Exposure to Ambient Air Pollution and the Incidence of Dementia in the Elderly of England: The ELSA Cohort

Abstract

Increasing evidence suggests an adverse association between ambient air pollution and the incidence of dementia in adult populations, although results at present are mixed and further work is required. The present study investigated the relationships between NO2, PM10, PM2.5 and ozone on dementia incidence in a cohort of English residents, aged 50 years and older, followed up between 2004 and 2017 (English Longitudinal Study of Ageing; n = 8525). Cox proportional hazards models were applied to investigate the association between time to incident dementia and exposure to pollutants at baseline. Hazard ratios (HRs) were calculated per 10 μg/m3. Models were adjusted for age, gender, physical activity, smoking status and level of education (the latter as a sensitivity analysis). A total of 389 dementia cases were identified during follow-up. An increased risk of developing dementia was suggested with increasing exposure to PM2.5 (HR: 1.10; 95% confidence interval (CI): 0.88, 1.37), whilst NO2, PM10 and ozone exhibited no discernible relationships. Hazard ratios were 0.97 (CI: 0.89, 1.05) for NO2; 0.98 (CI: 0.89, 1.08) for PM10; 1.01 (CI: 0.94, 1.09) for ozone. In the London sub-sample (39 dementia cases), a 10 μg/m3 increase in PM10 was found to be associated with increased risk of dementia by 16%, although not statistically significant (HR: 1.16; CI: 0.90, 1.48), and the magnitude of effect for PM2.5 increased, whilst NO2 and ozone exhibited similar associations as observed in the England-wide study. Further work is required to fully elucidate the potentially adverse associations between air pollution exposure and dementia incidence.