A Scoping Review of the Effects of Ambient Air Quality on Cognitive Frailty
A Scoping Review of the Effects of Ambient Air Quality on Cognitive Frailty
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DOI：
10.3390/environments11010004
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发表时间：
2023-12
期刊：
影响因子：
3.7
通讯作者：
James Robert Hodgson;Charlotte Benkowitz;Brian C. Castellani;Amanda Ellison;Rammina Yassaie;Helen Twohig;R. Bhudia;O. Jutila;Sally Fowler-Davis
中科院分区：
文献类型：
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作者：
James Robert Hodgson;Charlotte Benkowitz;Brian C. Castellani;Amanda Ellison;Rammina Yassaie;Helen Twohig;R. Bhudia;O. Jutila;Sally Fowler-Davis
环境和公共卫生研究对空气质量对大脑健康的影响给予了相当大的关注，系统的评价也很普遍。没有文献综述已经进行了认知功能障碍，一个多维综合征相结合的身体虚弱和认知功能障碍及其明显的相互依赖，与脆弱性增加和不良的健康后果，包括痴呆症。相反，认知能力下降和虚弱是通过对老年人的空气质量和认知能力和身体能力下降的共病研究来隐性探索的。进行了范围界定审查，以探讨是否需要进行系统性审查。结合Arksey和O 'Malley以及PRISMA-ScR检查表，使用“认知 *”+“弹性”+“空气质量”或“认知 *”+“老化”+“空气质量”对SCOPUS进行范围审查，得到n = 2503篇文章，使用纳入和排除标准筛选并减少到n = 16篇文章。空气质量似乎是认知能力下降的一个关键风险因素，即使空气质量水平低于世卫组织的目标。中度长期的环境空气污染似乎与认知能力脆弱的风险增加有关，这表明更早和更积极的干预措施可以保护老年人。在整个生命过程中，对认知的影响各不相同，既有情感上的影响，也有功能上的影响。影响可能对现有条件的老年人更加有害，包括经济和健康不平等。由于缺乏剂量反应、方法差异、控制共病效应和研究间差异，结果的概括性有限。尚未对认知功能障碍进行文献综述，主要是因为目前尚未将其视为明确的结局。研究结果支持需要更多的研究和更广泛的文献总结，但表明由于PM2.5浓度增加，在生命过程中认知功能会恶化。此外，空气质量似乎是一个关键的风险因素，即使低于世界卫生组织的目标。
Environmental and public health research has given considerable attention to the impact of air quality on brain health, with systematic reviews being widespread. No literature review has been conducted for cognitive frailty—a multidimensional syndrome combining physical frailty and cognitive impairment and their apparent co-dependence, linked to increased vulnerability and adverse health outcomes, including dementia. Instead, cognitive decline and frailty are implicitly explored through research on air quality and comorbid cognitive and physical decline in elderly populations. A scoping review was conducted to explore the need for a systematic review. Combining the Arksey and O’Malley, and PRISMA-ScR checklist, a scoping review of SCOPUS using ‘cogniti*’ + ‘resilience’ + ‘air quality’ or ‘cogniti*’ + ‘ageing’ + ‘air quality’ resulted in n = 2503 articles, screened and reduced using inclusion and exclusion criteria, to n = 16 articles. Air quality appears to be a critical risk factor for cognitive decline, even at air quality levels below WHO targets. Moderate long-term ambient air pollution appears linked to increased risk of cognitive frailty, suggesting earlier and more active interventions to protect older people. There are varied effects on cognition across the life course, with both emotional and functional impacts. Effects may be more detrimental to elderly people with existing conditions, including economic and health inequalities. Generalisation of results is limited due to the absence of a dose–response, variations in methods, controlling for comorbid effects, and variance across studies. No literature review has been performed for cognitive frailty, largely due to the fact that it is not presently treated as an explicit outcome. The findings support the need for more research and a more extensive summary of the literature but suggest that there is worsening cognitive function over the life course as a result of increased PM2.5 concentrations. Furthermore, air quality appears to be a critical risk factor even at levels below World Health Organisation targets.