Modelling historical air pollution and dementia/cognitive decline - towards a life course approach

空气污染与多种健康问题有关。然而，迄今为止还无法调查空气污染在发展多年或数十年发展的重要慢性健康状况中所起的作用，例如痴呆症（包括阿尔茨海默病和血管性痴呆）。这是由于在20世纪80年代之前对空气污染缺乏系统的监测。本项目将尝试通过利用各种空气污染物（二氧化氮[NOx]、二氧化硫[SO2]和细颗粒物[直径小于2.5微米或10微米；分别为PM2.5和PM10]）排放的历史数据，结合历史气象条件，制作20世纪中期的历史空气污染估算模型，来弥补这一研究缺口。然后，我们将把污染模型的输出与两个队列研究结合起来：(a)一个完整的人口窄年龄队列（苏格兰心理调查1947年队列，1947年11岁的70000人），其中通过电子健康记录和死亡证明确定痴呆症诊断；(b)该队列的一个子集（1936年洛锡安出生队列研究，N~1000），自2004年招募以来进行了纵向认知测试和临床痴呆诊断。这个项目将使我们能够证明，通过建模来估计历史空气污染数据是可能的，并将这些数据与现有的队列研究相结合，以调查痴呆症的生命历程起源。扩展这项工作的未来可能性包括：(i)对更多时间点的空气污染进行建模，以获得在整个生命过程中“暴露”于空气污染的更细粒度的概念；（ii）将模拟的空气污染数据与英国、欧洲和国际上的进一步队列研究联系起来；（三）将这些原则应用于其他慢性疾病，如心血管疾病。关键词：空气污染，痴呆，危险因素，生命历程流行病学，预防，建模普通大众；苏格兰老年痴呆症（慈善机构）；学术界；媒体;公共卫生

Air pollution has been linked with a variety of health problems. However, it has not hitherto been possible to investigate what role air pollution plays in the development of important chronic health conditions which develop over many years or decades, such as, for example, dementia (including Alzheimer disease and vascular dementia). This is due to little systematic monitoring of air pollution before the 1980s. This project will attempt to remedy this research gap by producing modelled historical air pollution estimates for the mid-twentieth century using historical data on emission of various air pollutants (nitrogen dioxides [NOx], sulphur dioxide [SO2] and fine particulate matter [smaller than 2.5 micrometres or 10 micrometres in diameter; PM2.5 and PM10, respectively], in combination with historical meteorological conditions). We will then combine the pollution model output with two cohort studies: (a) a complete population narrow-age cohort (the Scottish Mental Survey 1947 cohort, N~70,000 all aged 11 in 1947) where dementia diagnoses have been ascertained through electronic health records and death certificates; and (b) a subset of this cohort (the Lothian Birth Cohort 1936 study, N~1000) who have had longitudinal cognitive testing and clinical dementia diagnoses ascertained since recruitment in 2004.This project will allow us to demonstrate that it is possible to estimate historical air pollution data through modelling and to combine these data with existing cohort studies in order to investigate the life course origins of dementia. Future possibilities to extend this work include: (i) modelling air pollution over more time points to get a finer-grained idea of 'exposure' to air pollution throughout the course of life; (ii) linking the modelled air pollution data with further cohort studies in the UK, Europe, and internationally; and (iii) applying these principles to other chronic diseases, such as cardiovascular disease.KEYWORDS: Air pollution, Dementia, Risk Factors, Life Course Epidemiology, Prevention, ModellingSTAKEHOLDERS: People with dementia and their families; the general population; Alzheimer Scotland (charity); the academic community; the media; Public Health