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Environmental risk factors for dementia: a systematic review
Killin LO, Starr JM, Shiue IJ, Russ TC.. BMC geriatrics, 2016-10-12
Topic: Risk, prevention and care in population studies
Background Dementia risk reduction is a major and growing public health priority. While certain modifiable risk factors for dementia have been identified, there remains a substantial proportion of unexplained risk. There is evidence that environmental risk factors may explain some of this risk. Thus, we present the first comprehensive systematic review of environmental risk factors for dementia. Methods We searched the PubMed and Web of Science databases from their inception to January 2016, bibliographies of review articles, and articles related to publically available environmental data. Articles were included if they examined the association between an environmental risk factor and dementia. Studies with another outcome (for example, cognition), a physiological measure of the exposure, case studies, animal studies, and studies of nutrition were excluded. Data were extracted from individual studies which were, in turn, appraised for methodological quality. The strength and consistency of the overall evidence for each risk factor identified was assessed. Results We screened 4784 studies and included 60 in the review. Risk factors were considered in six categories: air quality, toxic heavy metals, other metals, other trace elements, occupational-related exposures, and miscellaneous environmental factors. Few studies took a life course approach. There is at least moderate evidence implicating the following risk factors: air pollution; aluminium; silicon; selenium; pesticides; vitamin D deficiency; and electric and magnetic fields. Conclusions Studies varied widely in size and quality and therefore we must be circumspect in our conclusions. Nevertheless, this extensive review suggests that future research could focus on a short list of environmental risk factors for dementia. Furthermore, further robust, longitudinal studies with repeated measures of environmental exposures are required to confirm these associations.
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APA 7th
Killin, L. O., Starr, J. M., Shiue, I. J., & Russ, T. C. (2016). Environmental risk factors for dementia: a systematic review. BMC geriatrics. https://doi.org/10.1186/s12877-016-0342-y
Vancouver
Killin LO, Starr JM, Shiue IJ, Russ TC. Environmental risk factors for dementia: a systematic review. BMC geriatrics. 2016. doi:10.1186/s12877-016-0342-y. PMID: 27729011.
BibTeX
@article{killin2016-27729011,
author = {Killin, L. O. and Starr, J. M. and Shiue, I. J. and Russ, T. C.},
title = {{Environmental risk factors for dementia: a systematic review}},
journal = {BMC geriatrics},
year = {2016},
doi = {10.1186/s12877-016-0342-y},
pmid = {27729011},
url = {https://doi.org/10.1186/s12877-016-0342-y}
}
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Key findings
- The strength and consistency of the overall evidence for each risk factor identified was assessed.
- Results We screened 4784 studies and included 60 in the review.
- Nevertheless, this extensive review suggests that future research could focus on a short list of environmental risk factors for dementia.
Why it matters
This systematic review examined environmental risk factors for dementia across categories such as air quality, heavy metals, and occupational exposures. It assessed the strength and consistency of evidence and suggests future research could focus on a short list of environmental risk factors, but it does not identify a treatment, cure, or proven prevention.
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Study details
- Study designsystematic review
- Participants60
- Evidence strengthHigh
How this study scored 69/100
Published in a peer-reviewed journal, and it is a systematic review of all the studies on the question. Scored zero for effect reported because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (BMC geriatrics) |
| Journal's citation record | 2 / 4 | BMC Geriatrics: journal h-index 153 (OpenAlex, 2026-10-29) |
| Study design | 12 / 12 | A systematic review of all the studies on the question |
| Strength of evidence | 5 / 5 | Rated “high” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 1 / 5 | 2016 — within 20 year(s) of the newest study here |
| Sample size | 1 / 4 | 60 participants |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomised / blinded | 0 / 2 | A review of other studies — randomisation is not credited here |
| Times cited | 6 / 7 | Cited 439 times (OpenAlex, 2026-10-10) |
| Citations per year | 4 / 5 | 36.6 citations a year over 12 year(s) since 2016 |
| Impact for its field and year | 3 / 6 | Cited 4.4× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 3 / 6 | Cited by 20 other studies in this library |
| Still being cited | 3 / 4 | Cited 113 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 2 / 4 | Last-listed author Tom C. Russ: h-index 45 (OpenAlex, whole career) |
| Institution's track record | 1 / 3 | University of Edinburgh: institution h-index 1,378 (OpenAlex) |
| Multi-centre collaboration | 2 / 3 | OpenAlex lists 4 institution(s) in 1 country |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 27729011) |
| Free to read | 2 / 2 | Free to read |
| Total | 69 / 100 | — |
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