Racial/Ethnic Disparities in Alzheimer’s Disease Risk: Role of Exposure to Ambient Fine Particles

Author:

Younan Diana1,Wang Xinhui1,Gruenewald Tara2,Gatz Margaret1,Serre Marc L3,Vizuete William3,Braskie Meredith N1,Woods Nancy F4ORCID,Kahe Ka5,Garcia Lorena6,Lurmann Fred7,Manson JoAnn E8,Chui Helena C1,Wallace Robert B9,Espeland Mark A10,Chen Jiu-Chiuan1

Affiliation:

1. University of Southern California, Los Angeles, USA

2. Chapman University, Orange, California, USA

3. University of North Carolina, Chapel Hill, USA

4. University of Washington School of Nursing, Seattle, USA

5. Columbia University Irving Medical Center, New York, New York, USA

6. University of California, Davis, USA

7. Sonoma Technology, Inc., Petaluma, California, USA

8. Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, USA

9. University of Iowa College of Public Health, USA

10. Wake Forest School of Medicine, Winston-Salem, North Carolina, USA

Abstract

Abstract Background Whether racial/ethnic disparities in Alzheimer’s disease (AD) risk may be explained by ambient fine particles (PM2.5) has not been studied. Method We conducted a prospective, population-based study on a cohort of Black (n = 481) and White (n = 6 004) older women (aged 65–79) without dementia at enrollment (1995–1998). Cox models accounting for competing risk were used to estimate the hazard ratio (HR) for racial/ethnic disparities in AD (1996–2010) defined by Diagnostic and Statistical Manual of Mental Disorders, 4th edition and the association with time-varying annual average PM2.5 (1999–2010) estimated by spatiotemporal model. Results Over an average follow-up of 8.3 (±3.5) years with 158 incident cases (21 in Black women), the racial disparities in AD risk (range of adjusted HRBlack women = 1.85–2.41) observed in various models could not be explained by geographic region, age, socioeconomic characteristics, lifestyle factors, cardiovascular risk factors, and hormone therapy assignment. Estimated PM2.5 exposure was higher in Black (14.38 ± 2.21 µg/m3) than in White (12.55 ± 2.76 µg/m3) women, and further adjustment for the association between PM2.5 and AD (adjusted HRPM2.5 = 1.18–1.28) slightly reduced the racial disparities by 2%–6% (HRBlack women = 1.81–2.26). The observed association between PM2.5 and AD risk was ~2 times greater in Black (HRPM2.5 = 2.10–2.60) than in White (HRPM2.5 = 1.07–1.15) women (range of interaction ps: <.01–.01). We found similar results after further adjusting for social engagement (social strain, social support, social activity, living alone), stressful life events, Women’s Health Initiative’s clinic sites, and neighborhood socioeconomic characteristics. Conclusions PM2.5 may contribute to racial/ethnic disparities in AD risk and its associated increase in AD risk was stronger among Black women.

Funder

Alzheimer’s Association

National Institute on Aging

National Institute of Environmental Health Sciences

Wake Forest Alzheimer’s Disease Core Center

Publisher

Oxford University Press (OUP)

Subject

Geriatrics and Gerontology,Ageing

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