Air Pollution and Cognitive Aging Among Older Women

描述(由申请人提供)：认知功能下降是继发性痴呆症的强烈预测因素，也是老年人的一个重要健康问题，他们的人数将在未来几十年迅速增长。在认知能力下降的潜在风险因素中，暴露在环境毒素中是可以改变的--既可以由个人也可以通过法规来改变。特别是，间接证据表明，长期暴露在空气污染中可能与认知能力下降有关。在对狗和人类的尸检研究中，暴露在空气污染中与大脑中类似阿尔茨海默病的变化有关。此外，大量数据描述了暴露在颗粒性空气污染--空气中悬浮的颗粒物--与心血管疾病(CVD)之间的联系，而CVD的许多风险因素似乎也与认知能力下降有关。然而，人们对空气污染与认知能力下降的直接关系知之甚少。这种关联可能与女性特别相关，她们比患有认知障碍的男性具有更大的终生风险，而且似乎更容易受到空气污染对健康的影响。因此，我们建议进行一项探索性流行病学研究，研究空气污染暴露与老年女性认知能力下降的关系。这项研究是老龄化和环境健康学科的一次独特的合作，将利用护士健康研究(NHS)的现有数据，NHS是自1976年以来跟踪调查的一大批女性前瞻性队列。具体地说，从1995年开始，通过对20,000名年龄最大的参与者(70-81岁)进行有效的电话访谈，对认知功能进行了评估，每隔一年半进行一次系列评估。测试电池评估一般认知状态、言语记忆、执行功能、处理速度和工作记忆。估计了1999-2002年美国邻近地区暴露在胸部(PM10)和细颗粒物(PM2.5)空气污染中的量。对于拟议的项目，我们将把这些PM模型延长到1988年，对于每个女性，我们将估计她在1988年到她的第一次认知评估时间之间的平均PM暴露时间。我们还将使用马萨诸塞州大波士顿的详细暴露模型和居住在邻近美国的女性更一般的模型来检查交通产生的颗粒物的暴露情况。我们将评估长期接触这三种空气污染物--胸部、细颗粒物和交通颗粒物--是否与老年女性的认知能力下降有关。利用R21机制，这个探索性项目创新性地使用了基于地理信息系统(GIS)的空气颗粒物暴露模型，并结合电话认知评估，在一大批女性中探索空气污染和认知老化的新领域。该项目将产生重要证据，证明长期暴露在颗粒性空气污染和认知老化之间的关系是可信的，来自该项目的数据将推动进一步的工作，以确认和阐述所发现的任何联系，包括评估痴呆症风险和评估其他常见空气污染物(例如臭氧)。公共卫生相关性：认知功能下降是老年人的一个重要健康问题，并强烈预测一个人最终是否会患上痴呆症。初步证据表明，暴露在空气污染中可能与认知能力下降有关，尤其是在老年女性中。我们的项目名为《老年女性中的空气污染和认知老化》，在一大批老年女性中评估了这种关系。由于暴露在空气污染中是认知能力下降的潜在风险因素，可以通过法规和个人行为进行修改，我们的发现以及进一步的验证性数据可能会为降低大量高危人群中认知能力下降的风险提供潜在方向。

DESCRIPTION (provided by applicant): Decline in cognitive function is a strong predictor of subsequent dementia and is an important health issue in older adults, whose numbers will burgeon in coming decades. Among potential risk factors for cognitive decline that can be modified-by both individuals and regulations-are exposures to environmental toxins. In particular, indirect evidence suggests that chronic exposure to air pollution may be associated with cognitive decline. In autopsy studies of dogs and humans, air pollution exposure is associated with Alzheimer-like changes in the brain. Moreover, abundant data describe the association of exposure to particulate air pollution-particles suspended in the air-with cardiovascular disease (CVD), while many risk factors for CVD also appear related to cognitive decline. Yet, little is known about the direct relation of air pollution to cognitive decline. Such an association may be especially pertinent to women, who carry a greater lifetime risk than men of cognitive impairments and who appear to be disproportionately susceptible to the health effects of air pollution. Therefore, we propose to conduct an exploratory epidemiologic study of air pollution exposure in relation to cognitive decline among older women. This study, a unique collaboration of the of aging and environmental health disciplines, will capitalize on available data from the Nurses' Health Study (NHS), a large prospective cohort of women followed since 1976. Specifically, beginning in 1995, cognitive function has been assessed via a validated telephone interview among the 20,000 oldest participants (aged 70-81), with serial assessments occurring every 1.5 years after. The test battery assesses general cognitive status, verbal memory, executive function, processing speed, and working memory. Exposures to thoracic (PM10) and fine (PM2.5) particulate air pollution from 1999-2002 have been estimated for the contiguous United States (US) region. For the proposed project, we will extend these PM models back to 1988, and for each woman, we will estimate her average PM exposures over the interval from 1988 to the time of her first cognitive assessment. We will also examine exposure to traffic-generated particles, using both a detailed model of exposure in greater Boston, MA and a more general model for women living in the contiguous US. We will evaluate whether long-term exposure to each of the 3 air pollutants-thoracic, fine and traffic particles-is related to cognitive decline among older women. Using the R21 mechanism, this exploratory project innovatively uses air particulate exposure models, based on geographic information systems (GIS), with telephone cognitive assessments to explore the new area of air pollution and cognitive aging in a large cohort of women. This project will generate important evidence on the plausibility of a relation between long-term exposure to particulate air pollution and cognitive aging, and the data from this project will stimulate further work to confirm and elaborate any associations found, including evaluations of dementia risk and evaluations of other common air pollutants (e.g., ozone). PUBLIC HEALTH RELEVANCE: Decline in cognitive function is an important health issue in older adults and strongly predicts whether an individual will eventually develop dementia. Preliminary evidence suggests that exposure to air pollution may be related to cognitive decline, particularly among older women, and our project, entitled "Air Pollution and Cognitive Aging among Older Women," evaluates this relation in a large population of older women. Since exposure to air pollution is a potential risk factor for cognitive decline that can be modified-by regulations and individual behaviors-our findings, along with further confirmatory data, may offer potential direction for reducing the risk of cognitive decline among a large high-risk population.