Air pollution and noise exposures in relation to dementia: from brain imaging markers to clinical disease

项目摘要 越来越多的证据表明，暴露在空气污染中可能会导致认知功能受损 阿尔茨海默病和相关痴呆(ADRD)的风险增加。更新、更稀少的证据 暗示这些结果也可能受到环境噪音的影响。如果这些环境暴露造成 会使老年人的认知能力恶化，他们将是少数几个普遍存在的认知障碍的危险因素之一 进行大范围的修改，以造福于整个人口。尽管对公共健康有重大影响，但 我们对空气污染和噪音如何影响神经认知老化的知识存在严重限制。大多数关于 这些与ADRD有关的暴露依赖于医疗或卫生行政记录，这些记录提供了 关于痴呆症状态的数据令人震惊地不可靠。这两种暴露都会增加心血管风险。如果医疗保健使用 因为这些情况使得痴呆症患者更有可能被诊断出患有痴呆症，而不是使用医疗记录 估计空气污染和噪音与ADRD风险的关系可能会高估这些联系。一个 第二个限制是，这些暴露促进认知恶化的机制是 尚不清楚，尽管已经提出了脑血管通路。最后，空气污染和环境噪音往往 同时发生，但很少有研究能够确定这些暴露是否会放大彼此的影响。至 克服这些限制和知识差距，我们建议调查空气污染的影响和 噪声暴露对认知功能减退和ADRD的影响，并使用脑MRI测量来评估这些 暴露对脑血管损伤和神经元死亡的影响我们利用了两个大的，种族上的 对老年人的各种基于人群的队列研究，芝加哥健康和老龄化项目(CHAP)和 亲子复原力与认知健康(PORCH)研究我们将整合来自队列的数据 参与者的认知衰退、ADRD和脑MRI，以及他们长期暴露在噪音中的估计 和交通造成的空气污染，这是与台地空气和附属项目持续合作产生的。我们 将重点关注与交通相关的空气污染(陷阱)，因为交通仍然是最普遍的来源之一 暴露在空气污染中。这项工作通过以下方式扩展了我们正在进行的研究：研究脑MRI测量 脑血管损伤；评估TRAP的其他成分，包括从刹车和刹车释放的金属 轮胎磨损；以及评估陷阱和噪音的组合影响。我们最重要的假设是 陷阱和噪声暴露会加速认知能力下降，增加ADRD风险，并促进脑血管疾病 脑缺血和脑萎缩。我们进一步假设，陷阱和噪声暴露共同影响这些 结果，这些结果超出了它们各自与这些结果的联系的预期。 环境污染物的减少已经使人们的健康受益。来自这里的数据 该项目可能为进一步减少人口负担提供动力--减少ADRD人口负担的前景 并将空气污染和噪声确定为人口层面的ADRD预防战略的目标。

PROJECT ABSTRACT Burgeoning evidence suggests that exposure to air pollution may result in impaired cognitive function, cognitive decline, and increased risk of Alzheimer's disease and related dementias (ADRD). Newer, sparser evidence hints that these outcomes could also be influenced by ambient noise. If these environmental exposures do worsen cognition in older adults, they would be among the few pervasive risk factors for cognitive loss that can be modified on broad scale to benefit entire populations. Despite major implications for public health, there are critical limitations in our knowledge of how air pollution and noise affect neurocognitive aging. Most studies of these exposures in relation to ADRD have relied on medical or health administrative records, which provide strikingly unreliable data on dementia status. Both exposures increase cardiovascular risk. If health care use for these conditions makes it more likely that a person with dementia is diagnosed, then using medical records to estimate of the relation of air pollution and noise to ADRD risk could overestimate these associations. A second limitation is that the mechanisms by which these exposures promote cognitive deterioration are unclear, although cerebrovascular pathways have been proposed. Finally, air pollution and ambient noise often co-occur, yet few studies have been able to determine if these exposures amplify each other's effects. To overcome these limitations and knowledge gaps, we propose to investigate the effects of air pollution and noise exposure on cognitive decline and ADRD and, using brain MRI measurements, to evaluate these exposures' influence on cerebrovascular injury and neuronal death. We take advantage of 2 large, racially diverse population-based cohort studies of older adults, the Chicago Health and Aging Project (CHAP) and the Parent Offspring Resilience and Cognitive Health (PORCH) study. We will integrate data from cohort participants on cognitive decline, ADRD, and brain MRI with estimates of their long-term exposures to noise and air pollution from traffic, generated in ongoing collaboration with the MESA Air and ancillary projects. We will focus on traffic-related air pollution (TRAP), because traffic remains one of the most pervasive sources of air pollution exposure. This work extends our ongoing research by: investigating brain MRI measures of cerebrovascular injury; evaluating other constituents of TRAP, including the metals released from brake and tire wear; and evaluating the effects of TRAP and noise in combination. Our overarching hypothesis is that TRAP and noise exposures hasten cognitive decline, increase ADRD risk, and promote cerebrovascular ischemia and brain atrophy. We further hypothesize that TRAP and noise exposure together influence these outcomes, above and beyond what would be expected from their individual associations with these outcomes. Reductions in environmental pollutants have already benefited the population's health. The data from this project may provide impetus—the prospect of reducing the population burden of ADRD—for further reductions and identify both air pollution and noise as targets for population-level strategies for ADRD prevention.