC Ketcham JD Kuminoff NV. Hazed and Confused: The Effect of Air Pollution on Dementia. NBER WORKING PAPER SERIES. NATIONAL BUREAU OF ECONOMIC RESEARCH, 2018 10.3386/w24970. · DOI
  32. [41]Zhang HW Kok VC Chuang SC. Long-term exposure to ambient hydrocarbons increases dementia risk in people aged 50 years and above in Taiwan. Curr Alzheimer Res 2019; 16: 1276- 89. 10.2174/1567205017666200103112443. 31902365 · DOI
  33. [42]Li CY Li CH Martini S Association between air pollution and risk of vascular dementia: A multipollutant analysis in Taiwan. Environ Int 2019;133(Pt B):105233. 10.1016/j.envint.2019.105233 31678904 · DOI
  34. [43]Cerza F Renzi M Gariazzo C Long-term exposure to air pollution and hospitalization for dementia in the Rome longitudinal study. Environ Health 2019; 18: 72. 10.1186/s12940-019-0511-5 PMC6689157 31399053 · DOI
  35. [44]Lee M Schwartz J Wang Y Long-term effect of fine particulate matter on hospitalization with dementia. Environ Pollut 2019; 254(Pt A):112926. 10.1016/j.envpol.2019.07.094 PMC7995172 31404729 · DOI
  36. [45]Bowe B Xie Y Yan Y Al-Aly Z. Burden of cause-specific mortality associated with PM2.5 air pollution in the United States. JAMA Netw Open 2019; 2: e1915834. 10.1001/jamanetworkopen.2019.15834. 31747037 PMC6902821 · DOI · Paper page
  37. [46]Yuchi W Sbihi H Davies H Road proximity, air pollution, noise, green space and neurologic disease incidence: a population-based cohort study. Environ Health 2020; 19:8. 10.1186/s12940-020-0565-4 PMC6974975 31964412 · DOI
  38. [47]Dimakakou E Johnston HJ Streftaris G Cherrie JW. Is environmental and occupational particulate air pollution exposure related to type-2 diabetes and dementia? a cross-sectional analysis of the UK Biobank. Int J Environ Res Public Health 2020; 17: 9581. 10.3390/ijerph17249581. 33371391 PMC7767456 · DOI
  39. [48]Ho HC Fong KNK Chan TC Shi Y. The associations between social, built and geophysical environment and age-specific dementia mortality among older adults in a high-density Asian city. Int J Health Geogr 2020; 19: 53. 10.1186/s12942-020-00252-y. 33276778 PMC7716506 · DOI
  40. [49]Ilango SD Chen H Hystad P. The role of cardiovascular disease in the relationship between air pollution and incident dementia: a population-based cohort study. Int J Epidemiol 2020; 49: 36- 44. 10.1093/ije/dyz154. 31347651 PMC7124495 · DOI
  41. [50]Klompmaker JO Hoek G Bloemsma LD. Surrounding green, air pollution, traffic noise exposure and non-accidental and cause-specific mortality. Environ Int 2020; 134: 105341. 10.1016/j.envint.2019.105341. 31783239 · DOI
  42. [51]Klompmaker JO Janssen NAH Bloemsma LD Effects of exposure to surrounding green, air pollution and traffic noise with non-accidental and cause-specific mortality in the Dutch national cohort. Environ Health 2021; 20: 82. 10.1186/s12940-021-00769-0 34261495 PMC8281461 · DOI
  43. [52]Smargiassi A Sidi EAL Robert LE. Exposure to ambient air pollutants and the onset of dementia in Québec, Canada. Environ Res 2020; 190: 109870. 10.1016/j.envres.2020.109870. 32739624 · DOI
  44. [53]Bagheri N Mavoa S Tabatabaei-Jafari H. The impact of built and social environmental characteristics on diagnosed and estimated future risk of dementia. J Alzheimers Dis 2021; 84: 621- 32. 10.3233/JAD-210208. 34569946 · DOI
  45. [54]Nunez Y Boehme AK Weisskopf MG. Fine particle exposure and clinical aggravation in neurodegenerative diseases in New York state. Environ Health Perspect 2021; 129: 27003. 10.1289/EHP7425. 33555200 PMC7869948 · DOI
  46. [55]Rhew SH Kravchenko J Lyerly HK. Exposure to low-dose ambient fine particulate matter PM2.5 and Alzheimer’s disease, non-Alzheimer’s dementia, and Parkinson’s disease in North Carolina. PLoS One 2021; 16: e0253253. 10.1371/journal.pone.0253253. 34242242 PMC8270415 · DOI
  47. [56]Ran J Schooling CM Han L. Long-term exposure to fine particulate matter and dementia incidence: A cohort study in Hong Kong Environ Pollut 2021; 271: 116303. 10.1016/j.envpol.2020.116303. 33370610 · DOI
  48. [57]Ran J Zhang Y Han L. The joint association of physical activity and fine particulate matter exposure with incident dementia in elderly Hong Kong residents. Environ Int 2021; 156: 106645. 10.1016/j.envint.2021.106645. 34015665 · DOI
  49. [58]Shi L Wu X Danesh Yazdi M. Long-term effects of PM2·5 on neurological disorders in the American Medicare population: a longitudinal cohort study. Lancet Planet Health 2020; 4: e557- 65. 10.1016/S2542-5196(20)30227-8. 33091388 PMC7720425 · DOI
  50. [60]van Wijngaarden E Rich DQ Zhang W Neurodegenerative hospital admissions and long-term exposure to ambient fine particle air pollution. Ann Epidemiol 2021; 54:79-86 e4. 10.1016/j.annepidem.2020.09.012 PMC7796937 33010415 · DOI
  51. [61]Zhao N Pinault L Toyib O Vanos J Tjepkema M Cakmak S. Long-term ozone exposure and mortality from neurological diseases in Canada. Environ Int 2021; 157: 106817. 10.1016/j.envint.2021.106817. 34385046 · DOI
  52. [62]Parra KL Alexander GE Raichlen DA Klimentidis YC Furlong MA. Exposure to air pollution and risk of incident dementia in the UK Biobank. Environ Res 2022; 209: 112895. 10.1016/j.envres.2022.112895. 35149105 PMC8976829 · DOI
  53. [63]Ma H Li X Zhou T Wang M Heianza Y Qi L. Long-term exposure to low-level air pollution, genetic susceptibility and risk of dementia. Int J Epidemiol 2022; dyac146. 10.1093/ije/dyac146. 35849335 · DOI
  54. [64]Li J Wang Y Steenland K. Long-term effects of PM2.5 components on incident dementia in the northeastern United States. Innovation (Camb) 2022; 3: 100208. 10.1016/j.xinn.2022.100208. 35199078 PMC8844282 · DOI
  55. [65]Raichlen DA Furlong M Klimentidis YC. Association of physical activity with incidence of dementia is attenuated by air pollution. Med Sci Sports Exerc 2022; 54: 1131- 8. 10.1249/MSS.0000000000002888. 35704438 PMC9204780 · DOI
  56. [66]So R Andersen ZJ Chen J. Long-term exposure to air pollution and mortality in a Danish nationwide administrative cohort study: Beyond mortality from cardiopulmonary disease and lung cancer. Environ Int 2022; 164: 107241. 10.1016/j.envint.2022.107241. 35544998 · DOI
  57. [67]Tessum CW Paolella DA Chambliss SE Apte JS Hill JD Marshall JD. PM2.5 polluters disproportionately and systemically affect people of color in the United States. Sci Adv 2021; 7: eabf4491. 10.1126/sciadv.abf4491. 33910895 PMC11426197 · DOI · Paper page
  58. [68]Liu J Clark LP Bechle MJ. Disparities in air pollution exposure in the United States by Race/Ethnicity and Income, 1990-2010. Environ Health Perspect 2021; 129: 127005. 10.1289/EHP8584. 34908495 PMC8672803 · DOI
  59. [72]Kurokawa J Ohara T. Long-term historical trends in air pollutant emissions in Asia: Regional Emission inventory in ASia (REAS) version 3. Atmos Chem Phys 2020; 20: 12761- 93 10.5194/acp-20-12761-2020. · DOI
  60. [75]Wolters FJ Chibnik LB Waziry R. Twenty-seven-year time trends in dementia incidence in Europe and the United States: The Alzheimer Cohorts Consortium. Neurology 2020; 95: e519- 31. 10.1212/WNL.0000000000010022. 32611641 PMC7455342 · DOI · Paper page
  61. [76]Weuve J. Magnitude matters: beyond detection in the presence of selection in research on socioeconomic inequalities in health 2012/12/13]. Epidemiology 2013; 24: 10- 3. 10.1097/EDE.0b013e3182788390. 23232608 · DOI
  62. [77]Leung M Kioumourtzoglou MA Raz R Weisskopf MG. Bias due to selection on live births in studies of environmental exposures during pregnancy: a simulation study. Environ Health Perspect 2021; 129: 47001. 10.1289/EHP7961. 33793300 PMC8043129 · DOI
  63. [78]VanderWeele TJ. Explanation in Causal Inference: Methods for Mediation and Interaction. Oxford University Press, 2015.
  64. [79]US Environmental Protection Agency. Supplement to the 2019 Integrated Science Assessment for Particulate Matter (Final Report, 2022). Washington, DC: U.S. Environmental Protection Agency, 2022. 36630543
  65. [80]de Graaf R Bijl RV Smit F Ravelli A Vollebergh WA. Psychiatric and sociodemographic predictors of attrition in a longitudinal study: The Netherlands Mental Health Survey and Incidence Study (NEMESIS). Am J Epidemiol 2000; 152: 1039- 47. 10.1093/aje/152.11.1039 11117613 · DOI
  66. [81]Mein G Johal S Grant RL Seale C Ashcroft R Tinker A. Predictors of two forms of attrition in a longitudinal health study involving ageing participants: an analysis based on the Whitehall II study. BMC Med Res Methodol 2012; 12: 164. 10.1186/1471-2288-12-164. 23106792 PMC3505167 · DOI
  67. [82]Weisskopf MG Sparrow D Hu H Power MC. Biased exposure-health effect estimates from selection in cohort studies: are environmental studies at particular risk?. Environ Health Perspect 2015; 123: 1113- 22. 10.1289/ehp.1408888. 25956004 PMC4629739 · DOI
  68. [83]Grodstein F Chang CH Capuano AW. Identification of dementia in recent medicare claims data, compared with rigorous clinical assessments ]. J Gerontol A Biol Sci Med Sci 2022; 77: 1272- 8. 10.1093/gerona/glab377. 34919685 PMC9159666 · DOI · Paper page
  69. [85]Lin PJ Daly AT Olchanski N. Dementia Diagnosis Disparities by Race and Ethnicity. Med Care 2021; 59: 679- 86. 10.1097/MLR.0000000000001577. 34091580 PMC8263486 · DOI · Paper page
  70. [86]Hajat A Hsia C O’Neill MS. Socioeconomic disparities and air pollution exposure: a global review. Curr Environ Health Rep 2015; 2: 440- 50. 10.1007/s40572-015-0069-5. 26381684 PMC4626327 · DOI · Paper page
  71. [88]Borenstein M Hedges LV Higgins JPT. Introduction to Meta-Analysis. Wiley, 2009 10.1002/9780470743386. · DOI · Paper page
  72. [89]Kioumourtzoglou MA Spiegelman D Szpiro AA. Exposure measurement error in PM2.5 health effects studies: a pooled analysis of eight personal exposure validation studies. Environ Health 2014; 13: 2. 10.1186/1476-069X-13-2. 24410940 PMC3922798 · DOI
  73. [90]Goldman GT Mulholland JA Russell AG Gass K Strickland MJ Tolbert PE. Characterization of ambient air pollution measurement error in a time-series health study using a geostatistical simulation approach. Atmos Environ (1994) 2012; 57: 101- 8. 10.1016/j.atmosenv.2012.04.045. 23606805 PMC3628542 · DOI
  74. [92]Weisskopf MG Webster TF. Trade-offs of personal vs. more proxy exposure measures in environmental epidemiology. Epidemiology 2017; 28: 635- 43. 10.1097/EDE.0000000000000686. 28520644 PMC5543716 · DOI
  75. [94]Southerland VA Brauer M Mohegh A. Global urban temporal trends in fine particulate matter (PM2·5) and attributable health burdens: estimates from global datasets. Lancet Planet Health 2022; 6: e139- 46. 10.1016/S2542-5196(21)00350-8. 34998505 PMC8828497 · DOI
  76. [95]Hammer MS van Donkelaar A Li C. Global Estimates and Long-Term Trends of Fine Particulate Matter Concentrations (1998-2018). Environ Sci Technol 2020; 54: 7879- 90. 10.1021/acs.est.0c01764. 32491847 · DOI
  77. [97]Qiu C Fratiglioni L. A major role for cardiovascular burden in age-related cognitive decline. Nat Rev Cardiol 2015; 12: 267- 77. 10.1038/nrcardio.2014.223. 25583619 · DOI
  78. [98]Block ML Calderón-Garcidueñas L. Air pollution: mechanisms of neuroinflammation and CNS disease. Trends Neurosci 2009; 32: 506- 16. 10.1016/j.tins.2009.05.009. 19716187 PMC2743793 · DOI
  79. [99]Calderón-Garcidueñas L Reed W Maronpot RR. Brain inflammation and Alzheimer’s-like pathology in individuals exposed to severe air pollution. Toxicol Pathol 2004; 32: 650- 8. 10.1080/01926230490520232 15513908 · DOI
  80. [101]Calderón-Garcidueñas L Solt AC Henríquez-Roldán C. Long-term air pollution exposure is associated with neuroinflammation, an altered innate immune response, disruption of the blood-brain barrier, ultrafine particulate deposition, and accumulation of amyloid beta-42 and alpha-synuclein in children and young adults. Toxicol Pathol 2008; 36: 289- 310. 10.1177/0192623307313011. 18349428 · DOI · Paper page
  81. [102]Costa LG Cole TB Coburn J Chang YC Dao K Roqué PJ. Neurotoxicity of traffic-related air pollution. Neurotoxicology 2017; 59: 133- 9. 10.1016/j.neuro.2015.11.008. 26610921 PMC4875879 · DOI
  82. [104]Cantuaria ML Waldorff FB Wermuth L. Residential exposure to transportation noise in Denmark and incidence of dementia: national cohort study. BMJ 2021; 374: n1954. 10.1136/bmj.n1954. 34497091 PMC8424489 · DOI
  83. [105]Hernán MA. The hazards of hazard ratios. Epidemiology 2010; 21: 13- 5. 10.1097/EDE.0b013e3181c1ea43. 20010207 PMC3653612 · DOI
  84. [106]Lau J Ioannidis JP Terrin N Schmid CH Olkin I. The case of the misleading funnel plot. BMJ 2006; 333: 597- 600. 10.1136/bmj.333.7568.597. 16974018 PMC1570006 · DOI · Paper page

Cited by

Sorted by citations

Authors
Wilker, E. H., Osman, M., & Weisskopf, M. G.
Affiliations
Harvard University (US)
Corresponding author
Weisskopf, Marc G
ORCID
Venue
BMJ
Publisher
BMJ
Published
2023-04-05
Volume
381
Pages
e071620
ISSN
1756-1833 (ISSN-L)
DOI
10.1136/bmj-2022-071620
PMC
PMC10498344
OpenAlex
W4362632520
Cited by
186
References
16
Citations by year
2026: 44 · 2025: 62 · 2024: 63 · 2023: 16 · 2021: 1
FWCI
4.91
Type
journal article
Language
en
Open access
Licence
Locations
  • BMJ (publishedVersion, cc-by-nc)
  • PubMed (publishedVersion)
  • PubMed Central (publishedVersion, cc-by-nc)
Funders
  • National Heart, Lung, and Blood Institute (T32HL007118)
  • National Institute of Environmental Health Sciences (P30ES000002)
Topics
  • 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
  • Physical Sciences › Environmental Science › Health, Toxicology and Mutagenesis › Health, Environment, Cognitive Aging
Keywords
ambient air pollution, dementia, nitrogen dioxide, nitrogen oxides, ozone, traffic-related air pollution, dementia risk factors, exposure assessment, case ascertainment, risk of bias
MeSH terms
Air Pollutants, Air Pollution, Dementia, Environmental Exposure, Humans

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