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54/100

✓ Peer-reviewed alzhub usefulness score 54 out of 100. Disparities

Topic: Risk, prevention and care in population studies

Background There is mounting evidence that long-term exposure to air pollution is related to accelerated cognitive decline in aging populations. Factors that influence individual susceptibility remain largely unknown, but may involve the apolipoprotein E genotype E4 (APOE-ε4) allele. Objectives We assessed whether the association between long-term exposure to ambient air pollution and cognitive decline differed by APOE-ε4 status and cognitive risk factors. Methods The Washington Heights Inwood Community Aging Project (WHICAP) is a prospective study of aging and dementia. Neuropsychological testing and medical examinations occur every 18-24 months. We used mixed-effects models to evaluate whether the association between markers of ambient air pollution (nitrogen dioxide [NO 2 ]), fine [PM 2.5 ], and coarse [PM 10 ] particulate matter) and the rate of decline in global and domain-specific cognition differed across strata defined by APOE-ε4 genotypes and cognitive risk factors, adjusting for sociodemographic factors and temporal trends. Results Among 4821 participants with an average of 6 years follow-up, higher concentrations of ambient air pollution were associated with more rapid cognitive decline. This association was more pronounced among APOE-ε4 carriers (p 2 was associated with an additional decline of 0.09 standard deviations (SD) (95%CI -0.1, -0.06) in global cognition across biennial visits among APOE-ε4 positive individuals and a 0.07 SD (95%CI -0.09, -0.05) decline among APOE-ε4 negative individuals. Results for PM 2.5, PM 10 and cognitive domains were similar. The association between air pollutants and rate of cognitive decline also varied across strata of race-ethnicity with the association strongest among White non-Hispanic participants. Conclusions These results add to the body of evidence on the adverse impact of ambient air pollution on cognitive aging and brain health and provide new insights into the genetic and behavioral factors that may impact individual susceptibility.

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APA 7th

Kulick, E. R., Elkind, M. S. V., Boehme, A. K., Joyce, N. R., Schupf, N., Kaufman, J. D., et al. (2020). Long-term exposure to ambient air pollution, APOE-ε4 status, and cognitive decline in a cohort of older adults in northern Manhattan. Environment international. https://doi.org/10.1016/j.envint.2019.105440

Vancouver

Kulick ER, Elkind MSV, Boehme AK, Joyce NR, Schupf N, Kaufman JD, et al. Long-term exposure to ambient air pollution, APOE-ε4 status, and cognitive decline in a cohort of older adults in northern Manhattan. Environment international. 2020. doi:10.1016/j.envint.2019.105440. PMID: 31926436.

BibTeX

@article{kulick2020-31926436,
  author  = {Kulick, E. R. and Elkind, M. S. V. and Boehme, A. K. and Joyce, N. R. and Schupf, N. and Kaufman, J. D. and Mayeux, R. and Manly, J. J. and others},
  title   = {{Long-term exposure to ambient air pollution, APOE-ε4 status, and cognitive decline in a cohort of older adults in northern Manhattan}},
  journal = {Environment international},
  year    = {2020},
  doi     = {10.1016/j.envint.2019.105440},
  pmid    = {31926436},
  url     = {https://doi.org/10.1016/j.envint.2019.105440}
}

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Key findings

Results Among 4821 participants with an average of 6 years follow-up, higher concentrations of ambient air pollution were associated with more rapid cognitive decline.
This association was more pronounced among APOE-ε4 carriers (p < 0.001).
Results for PM 2.5, PM 10 and cognitive domains were similar.
Conclusions These results add to the body of evidence on the adverse impact of ambient air pollution on cognitive aging and brain health and provide new insights into the genetic and behavioral factors that may impact individual susceptibility.

Why it matters

This study found that higher long-term exposure to ambient air pollution was associated with more rapid cognitive decline, and that this association was more pronounced among carriers of the APOE-ε4 allele. It identifies air pollution as a possible risk factor but does not test any treatment, cure, or prevention.

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Study details

Participants4,821
Evidence strengthLow

How this study scored 54/100

Published in a peer-reviewed journal. Scored zero for study design, effect reported and randomised / blinded because the record does not state it.

Component	Points	Why
Journal tier	7 / 10	Tier 3 — peer-reviewed journal (Environment international)
Journal's citation record	3 / 4	Environment International: journal h-index 335 (OpenAlex, 2026-10-29)
Study design	0 / 12	No study design recorded — scores zero, not guessed (not stated in the record — scored 0)
Strength of evidence	1 / 5	Rated “low” in our summary
Peer-review validation	10 / 10	Peer-reviewed. Published as an article in a named peer-reviewed journal.
How recent	2 / 5	2020 — within 10 year(s) of the newest study here
Sample size	3 / 4	4,821 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	No randomisation or blinding stated — scores zero (not stated in the record — scored 0)
Times cited	5 / 7	Cited 124 times (OpenAlex, 2026-10-10)
Citations per year	3 / 5	15.5 citations a year over 8 year(s) since 2020
Impact for its field and year	3 / 6	Cited 7.6× the average for papers of its field and year (OpenAlex FWCI)
Cited by studies here	2 / 6	Cited by 3 other studies in this library
Still being cited	2 / 4	Cited 39 times in 2024–2026 (2026 still in progress; OpenAlex)
Senior author's track record	3 / 4	Last-listed author Gregory A. Wellenius: h-index 70 (OpenAlex, whole career)
Institution's track record	3 / 3	University of Washington: institution h-index 3,540 (OpenAlex)
Multi-centre collaboration	2 / 3	OpenAlex lists 4 institution(s) in 1 country
Indexed in PubMed	2 / 2	Indexed in PubMed (PMID 31926436)
Free to read	0 / 2	Behind a paywall — scores zero
Total	54 / 100	—

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