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The impacts of air pollution on mortality and hospital readmission among Medicare beneficiaries with Alzheimer's disease and Alzheimer's disease-related dementias: a national retrospective cohort study in the USA
Shuxin Dong, Danielle Braun, Xiao Jun Wu, Maayan Yitshak‐Sade, Deborah Blacker, Marianthi‐Anna Kioumourtzoglou, Joel Schwartz, Daniel Mork et al.. The Lancet Planetary Health, 2025-02-01
Topic: Risk, prevention and care in population studies
In both the mortality and readmission cohorts we found significant associations with each pollutant. For an IQR increase in NO 2 , we found a hazard ratio (HR) for mortality of 1·012 (95% CI 1·009–1·015) and an HR for readmission of 1·110 (1·104–1·117). In the readmission cohort, we found an HR of 1·084 (1·079–1·089) for an IQR increase (3·87 μg/m 3 ) in PM 2·5 . The results slightly decreased in multi-pollutant models. The results of effect modification for mortality and readmission varied by pollutant, but higher risks were found among Black males and among those eligible for Medicaid in general. Interpretation We provide new evidence that among a susceptible population with previous AD/ADRD-related hospitalisations, annual air pollution exposure since first hospitalisation is associated with risk of readmission and death.
Key findings
- In both the mortality and readmission cohorts we found significant associations with each pollutant.
- For an IQR increase in NO 2 , we found a hazard ratio (HR) for mortality of 1·012 (95% CI 1·009–1·015) and an HR for readmission of 1·110 (1·104–1·117).
- In the readmission cohort, we found an HR of 1·084 (1·079–1·089) for an IQR increase (3·87 μg/m 3 ) in PM 2·5 .
- The results slightly decreased in multi-pollutant models.
- The results of effect modification for mortality and readmission varied by pollutant, but higher risks were found among Black males and among those eligible for Medicaid in general.
Why it matters
Among Medicare beneficiaries already hospitalized for Alzheimer's disease or related dementias, higher annual air pollution exposure was linked to higher risk of death and hospital readmission. This shows an association only and tests no treatment, cure, or prevention.
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Study details
- Study designretrospective cohort
- Participants118
- Evidence strengthModerate
How this study scored 58/100
Published in a peer-reviewed journal, and it is a retrospective cohort study, reconstructed from past records. Scored zero for effect reported and randomised / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (The Lancet Planetary Health) |
| Journal's citation record | 1 / 4 | The Lancet Planetary Health: journal h-index 139 (OpenAlex, 2026-10-29) |
| Study design | 7 / 12 | A retrospective cohort study, reconstructed from past records |
| 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 | 4 / 5 | 2025 — within 3 year(s) of the newest study here |
| Sample size | 2 / 4 | 118 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 | 2 / 7 | Cited 11 times (OpenAlex, 2026-10-10) |
| Citations per year | 2 / 5 | 3.7 citations a year over 3 year(s) since 2025 |
| Impact for its field and year | 3 / 6 | Cited 4.5× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 0 / 6 | No other study in this library cites it |
| Still being cited | 1 / 4 | Cited 11 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 4 / 4 | Last-listed author Antonella Zanobetti: h-index 117 (OpenAlex, whole career) |
| Institution's track record | 3 / 3 | Harvard University: institution h-index 3,235 (OpenAlex) |
| Multi-centre collaboration | 2 / 3 | OpenAlex lists 5 institution(s) in 1 country |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 39986315) |
| Free to read | 2 / 2 | Free to read |
| Total | 58 / 100 | — |
What each of these 20 components measures, and what this score is not →
Read the original
- DOI: 10.1016/s2542-5196(25)00001-4
- PubMed: 39986315
- Original source →
- Free full text: The Lancet Planetary Health →
Full text: free to read — OpenAlex lists this copy as free to read: the link above (checked 6 Feb 1020).
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's author list ends in “et al.”, so not every author is named. Check the citation against the original before you use it.
APA 7th
Dong, S., Braun, D., Wu, X. J., Yitshak‐Sade, M., Blacker, D., Kioumourtzoglou, M., et al. (2025). The impacts of air pollution on mortality and hospital readmission among Medicare beneficiaries with Alzheimer's disease and Alzheimer's disease-related dementias: a national retrospective cohort study in the USA. The Lancet Planetary Health. https://doi.org/10.1016/s2542-5196(25)00001-4
Vancouver
Dong S, Braun D, Wu XJ, Yitshak‐Sade M, Blacker D, Kioumourtzoglou M, et al. The impacts of air pollution on mortality and hospital readmission among Medicare beneficiaries with Alzheimer's disease and Alzheimer's disease-related dementias: a national retrospective cohort study in the USA. The Lancet Planetary Health. 2025. doi:10.1016/s2542-5196(25)00001-4. PMID: 39986315.
BibTeX
@article{dong2025-39986315,
author = {Dong, Shuxin and Braun, Danielle and Wu, Xiao Jun and Yitshak‐Sade, Maayan and Blacker, Deborah and Kioumourtzoglou, Marianthi‐Anna and Schwartz, Joel and Mork, Daniel and others},
title = {{The impacts of air pollution on mortality and hospital readmission among Medicare beneficiaries with Alzheimer's disease and Alzheimer's disease-related dementias: a national retrospective cohort study in the USA}},
journal = {The Lancet Planetary Health},
year = {2025},
doi = {10.1016/s2542-5196(25)00001-4},
pmid = {39986315},
url = {https://doi.org/10.1016/s2542-5196(25)00001-4}
}
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