Neighborhood Psychosocial Hazards and the Association of Cumulative Lead Dose With Cognitive Function in Older Adults
Neighborhood Psychosocial Hazards and the Association of Cumulative Lead Dose With Cognitive Function in Older Adults
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DOI：
10.1093/aje/kwn390
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发表时间：
2009-03-15
影响因子：
5
通讯作者：
Schwartz, Brian S.
中科院分区：
文献类型：
--
作者：
Glass, Thomas A.;Bandeen-Roche, Karen;Schwartz, Brian S.
在20世纪70年代之前，今天的美国老年人暴露在高水平的铅环境中。作者先前报道，终生累积铅剂量与老年人较低的认知测试表现有关。实验表明，环境压力可能加剧铅的有害影响。目前还没有针对这一问题的大规模、以人群为基础的研究。在巴尔的摩记忆研究（2001-2005）中，作者评估了胫骨铅与认知功能的横断面关联是否被邻里社会心理危害所改变，这是一项关于认知能力下降决定因素的纵向队列研究。采用（109）cd诱导k壳x射线荧光法测定胫骨铅含量。邻里社会心理危害独立于研究对象进行测量。从巴尔的摩市65个相邻社区随机抽取的1,001名年龄在50-70岁之间的不同人口统计学的成年人中获得了完整的数据。分层混合效应回归模型显示，在调整了年龄、性别、种族/民族、教育程度、测试技术人员和时间后，邻里社会心理危险加剧了胫骨铅在7个认知领域中的3个领域的不良关联（语言，P = 0.039；处理速度，P = 0.067；执行功能，P = 0.025）。环境压力和铅暴露在整个生命周期中的共同发生可能部分解释了晚年认知功能中持续存在的种族/民族和社会经济差异。
Before the 1970s, today's older Americans were exposed to high levels of lead in the environment. The authors previously reported that lifetime cumulative lead dose was associated with lower cognitive test performance in older adults. Experiments suggest that environmental stress may intensify the detrimental influence of lead. No large, population-based studies of this question have been done. The authors evaluated whether cross-sectional associations of tibia lead with cognitive function were modified by neighborhood psychosocial hazards in the Baltimore Memory Study (2001-2005), a longitudinal cohort study of determinants of cognitive decline. Tibia lead was measured via (109)Cd-induced K-shell X-ray fluorescence. Neighborhood psychosocial hazards were measured independently of study subjects. Complete data were available among 1,001 demographically diverse adults aged 50-70 years, randomly selected from 65 contiguous neighborhoods in Baltimore City. Hierarchical mixed-effects regression models showed that neighborhood psychosocial hazards exacerbated the adverse associations of tibia lead in 3 of 7 cognitive domains after adjustment for age, sex, race/ethnicity, education, testing technician, and time of day (language, P = 0.039; processing speed, P = 0.067; executive functioning, P = 0.025). The joint occurrence of environmental stress and lead exposure across the life span may partially explain persistent racial/ethnic and socioeconomic disparities in cognitive function in late life.