Are noise and air pollution related to the incidence of dementia? A cohort study in London, England.
Are noise and air pollution related to the incidence of dementia? A cohort study in London, England.
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DOI：
10.1136/bmjopen-2018-022404
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发表时间：
2018-09-11
期刊：
影响因子：
2.9
通讯作者：
Kelly FJ
中科院分区：
文献类型：
--
作者：
Carey IM;Anderson HR;Atkinson RW;Beevers SD;Cook DG;Strachan DP;Dajnak D;Gulliver J;Kelly FJ
调查痴呆症的发病率是否与伦敦居民区的空气和噪音污染水平有关。使用初级保健数据的回溯性队列研究。75个大伦敦地区的实践。1302005年1月1日，年龄50-79岁的 978名成年人登记了他们的一般做法，没有记录的痴呆症病史或疗养院住所。2005-2013年间首次记录的痴呆症诊断以及阿尔茨海默病和血管性痴呆症的亚组。根据弥散模型估算了2004年期间二氧化氮(NO2)、空气动力学直径中值为PM2.5的颗粒物(≤2.5)和臭氧(03)的年平均浓度，其分辨率为20×20 m。交通强度、与主要道路的距离和夜间噪音水平(Lnight)是在邮政编码水平上估计的。所有暴露措施都通过住宅邮政编码匿名链接到临床数据。COX模型的HR根据年龄、性别、种族、吸烟和体重指数进行了调整，并对区域剥夺和共病进行了进一步的调整。2181名受试者(1.7%)被诊断为痴呆症(39%提到阿尔茨海默病，29%提到血管性痴呆)。痴呆症与除臭氧以外的所有空气污染指标都存在正的暴露反应关系，这一点不容易通过进一步的调整来解释。生活在二氧化氮浓度最高五分之一(>；41.5 微克/立方米)和最低五分之一(<；31.9 微克/立方米)地区的成年人患痴呆症的风险更高(HR=1.4，95% CI 1.12至1.74)。PM2.5、仅来自主要交通来源的PM2.5和Lnight也会增加患痴呆症的风险，但在多污染物模型中，只有NO2和PM2.5仍然具有统计学意义。与血管性痴呆相比，阿尔茨海默病的相关性更一致。我们已经发现了证据表明，伦敦的居民区空气污染水平与被诊断为痴呆症之间存在正相关，而痴呆症的诊断无法用已知的混杂因素来解释。
To investigate whether the incidence of dementia is related to residential levels of air and noise pollution in London. Retrospective cohort study using primary care data. 75 Greater London practices. 130 978 adults aged 50–79 years registered with their general practices on 1 January 2005, with no recorded history of dementia or care home residence. A first recorded diagnosis of dementia and, where specified, subgroups of Alzheimer’s disease and vascular dementia during 2005–2013. The average annual concentrations during 2004 of nitrogen dioxide (NO2), particulate matter with a median aerodynamic diameter ≤2.5 µm (PM2.5) and ozone (O3) were estimated at 20×20 m resolution from dispersion models. Traffic intensity, distance from major road and night-time noise levels (Lnight) were estimated at the postcode level. All exposure measures were linked anonymously to clinical data via residential postcode. HRs from Cox models were adjusted for age, sex, ethnicity, smoking and body mass index, with further adjustments explored for area deprivation and comorbidity. 2181 subjects (1.7%) received an incident diagnosis of dementia (39% mentioning Alzheimer’s disease, 29% vascular dementia). There was a positive exposure response relationship between dementia and all measures of air pollution except O3, which was not readily explained by further adjustment. Adults living in areas with the highest fifth of NO2 concentration (>41.5 µg/m3) versus the lowest fifth (<31.9 µg/m3) were at a higher risk of dementia (HR=1.40, 95% CI 1.12 to 1.74). Increases in dementia risk were also observed with PM2.5, PM2.5 specifically from primary traffic sources only and Lnight, but only NO2 and PM2.5 remained statistically significant in multipollutant models. Associations were more consistent for Alzheimer’s disease than vascular dementia. We have found evidence of a positive association between residential levels of air pollution across London and being diagnosed with dementia, which is unexplained by known confounding factors.
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DOI：
10.1016/s0140-6736(17)30505-6
发表时间：
2017-05-13
期刊：
Lancet (London, England)
影响因子：
--
作者：
Cohen AJ;Brauer M;Burnett R;Anderson HR;Frostad J;Estep K;Balakrishnan K;Brunekreef B;Dandona L;Dandona R;Feigin V;Freedman G;Hubbell B;Jobling A;Kan H;Knibbs L;Liu Y;Martin R;Morawska L;Pope CA 3rd;Shin H;Straif K;Shaddick G;Thomas M;van Dingenen R;van Donkelaar A;Vos T;Murray CJL;Forouzanfar MH
通讯作者：
Forouzanfar MH
影响因子：
6.8
作者：
Cacciottolo M;Wang X;Driscoll I;Woodward N;Saffari A;Reyes J;Serre ML;Vizuete W;Sioutas C;Morgan TE;Gatz M;Chui HC;Shumaker SA;Resnick SM;Espeland MA;Finch CE;Chen JC
通讯作者：
Chen JC
影响因子：
5
作者：
Ailshire, Jennifer A.;Crimmins, Eileen M.
通讯作者：
Crimmins, Eileen M.
影响因子：
14
作者：
Brookmeyer, Ron;Johnson, Elizabeth;Arrighi, H. Michael
通讯作者：
Arrighi, H. Michael
影响因子：
7.2
作者：
Carey, Iain M.;Shah, Sunil M.;Cook, Derek G.
通讯作者：
Cook, Derek G.