Short-term associations between warm-season ambient temperature and emergency department visits for Alzheimer's disease and related dementia in five US states.
Short-term associations between warm-season ambient temperature and emergency department visits for Alzheimer's disease and related dementia in five US states.
复制标题
美国五个州暖季环境温度与阿尔茨海默病和相关痴呆症急诊就诊之间的短期关联。
DOI：
10.1016/j.envres.2022.115176
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发表时间：
2023
影响因子：
8.3
通讯作者：
Chang,HowardH
中科院分区：
文献类型：
--
作者：
Zhang,Yuzi;Ebelt,StefanieT;Shi,Liuhua;Scovronick,NoahC;D'Souza,RohanR;Steenland,Kyle;Chang,HowardH
背景：由于气候变化，预计未来环境温度将升高。阿尔茨海默病（AD）和阿尔茨海默病相关痴呆（ADRD）影响着数百万人，在美国代表着巨大的健康负担。高温可能是AD/ADRD结果的危险因素，最近几项研究报告了温度与AD死亡率之间的关联。然而，热量和阿尔茨海默病发病率之间的联系尚不清楚。研究人员在美国五个州（加利福尼亚州、密苏里州、北卡罗来纳州、新泽西州和纽约州）研究了长达14年（2005-2018年）暖季（5月至10月）45岁及以上个体的日常环境温度与AD/ADRD急诊科（ED）就诊之间的短期关联。每日邮政编码水平的最高、平均和最低温度暴露来自1公里网格化的Daymet产品。使用条件逻辑回归的时间分层病例交叉设计评估关联。结果我们发现，在5个州的340万AD/ADRD ED患者中，环境温度具有一致的积极短期影响。每日平均温度的3天积温暴露从第50个百分位数增加到第95个百分位数与AD/ADRD ED就诊的合并优势比为1.042 （95% CI: 1.034, 1.051）相关。我们观察到的证据表明，65-74岁的患者和因急诊科就诊而入院的患者的相关性更强。与其他原因的ED访问相比，AD/ADRD ED访问的温度相关性也更强，特别是在65-74岁的患者中。结论AD/ADRD患者可能是短期高温暴露的易感人群。我们的研究结果支持在全球变暖的背景下制定有针对性的策略来减少与热相关的AD/ADRD发病率。
AbstractsBackgroundAmbient temperatures are projected to increase in the future due to climate change. Alzheimer's disease (AD) and Alzheimer's disease-related dementia (ADRD) affect millions of individuals and represent substantial health burdens in the US. High temperature may be a risk factor for AD/ADRD outcomes with several recent studies reporting associations between temperature and AD mortality. However, the link between heat and AD morbidity is poorly understood.MethodsWe examined short-term associations between warm-season daily ambient temperature and AD/ADRD emergency department (ED) visits for individuals aged 45 years or above during the warm season (May to October) for up to 14 years (2005–2018) in five US states: California, Missouri, North Carolina, New Jersey, and New York. Daily ZIP code-level maximum, average and minimum temperature exposures were derived from 1 km gridded Daymet products. Associations are assessed using a time-stratified case-crossover design using conditional logistic regression.ResultsWe found consistent positive short-term effects of ambient temperature among 3.4 million AD/ADRD ED visits across five states. An increase of the 3-day cumulative temperature exposure of daily average temperature from the 50th to the 95th percentile was associated with a pooled odds ratio of 1.042 (95% CI: 1.034, 1.051) for AD/ADRD ED visits. We observed evidence of the association being stronger for patients 65–74 years of age and for ED visits that led to hospital admissions. Temperature associations were also stronger among AD/ADRD ED visits compared to ED visits for other reasons, particularly among patients aged 65–74 years.ConclusionPeople with AD/ADRD may represent a vulnerable population affected by short-term exposure to high temperature. Our results support the development of targeted strategies to reduce heat-related AD/ADRD morbidity in the context of global warming.