Invited commentary: how exposure to air pollution may shape dementia risk, and what epidemiology can say about it.
Invited commentary: how exposure to air pollution may shape dementia risk, and what epidemiology can say about it.
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特邀评论：接触空气污染如何影响痴呆风险，以及流行病学对此有何看法。
DOI：
10.1093/aje/kwu153
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发表时间：
2014
影响因子：
5
通讯作者：
Weuve,Jennifer
中科院分区：
文献类型：
--
作者：
Weuve,Jennifer
预计到2050年，美国阿尔茨海默病(AD)痴呆症的人数将增加两倍。目前还没有有效的治疗方法，预防研究的重点是行为和医疗条件，这些很难在人群层面上加以改变。心血管疾病流行病学可以为寻找AD危险因素提供信息；暴露于细颗粒物(PM)空气污染会增加心血管风险，污染物法规似乎可以减少心血管死亡，血管病理影响痴呆症风险。在本期《华尔街日报》上，Ailshire and Crimmins(Am J Epidformol.2014；180(4)：359-366)报告了对生活在美国各地的14,000名老年人的数据分析，表明暴露在PM和认知功能之间存在负相关，这一结果与AD有关，因为在临床疾病之前，认知能力会长期下降。他们的工作加入了越来越多的数据，这些数据将PM暴露与AD风险联系起来。如果这些数据反映了因果关系，PM暴露将是为数不多的AD风险因素之一，这些因素不仅广泛存在，而且还可以通过监管干预在人群水平上进行修改。空气污染和痴呆症流行病学家之间的积极合作对于完善现有证据和填补根本空白至关重要，包括缺乏关于AD本身的研究。
The number of Americans with Alzheimer's disease (AD) dementia is expected to triple by 2050. No effective treatments exist, and prevention research has focused on behaviors and medical conditions, which have been difficult to modify at the population level. Cardiovascular disease epidemiology can inform the search for AD risk factors; exposure to fine particulate matter (PM) air pollution increases cardiovascular risk, pollutant regulations appear to reduce cardiovascular deaths, and vascular pathology influences dementia risk. In this issue of theJournal, Ailshire and Crimmins (Am J Epidemiol.2014;180(4):359–366) report analyses of data from 14,000 older adults living across the United States, indicating an inverse association between exposure to PM and cognitive function, an outcome related to AD by virtue of the long period of cognitive decline that precedes clinical disease. Their work joins a growing body of data linking PM exposure to AD risk. If these data reflect causality, PM exposure would be 1 of few AD risk factors that are not only widespread, but that also can be modified at the population level using regulatory intervention. Active collaboration between air pollution and dementia epidemiologists will be critical for refining the available evidence and filling fundamental gaps, including the lack of studies on AD itself.