Long-term exposure to air pollution and cognitive aging: Findings from a United States cohort of older adults

Abstract

Background

Growing epidemiologic evidence suggests long-term exposure to air pollution increases the risk of Alzheimer's disease and related dementias (ADRD) in older adults but research on its effect on early indicators of ADRD is limited.

Objective

We examined the effect of fine particulate matter (PM_2.5) and nitrogen dioxide (NO₂) on cognitive performance and decline in a cohort of older adults.

Methods

This analysis draws from the Ginkgo Evaluation of Memory Study, a clinical trial aimed at understanding ADRD prevention. Participants aged 75 years and older completed an annual neuropsychological battery for up to 8 years. Air pollution was estimated using fine-scale models and accounted for residential history. Cognitive performance at baseline and trajectories of cognitive function across levels of air pollution were estimated using linear mixed regression models. Longitudinal analyses incorporated inverse probability weights to account for differential selection across visits.

Results

This study included 3044 individuals. Exposure to PM_2.5 was associated with slightly worse performance at intercepts for all domains. Higher exposure was not associated with faster declines in cognitive performance over follow-up. Results for NO₂ follow a similar pattern.

Conclusions

Findings support associations between exposure to higher concentrations of air pollution and worse cognitive performance at baseline, but not cognitive decline.

Keywords

air pollution Alzheimer’s disease cognitive decline epidemiology

Get full access to this article

View all access options for this article.

References

Vollset

Goren

Yuan

C-W

, et al. Fertility, mortality, migration, and population scenarios for 195 countries and territories from 2017 to 2100: a forecasting analysis for the global burden of disease study. Lancet 2020; 396: 1285–1306.

Brito

DVC

Esteves

Rajado

, et al. Assessing cognitive decline in the aging brain: lessons from rodent and human studies. NPJ Aging 2023; 9: 23.

Power

Adar

Yanosky

, et al. Exposure to air pollution as a potential contributor to cognitive function, cognitive decline, brain imaging, and dementia: a systematic review of epidemiologic research. Neurotoxicology 2016; 56: 235–253.

Weuve

Bennett

Ranker

, et al. Exposure to air pollution in relation to risk of dementia and related outcomes: an updated systematic review of the epidemiological literature. Environ Health Perspect 2021; 129: 096001.

Semmens

Leary

Fitzpatrick

, et al. Air pollution and dementia in older adults in the Ginkgo evaluation of memory study. Alzheimers Dement 2023; 19: 549–559.

Livingston

Huntley

Liu

, et al. Dementia prevention, intervention, and care: 2024 report of the lancet standing commission. Lancet 2024; 404: 572–628.

Block

Calderón-Garcidueñas

. Air pollution: mechanisms of neuroinflammation and CNS disease. Trends Neurosci 2009; 32: 506–516.

Calderón-Garcidueñas

Solt

Henríquez-Roldán

, et al. Long-term air pollution exposure is associated with neuroinflammation, an altered innate immune response, disruption of the blood-brain barrier, ultrafine particulate deposition, and accumulation of amyloid β-42 and α-synuclein in children and young adult. Toxicol Pathol 2008; 36: 289–310.

Calderon-Garciduenas

Azzarelli

Acuna

, et al. Safety evaluation — environmental air pollution and brain damage. Toxicol Pathol 2002; 30: 373–389.

10.

Duchesne

Gutierrez

L-A

Carrière

, et al. Exposure to ambient air pollution and cognitive decline: results of the prospective three-city cohort study. Environ Int 2022; 161: 107118.

11.

Andrews

Adar

Szpiro

, et al. Association of tailpipe-related and nontailpipe–related air pollution exposure with cognitive decline in the Chicago health and aging project. Environ Health Perspect 2024; 132: 127002.

12.

DeKosky

Fitzpatrick

Ives

, et al. The Ginkgo evaluation of memory (GEM) study: design and baseline data of a randomized trial of Ginkgo biloba extract in prevention of dementia. Contemp Clin Trials 2006; 27: 238–253.

13.

DeKosky

Williamson

Fitzpatrick

, et al. Ginkgo biloba for prevention of dementia: a randomized controlled trial. JAMA 2008; 300: 2253–2262.

14.

Hughes

Berg

Danziger

, et al. A new clinical scale for the staging of dementia. Br J Psychiatry J Ment Sci 1982; 140: 566–572.

15.

Snitz

O’Meara

Carlson

, et al. Ginkgo biloba for preventing cognitive decline in older adults: a randomized trial. JAMA 2009; 302: 2663–2670.

16.

Delis

Kramer

Kaplan

, et al. CVLT: California Verbal Learning Test-Adult Version: Manual. San Antonio, TX: Psychological Corporation, 1987.

17.

Rey

. L’examen psychologique dans les cas d’encephalopathie traumatique. Arch Psychol 1941; 28: 286–340.

18.

Osterrieth

. Le test de copie d’une figure complexe; contribution a l’etude de la perception et de la memoire. Arch Psychol 1945; 30: 306–356.

19.

Reitan

. Validity of the trail making test as an indicator of organic brain damage. Percept Mot Skills 1958; 8: 271–276.

20.

Trenerry

Crosson

DeBoe

, et al. Stroop neuropsychological screening test. Odessa, FL: Psychological Assessment Resources, 1989.

21.

Wechsler

. WAIS-R manual: Wechsler adult intelligence scale-revised. New York: Psychological Corporation, 1981.

22.

Lopez

Becker

Jagust

, et al. Neuropsychological characteristics of mild cognitive impairment subgroups. J Neurol Neurosurg Psychiatry 2006; 77: 159.

23.

Saxton

Ratcliff

Munro

, et al. Normative data on the Boston naming test and two equivalent 30-item short forms. Clin Neuropsychol 2000; 14: 526–534.

24.

Spreen

Strauss

. A compendium of neuropsychological tests: Administration, norms, and commentary. New York: Oxford University Press, 1998.

25.

Young

Bechle

Sampson

, et al. Satellite-based NO2 and model validation in a national prediction model based on universal kriging and land-use regression. Environ Sci Technol 2016; 50: 3686–3694.

26.

Kim

S-Y

Olives

Sheppard

, et al. Historical prediction modeling approach for estimating long-term concentrations of PM2. 5 in cohort studies before the 1999 implementation of widespread monitoring. Environ Health Perspect 2017; 125: 38–46.

27.

Cole

Hernán

. Constructing inverse probability weights for marginal structural models. Am J Epidemiol 2008; 168: 656–664.

28.

Weuve

Tchetgen Tchetgen

Glymour

, et al. Accounting for bias due to selective attrition. Epidemiology 2012; 23: 119–128.

29.

Hayes-Larson

Mobley

Mungas

, et al. Accounting for lack of representation in dementia research: generalizing KHANDLE study findings on the prevalence of cognitive impairment to the California older population. Alzheimers Dement 2022; 18: 2209–2217.

30.

Stuart

. Matching methods for causal inference: a review and a look forward. Stat Sci Rev J Inst Math Stat 2010; 25: 1.

31.

Vivot

Power

Glymour

, et al. Jump, hop, or skip: modeling practice effects in studies of determinants of cognitive change in older adults. Am J Epidemiol 2016; 183: 302–314.

32.

Hayes-Larson

Andrews

Kezios

, et al. Approaches to timescale choice in cognitive aging research and potential implications for estimated exposure effects: coordinated analyses in 10 cohorts of older adults. Epidemiology 2025; 36: 560–571.

33.

Ailshire

Crimmins

. Fine particulate matter air pollution and cognitive function among older US adults. Am J Epidemiol 2014; 180: 359–366.

34.

Tzivian

Dlugaj

Winkler

, et al. Long-term air pollution and traffic noise exposures and mild cognitive impairment in older adults: a cross-sectional analysis of the Heinz Nixdorf recall study. Environ Health Perspect 2016; 124: 1361.

35.

Weuve

Puett

Schwartz

, et al. Exposure to particulate air pollution and cognitive decline in older women. Arch Intern Med 2012; 172: 219–227.

36.

Younan

Petkus

Widaman

, et al. Particulate matter and episodic memory decline mediated by early neuroanatomic biomarkers of Alzheimer’s disease. Brain 2020; 143: 289–302.

37.

Petkus

Younan

Widaman

, et al. Exposure to fine particulate matter and temporal dynamics of episodic memory and depressive symptoms in older women. Environ Int 2020; 135: 105196.

38.

Petkus

Younan

Wang

, et al. Air pollution and the dynamic association between depressive symptoms and memory in oldest-old women. J Am Geriatr Soc 2021; 69: 474–484.

39.

Shaffer

Blanco

, et al. Fine particulate matter and dementia incidence in the adult changes in thought study. Environ Health Perspect 2021; 129: 087001.

40.

Sjölander

. Selection bias with outcome-dependent sampling. Epidemiol Camb Mass 2023; 34: 186–191.

Supplementary Material

Please find the following supplemental material available below.

For Open Access articles published under a Creative Commons License, all supplemental material carries the same license as the article it is associated with.

For non-Open Access articles published, all supplemental material carries a non-exclusive license, and permission requests for re-use of supplemental material or any part of supplemental material shall be sent directly to the copyright owner as specified in the copyright notice associated with the article.

0.00 MB

0.39 MB