Citation:

Frndak, S., Z. Deng, C. Ward-Caviness, I. Gorski-Steiner, R. Thorpe, AND A. Dickerson. Risk of Dementia Due to Co-Exposure to Air Pollution and Neighborhood Disadvantage. ENVIRONMENTAL RESEARCH. Elsevier B.V., Amsterdam, Netherlands, 251(Part 2):118709, (2024). https://doi.org/10.1016/j.envres.2024.118709

Impact/Purpose:

This manuscript describes how different air toxics impact dementia risk in different neighborhood socioeconomic status settings. Air toxics are examined individually and as a mixture.

Description:

Background: Co-exposure to air pollution and neighborhood disadvantage may influence cognitive decline. We tested these associations in the context of dementia risk. Methods: We leveraged a cohort of community dwelling adults ≥65 years (n=5,112) enrolled from 2011 to 2018 in the National Health and Aging Trends Study (NHATS). Five air pollutants (PM10, PM2.5, CO, NO, and NO2) and neighborhood disadvantage were tested for joint and synergistic associations with dementia risk. Air pollutant concentrations at the 2010 census tract level were assigned using the US Environmental Protection Agency’s Community Multiscale Air Quality Modeling System. Neighborhood disadvantage was defined using the census tract Social Deprivation Index (SDI). Dementia was determined through self- or proxy-report or scores indicative of “probable dementia” according to NHATS screening tools. Joint effects were tested using quantile g-computation Cox proportional hazards models. We also stratified joint air pollution effects across SDI tertiles. Analyses adjusted for age at enrollment, sex, education, partner status, urbanicity, annual income, race and ethnicity, years at current residence, census segregation, and census region. Results: SDI score (aHR = 1.08; 95%CI 0.96,1.22), joint air pollution (aHR=1.03, 95% CI 0.92, 1.16) and joint SDI with air pollution (aHR=1.04, 95% CI 0.89, 1.22) were not associated with dementia risk. Models stratified by SDI tertile demonstrated no association between joint air pollution and dementia risk. After accounting for competing risk of death, joint SDI with air pollution was not associated with dementia risk (aHR=1.06; 95% CI 0.87, 1.29). In stratified models, joint air pollution was associated with greater risk of dementia at high (aHR=1.13; 95% CI 1.01, 1.25), but not at medium or low SDI.  Conclusion: Air pollution was associated with greater dementia risk in disadvantaged areas after accounting for competing risks. Air pollution associations with dementia risk may be attenuated when competing risks are more prominent among disadvantaged neighborhoods.

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