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Long-term exposure to air pollution and hospitalization for dementia in the Rome longitudinal study
Cerza F, Renzi M, Gariazzo C, Davoli M, Michelozzi P, Forastiere F, Cesaroni G.. Environmental health : a global access science source, 2019-08-09
Topic: Air pollution and environmental exposures
Background Few studies have explored the role of air pollution in neurodegenerative processes, especially various types of dementia. Our aim was to evaluate the association between long-term exposure to air pollution and first hospitalization for dementia subtypes in a large administrative cohort. Methods We selected 350,844 subjects (free of dementia) aged 65-100 years at inclusion (21/10/2001) and followed them until 31/12/2013. We selected all subjects hospitalized for the first time with primary or secondary diagnoses of various forms of dementia. We estimated the exposure at residence using land use regression models for nitrogen oxides (NOx, NO 2 ) and particulate matter (PM) and a chemical transport model for ozone (O 3 ). We used Cox models to estimate the association between exposure and first hospitalization for dementia and its subtypes: vascular dementia (Vd), Alzheimer's disease (Ad) and senile dementia (Sd). Results We selected 21,548 first hospitalizations for dementia (7497 for Vd, 7669 for Ad and 7833 for Sd). Overall, we observed a negative association between exposure to NO 2 (10 μg/m 3 ) and dementia hospitalizations (HR = 0.97; 95% CI: 0.96-0.99) and a positive association between exposure to O 3 , NOx and dementia hospitalizations, (O 3 : HR = 1.06; 95% CI: 1.04-1.09 per 10 μg/m 3 ; NOx: HR = 1.01; 95% CI: 1.00-1.02 per 20 μg/m 3 ).H. Exposure to NOx, NO 2 , PM 2.5 , and PM 10 was positively associated with Vd and negatively associated with Ad. Hospitalization for Sd was positively associated with exposure to O 3 (HR = 1.20; 95% CI: 1.15-1.24 per 10 μg/m 3 ). Conclusions Our results showed a positive association between exposure to NOx and O 3 and hospitalization for dementia and a negative association between NO 2 exposure and hospitalization for dementia. In the analysis by subtype, exposure to each pollutants (except O 3 ) demonstrated a positive association with vascular dementia, while O 3 exposure was associated with senile dementia. The results regarding vascular dementia are a clear indication that the brain effects of air pollution are linked with vascular damage.
Key findings
- Results We selected 21,548 first hospitalizations for dementia (7497 for Vd, 7669 for Ad and 7833 for Sd).
- Overall, we observed a negative association between exposure to NO 2 (10 μg/m 3 ) and dementia hospitalizations (HR = 0.97; 95% CI: 0.96-0.99) and a positive association between exposure to O 3 , NOx and dementia hospitalizations, (O 3 : HR = 1.06; 95% CI: 1.04-1.09 per 10 μg/m 3 ; NOx: HR = 1.01; 95% CI: 1.00-1.02 per 20 μg/m 3 ).H.
- Exposure to NOx, NO 2 , PM 2.5 , and PM 10 was positively associated with Vd and negatively associated with Ad.
- Hospitalization for Sd was positively associated with exposure to O 3 (HR = 1.20; 95% CI: 1.15-1.24 per 10 μg/m 3 ).
- Conclusions Our results showed a positive association between exposure to NOx and O 3 and hospitalization for dementia and a negative association between NO 2 exposure and hospitalization for dementia.
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Study details
- Participants350,844
- Effect sizeHR = 0.97; HR = 1.06; HR = 1.01
- Evidence strengthModerate
How this study scored 62/100
Published in a peer-reviewed journal. Scored zero for study design and randomised / blinded because the record does not state it. We have no data on journal's citation record, times cited, citations per year, impact for its field and year, cited by studies here, still being cited, senior author's track record, institution's track record and multi-centre collaboration, so those were left out: it earned 36 of the 58 points we could judge it on, which is 62 out of 100.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Environmental health : a global access science source) |
| Journal's citation record | — / 4 | No journal record from OpenAlex — left out of this score |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 3 / 5 | Rated “moderate” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 2 / 5 | 2019 — within 10 year(s) of the newest study here |
| Sample size | 4 / 4 | 350,844 participants |
| Effect reported | 3 / 3 | Effect reported with a statistic (interval, p-value, ratio or similar) |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | — / 7 | No citation count (not found in OpenAlex) — left out of this score |
| Citations per year | — / 5 | No citation count or no year — left out of this score |
| Impact for its field and year | — / 6 | No field-weighted citation impact (OpenAlex has none yet) — left out of this score |
| Cited by studies here | — / 6 | Not yet checked against this library's citation graph — left out of this score |
| Still being cited | — / 4 | No yearly citation counts — left out of this score |
| Senior author's track record | — / 4 | Senior author's record not available — left out of this score |
| Institution's track record | — / 3 | No institution listed in OpenAlex — left out of this score |
| Multi-centre collaboration | — / 3 | Institutions not listed — left out of this score |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 31399053) |
| Free to read | 2 / 2 | Free to read |
| Points | 36 / 58 | Scored on 11 of 20 parts. We have no data for the rest, so they are left out: 36 of the 58 points we could judge it on is 62 out of 100. |
| Total | 62 / 100 | — |
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Cite this study APA, Vancouver, BibTeX · download .bib or .ris
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. The record names 7 authors; APA and Vancouver show the first six, BibTeX and the downloads carry all of them. Check the citation against the original before you use it.
APA 7th
Cerza, F., Renzi, M., Gariazzo, C., Davoli, M., Michelozzi, P., Forastiere, F., et al. (2019). Long-term exposure to air pollution and hospitalization for dementia in the Rome longitudinal study. Environmental health : a global access science source. https://doi.org/10.1186/s12940-019-0511-5
Vancouver
Cerza F, Renzi M, Gariazzo C, Davoli M, Michelozzi P, Forastiere F, et al. Long-term exposure to air pollution and hospitalization for dementia in the Rome longitudinal study. Environmental health : a global access science source. 2019. doi:10.1186/s12940-019-0511-5. PMID: 31399053.
BibTeX
@article{cerza2019-31399053,
author = {Cerza, F. and Renzi, M. and Gariazzo, C. and Davoli, M. and Michelozzi, P. and Forastiere, F. and Cesaroni, G.},
title = {{Long-term exposure to air pollution and hospitalization for dementia in the Rome longitudinal study}},
journal = {Environmental health : a global access science source},
year = {2019},
doi = {10.1186/s12940-019-0511-5},
pmid = {31399053},
url = {https://doi.org/10.1186/s12940-019-0511-5}
}
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