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April 19, 2022
Abstract
Introduction
Growing evidence implicates air pollution as a risk factor for dementia, but prior work is limited by challenges in diagnostic accuracy and assessing exposures in the decades prior to disease development. We evaluated the impact of long-term fine particulate matter (PM2.5) exposures on incident dementia (all-cause, Alzheimer’s disease [AD], and vascular dementia [VaD]) in older adults.
Methods
A panel of neurologists adjudicated dementia cases based on extensive neuropsychological testing and magnetic resonance imaging. We applied validated fine-scale air pollutant models to reconstructed residential histories to assess exposures.
Results
An interquartile range increase in 20-year PM2.5 was associated with a 20% higher risk of dementia (95% confidence interval [CI]: 5%, 37%) and an increased risk of mixed VaD/AD but not AD alone.
Discussion
Our findings suggest that air pollutant exposures over decades contribute to dementia and that effects of current exposures may be experienced years into the future.

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Author: Erin O. Semmens,
Cindy S. Leary,
Annette L. Fitzpatrick,
Sindana D. Ilango,
Christina Park,
Claire E. Adam,
Steven T. DeKosky,
Oscar Lopez,
Anjum Hajat,
Joel D. Kaufman