Association between solid fuel use and cognitive impairment: A cross-sectional and follow-up study in a middle-aged and older Chinese population
Association between solid fuel use and cognitive impairment: A cross-sectional and follow-up study in a middle-aged and older Chinese population
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DOI：
10.1016/j.envint.2020.106251
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发表时间：
2021-01-01
影响因子：
11.8
通讯作者：
Xia, Yang
中科院分区：
文献类型：
--
作者：
Cao, Limin;Zhao, Zhiying;Xia, Yang
背景：迄今为止，很少有研究关注室内空气污染对认知障碍的影响。因此，我们的目的是探讨家庭燃料的使用，家庭空气污染的主要原因，与认知功能之间的中年和老年人的样本Chinese.Methods：共10,372和8,397名参与者从中国健康和退休纵向研究（CHARLS）的横断面和随访分析，分别入组。认知功能通过结构化问卷在三个维度进行评估：定向和注意力，情景记忆和视觉构建。家庭固体燃料使用（用于烹饪和加热）和认知功能之间的关联是由广义线性模型阐明的。此外，我们探讨了在烹饪和加热固体燃料的使用的综合效果，并检查切换烹饪燃料类型的影响，对4年的变化在认知functioning.Results：在横断面研究中，固体燃料使用烹饪或加热，单独或同时，与认知功能障碍，调整后的潜在混杂因素。同样，在后续研究中，固体烹饪燃料的使用与整体认知得分的更大下降有关（β = 0.24，95%置信区间[CI]：-0.45，-0.04），主要发生在情景记忆中（β =-0.19，95%CI：-0.34，0.03）和视觉结构（β =-0.03，95%CI：-0.05，-0.01）维度;固体加热燃料的使用仅与定向和注意力维度的较大下降相关（β =-0.13，95%CI：-0.25，0.01）。家庭燃料使用的综合影响也被观察到（P < 0.05）。此外，从固体燃料转换为清洁烹饪燃料的受试者在所有维度上的认知下降程度均显著低于持续使用固体燃料的受试者（P < 0.05）。因此，改善烹饪燃料的结构可能对预防认知障碍具有巨大的公共卫生价值。
Background: To date, few studies have focused on the influence of indoor air pollution on cognitive impairment. Thus, we aimed to explore the association of household fuel use, the major cause of household air pollution, with cognitive functioning among a sample of middle-aged and older Chinese individuals.Methods: A total of 10,372 and 8,397 participants from the China Health and Retirement Longitudinal Study (CHARLS) were enrolled in the cross-sectional and follow-up analyses, respectively. Cognitive functioning was evaluated via a structured questionnaire in three dimensions: orientation and attention, episodic memory, and visuo-construction. The associations between household solid fuel use (for cooking and heating) and cognitive functioning were elucidated by generalized linear models. Furthermore, we explored the combined effect of solid fuel use in cooking and heating and examined the effects of switching cooking fuel types on a 4-year change in cognitive functioning.Results: In the cross-sectional study, solid fuel use for cooking or heating, separately or simultaneously, was positively associated with cognitive impairment, after adjusting for potential confounders. Similarly, in the follow-up study, solid cooking fuel use was associated with a greater decline in cognitive score overall (beta = 0.24, 95% confidence interval [CI]:-0.45,-0.04), mostly in the episodic memory (beta = -0.19, 95% CI:-0.34, 0.03) and visuo-construction (beta = -0.03, 95% CI:-0.05,-0.01) dimensions; solid heating fuel use was associated only with a greater decrease in the orientation and attention dimension (beta = -0.13, 95% CI: -0.25, 0.01). A combined effect of household fuel use was also observed (P < 0.05). Moreover, subjects who switched from solid to cleaner cooking fuel displayed a significantly lower degree of cognitive decline for all dimensions than did persistent solid fuel users over a 4-year period (P < 0.05).Conclusion: Our findings show that household solid fuel use is a risk factor for the development of cognitive impairment. Improving the structure of cooking fuel may therefore have great public health value for the prevention of cognitive impairment.