Role of air pollution and socioeconomic position on cognitive function over six years in the United States

项目概要（摘要） 阿尔茨海默病和相关病症代表了巨大的公共卫生和卫生保健负担， 对可改变的风险因素进行创新研究。对痴呆症可修正预测因子的研究已经转向 暴露在环境中。先前的研究表明，空气污染会加速老年人的认知能力下降 人口。但这项研究存在重大空白。很少有研究使用纵向测量， 具有全国代表性。此外，迫切需要进行更全面的研究 社会经济地位（SEP）。虽然已知认知结果因SEP而异，但关节 空气污染和SEP的影响在很大程度上仍然未知。我们的研究建议探索空气对 污染（PM2.5）对认知能力下降的影响，以及空气污染和SEP之间相互作用的可能性。 空气污染暴露因SEP而异;处境不利的个人暴露于更多的空气污染。 在评估空气污染对认知的影响时，SEP的核算很重要。此外，我们认为 空气污染对认知结果的影响对于SEP高的人与SEP低的人不同， 我提交我的建议供考虑，以支持我的论文研究，与 总体目标是进一步研究认知老化和痴呆症的环境和社会决定因素。 本申请的总体目标是确定空气污染和SEP是否以及如何影响认知能力。 下降我的具体目标如下：目标1评估空气污染与认知能力之间的关系。 国家健康和老龄化趋势研究（NHATS）。NHATS始于2011年， 全国代表性的65岁及以上的医疗保险患者人群， 评估。通过将估计空气污染的气溶胶光学厚度模型与个人水平的NHATS数据联系起来， 我们可以模拟NHATS参与者长期接触PM2.5的情况。目标2考察空气的联合效应 污染和SEP对认知水平和NHATS下降的影响。SEP将被衡量为教育，收入， 先进的统计方法，包括多层次的建模， 个人和普查区水平的变化，将为了解空气污染对 认知老化 这项研究提供了一个及时的机会，有助于新兴的文学如何环境和社会 随着时间的推移，暴露会相互作用，塑造老年人的认知功能。因为政策改革可能会 针对环境和社会因素中的一个或两个，这项研究建议的结果可以提供信息， 决策，使最有可能受影响的人受益。在我优秀的导师团队的支持下- 认知老化和痴呆症、健康的社会决定因素和空气污染等方面的专家肯定， 建议将有助于预测认知老化的研究，并提高我所需的技能，以进一步 在后续的研究中。

PROJECT SUMMARY (ABSTRACT) Alzheimer's Disease and related disorders represent a huge public health and health care burden, prompting innovative research of modifiable risk factors. The search for modifiable predictors of dementia has turned towards environmental exposures. Prior research suggests air pollution accelerates cognitive decline in older populations. But this research has major gaps. Few studies have used longitudinal measures, nor have they been nationally-representative. Additionally, there's an urgent need for studies that more comprehensively account for socioeconomic position (SEP). While it is known that cognitive outcomes vary by SEP, the joint effect of air pollution and SEP remains largely unknown. Our study proposes to explore the impact of air pollution (PM2.5) on cognitive decline, and the potential for interaction between air pollution and SEP. Air pollution exposure varies by SEP; more disadvantaged individuals are exposed to more air pollution. Accounting for SEP is important when evaluating the effects of air pollution on cognition. Further, we believe that the effect of air pollution on cognition outcomes is different for those with high SEP compared to those with lower SEP. I'm submitting my proposal for consideration in order to support my dissertation research, with the overall goal of furthering study of environmental and social determinants of cognitive aging and dementia. The overall objective of this application is to determine if and how air pollution and SEP influence cognitive decline. My specific aims are as follows: Aim 1 assesses the relationship between air pollution and cognitive level and decline in the National Health and Aging Trends Study (NHATS). Started in 2011, NHATS follows a nationally-representative population of Medicare patients 65 years and older, with annual, in-person cognitive assessments. By linking aerosol optical depth models estimating air pollution to individual-level NHATS data, we can model long-term exposure to PM2.5 among NHATS participants. Aim 2 examines the joint effect of air pollution and SEP on cognitive level and decline in NHATS. SEP will be measured as education, income, financial strain, and neighborhood-SEP. Advanced statistical methods, including multi-level modeling of individual and census-tract level change, will provide a strong basis for understanding effects of air pollution on cognitive aging. This study presents a timely opportunity to contribute to emerging literature on how environmental and social exposures interact to shape cognitive function over time in older adults. Because policy reforms can potentially target either or both environmental and social factors, the findings of this research proposal can inform decision-making, benefitting those most likely affected. With the support of my terrific mentorship team— experts in cognitive aging and dementia, social determinants of health, and air pollution exposure—this proposal will contribute to predictors of cognitive aging research, and enhance skills required for me to further this area in subsequent research.