4.7 Article

Air quality improvement and incident dementia: Effects of observed and hypothetical reductions in air pollutant using parametric g-computation

Journal

ALZHEIMERS & DEMENTIA
Volume 18, Issue 12, Pages 2509-2517

Publisher

WILEY
DOI: 10.1002/alz.12606

Keywords

air pollution; causal inference; dementia; g-formula; particulate matter

Funding

  1. Alzheimer's DiseaseResource Center for advancing MinorityAging Research at theUniversity of California San Diego (National Institute onAging) [P30AG059299]
  2. National Institutes of Health [R01CA228147]
  3. Fondation pour la Recherche Medicale
  4. Caisse Nationale Maladie des Travailleurs Salaries
  5. Direction Generale de la Sante
  6. MGEN
  7. Institut de la Longevite
  8. Agence Nationale de la Recherche ANRPNRA2006 [0601-01]
  9. Agence Nationale de la Recherche Longvie 2007 [LVIE-003-01]
  10. Agence Francaise de Securite Sanitaire des Produits de Sante
  11. Regional Government of Aquitaine
  12. Regional Government of Bourgogne
  13. Languedoc-Roussillon
  14. Fondation de France
  15. Ministry of Research-INSERM ProgrammeCohorts
  16. FondationPlanAlzheimer [FCS 2009-2012]
  17. Caisse Nationale de Solidarite pour l'Autonomie (CNSA)
  18. Novartis
  19. Agence nationale de securite sanitaire de l'alimentation, de l'environnement et du travail [2019/1/116]

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This study found that reducing air pollution, especially particulate matter (PM2.5), can help lower the risk of dementia, highlighting the importance of reducing air pollution in the prevention of dementia.
Introduction No evidence exists about the impact of air pollution reduction on incidence of dementia. The aim of this study was to quantify how air quality improvement leads to dementia-incidence benefits. Methods In the French Three-City cohort (12 years of follow-up), we used parametric g-computation to quantify the expected number of prevented dementia cases under different hypothetical interventions with particulate matter measuring <2.5 mu m (PM2.5) reductions. Results Among 7051 participants, 789 participants developed dementia. The median PM2.5 reduction between 1990 and 2000 was 12.2 (mu g/m(3)). Such a reduction reduced the risk of all-cause dementia (hazard ratio [HR], 0.85; 95% confidence interval [CI], 0.76 to 0.95). If all study participants were enjoying a hypothetical reduction of more than 13.10 mu g/m(3) (median reduction observed in the city of Montpellier), the rate difference was -0.37 (95% CI, -0.57 to -0.17) and the rate ratio was 0.67 (95% CI, 0.50 to 0.84). Discussion These findings highlight the possible substantial benefits of reducing air pollution in the prevention of dementia.

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