Cumulative lead dose and cognitive function in older adults.
Cumulative lead dose and cognitive function in older adults.
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DOI：
10.1097/ede.0b013e3181b5f100
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发表时间：
2009-11
期刊：
影响因子：
--
通讯作者：
Schwartz BS
中科院分区：
文献类型：
--
作者：
Bandeen-Roche K;Glass TA;Bolla KI;Todd AC;Schwartz BS
To evaluate whether cumulative lead dose from environmental exposures is associated with cognitive function and decline, and whether persistent, reversible, or progressive effects are indicated. We used longitudinal linear modeling to evaluate associations of tibia lead concentration with cognitive function and decline in socio-demographically diverse, community-dwelling adults, aged 50-70 years, randomly selected from neighborhoods in Baltimore. Six summary measures of cognitive function were created from standard tests in these domains: language, processing speed, eye-hand coordination, executive functioning, verbal memory and learning, and visual memory. The mean (SD) tibia lead level was 18.8 (11.6) μg/g. In models adjusting for demographic characteristics, socioeconomic status (SES), and race/ethnicity, higher tibia lead was associated with a progressive decline in eye-hand coordination in all subjects; stratified analysis substantiated this association only in African-Americans. In all subjects, tibia lead was associated with persistent effects with worse cognitive function in all six domains, but these associations weakened after increasing covariate control. In fully adjusted stratified analysis, persistent effects were present in whites in eye-hand coordination, executive functioning, and verbal memory and learning. The study presents the strongest adult evidence to date in a diverse population of the impacts of cumulative lead dose on cognitive function independent of SES. As the study population was relatively young and the average total duration of follow-up short (< 30 months), the findings may represent the lower bound of what the impact of cumulative lead dose might be on the cognitive function of older Americans.
