Are noise and air pollution related to the incidence of dementia? A cohort study in London, England
ObjectiveTo investigate whether the incidence of dementia is related to residential levels of air and noise pollution in London.DesignRetrospective cohort study using primary care data.Setting75 Greater London practices.Participants130 978 adults aged 50–79 years registered with their general practi...
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| Published in | BMJ open Vol. 8; no. 9; p. e022404 |
|---|---|
| Main Authors | , , , , , , , , |
| Format | Journal Article |
| Language | English |
| Published |
England
British Medical Journal Publishing Group
01.09.2018
BMJ Publishing Group LTD BMJ Publishing Group |
| Subjects | |
| Online Access | Get full text |
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| Abstract | ObjectiveTo investigate whether the incidence of dementia is related to residential levels of air and noise pollution in London.DesignRetrospective cohort study using primary care data.Setting75 Greater London practices.Participants130 978 adults aged 50–79 years registered with their general practices on 1 January 2005, with no recorded history of dementia or care home residence.Primary and secondary outcome measuresA first recorded diagnosis of dementia and, where specified, subgroups of Alzheimer’s disease and vascular dementia during 2005–2013. The average annual concentrations during 2004 of nitrogen dioxide (NO2), particulate matter with a median aerodynamic diameter ≤2.5 µm (PM2.5) and ozone (O3) were estimated at 20×20 m resolution from dispersion models. Traffic intensity, distance from major road and night-time noise levels (Lnight) were estimated at the postcode level. All exposure measures were linked anonymously to clinical data via residential postcode. HRs from Cox models were adjusted for age, sex, ethnicity, smoking and body mass index, with further adjustments explored for area deprivation and comorbidity.Results2181 subjects (1.7%) received an incident diagnosis of dementia (39% mentioning Alzheimer’s disease, 29% vascular dementia). There was a positive exposure response relationship between dementia and all measures of air pollution except O3, which was not readily explained by further adjustment. Adults living in areas with the highest fifth of NO2 concentration (>41.5 µg/m3) versus the lowest fifth (<31.9 µg/m3) were at a higher risk of dementia (HR=1.40, 95% CI 1.12 to 1.74). Increases in dementia risk were also observed with PM2.5, PM2.5 specifically from primary traffic sources only and Lnight, but only NO2 and PM2.5 remained statistically significant in multipollutant models. Associations were more consistent for Alzheimer’s disease than vascular dementia.ConclusionsWe have found evidence of a positive association between residential levels of air pollution across London and being diagnosed with dementia, which is unexplained by known confounding factors. |
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| AbstractList | To investigate whether the incidence of dementia is related to residential levels of air and noise pollution in London.
Retrospective cohort study using primary care data.
75 Greater London practices.
130 978 adults aged 50-79 years registered with their general practices on 1 January 2005, with no recorded history of dementia or care home residence.
A first recorded diagnosis of dementia and, where specified, subgroups of Alzheimer's disease and vascular dementia during 2005-2013. The average annual concentrations during 2004 of nitrogen dioxide (NO
), particulate matter with a median aerodynamic diameter ≤2.5 µm (PM
) and ozone (O
) were estimated at 20×20 m resolution from dispersion models. Traffic intensity, distance from major road and night-time noise levels (L
) were estimated at the postcode level. All exposure measures were linked anonymously to clinical data via residential postcode. HRs from Cox models were adjusted for age, sex, ethnicity, smoking and body mass index, with further adjustments explored for area deprivation and comorbidity.
2181 subjects (1.7%) received an incident diagnosis of dementia (39% mentioning Alzheimer's disease, 29% vascular dementia). There was a positive exposure response relationship between dementia and all measures of air pollution except O
, which was not readily explained by further adjustment. Adults living in areas with the highest fifth of NO
concentration (>41.5 µg/m
) versus the lowest fifth (<31.9 µg/m
) were at a higher risk of dementia (HR=1.40, 95% CI 1.12 to 1.74). Increases in dementia risk were also observed with PM
, PM
specifically from primary traffic sources only and L
, but only NO
and PM
remained statistically significant in multipollutant models. Associations were more consistent for Alzheimer's disease than vascular dementia.
We have found evidence of a positive association between residential levels of air pollution across London and being diagnosed with dementia, which is unexplained by known confounding factors. ObjectiveTo investigate whether the incidence of dementia is related to residential levels of air and noise pollution in London.DesignRetrospective cohort study using primary care data.Setting75 Greater London practices.Participants130 978 adults aged 50–79 years registered with their general practices on 1 January 2005, with no recorded history of dementia or care home residence.Primary and secondary outcome measuresA first recorded diagnosis of dementia and, where specified, subgroups of Alzheimer’s disease and vascular dementia during 2005–2013. The average annual concentrations during 2004 of nitrogen dioxide (NO2), particulate matter with a median aerodynamic diameter ≤2.5 µm (PM2.5) and ozone (O3) were estimated at 20×20 m resolution from dispersion models. Traffic intensity, distance from major road and night-time noise levels (Lnight) were estimated at the postcode level. All exposure measures were linked anonymously to clinical data via residential postcode. HRs from Cox models were adjusted for age, sex, ethnicity, smoking and body mass index, with further adjustments explored for area deprivation and comorbidity.Results2181 subjects (1.7%) received an incident diagnosis of dementia (39% mentioning Alzheimer’s disease, 29% vascular dementia). There was a positive exposure response relationship between dementia and all measures of air pollution except O3, which was not readily explained by further adjustment. Adults living in areas with the highest fifth of NO2 concentration (>41.5 µg/m3) versus the lowest fifth (<31.9 µg/m3) were at a higher risk of dementia (HR=1.40, 95% CI 1.12 to 1.74). Increases in dementia risk were also observed with PM2.5, PM2.5 specifically from primary traffic sources only and Lnight, but only NO2 and PM2.5 remained statistically significant in multipollutant models. Associations were more consistent for Alzheimer’s disease than vascular dementia.ConclusionsWe have found evidence of a positive association between residential levels of air pollution across London and being diagnosed with dementia, which is unexplained by known confounding factors. Objective To investigate whether the incidence of dementia is related to residential levels of air and noise pollution in London.Design Retrospective cohort study using primary care data.Setting 75 Greater London practices.Participants 130 978 adults aged 50–79 years registered with their general practices on 1 January 2005, with no recorded history of dementia or care home residence.Primary and secondary outcome measures A first recorded diagnosis of dementia and, where specified, subgroups of Alzheimer’s disease and vascular dementia during 2005–2013. The average annual concentrations during 2004 of nitrogen dioxide (NO2), particulate matter with a median aerodynamic diameter ≤2.5 µm (PM2.5) and ozone (O3) were estimated at 20×20 m resolution from dispersion models. Traffic intensity, distance from major road and night-time noise levels (Lnight) were estimated at the postcode level. All exposure measures were linked anonymously to clinical data via residential postcode. HRs from Cox models were adjusted for age, sex, ethnicity, smoking and body mass index, with further adjustments explored for area deprivation and comorbidity.Results 2181 subjects (1.7%) received an incident diagnosis of dementia (39% mentioning Alzheimer’s disease, 29% vascular dementia). There was a positive exposure response relationship between dementia and all measures of air pollution except O3, which was not readily explained by further adjustment. Adults living in areas with the highest fifth of NO2 concentration (>41.5 µg/m3) versus the lowest fifth (<31.9 µg/m3) were at a higher risk of dementia (HR=1.40, 95% CI 1.12 to 1.74). Increases in dementia risk were also observed with PM2.5, PM2.5 specifically from primary traffic sources only and Lnight, but only NO2 and PM2.5 remained statistically significant in multipollutant models. Associations were more consistent for Alzheimer’s disease than vascular dementia.Conclusions We have found evidence of a positive association between residential levels of air pollution across London and being diagnosed with dementia, which is unexplained by known confounding factors. To investigate whether the incidence of dementia is related to residential levels of air and noise pollution in London.OBJECTIVETo investigate whether the incidence of dementia is related to residential levels of air and noise pollution in London.Retrospective cohort study using primary care data.DESIGNRetrospective cohort study using primary care data.75 Greater London practices.SETTING75 Greater London practices.130 978 adults aged 50-79 years registered with their general practices on 1 January 2005, with no recorded history of dementia or care home residence.PARTICIPANTS130 978 adults aged 50-79 years registered with their general practices on 1 January 2005, with no recorded history of dementia or care home residence.A first recorded diagnosis of dementia and, where specified, subgroups of Alzheimer's disease and vascular dementia during 2005-2013. The average annual concentrations during 2004 of nitrogen dioxide (NO2), particulate matter with a median aerodynamic diameter ≤2.5 µm (PM2.5) and ozone (O3) were estimated at 20×20 m resolution from dispersion models. Traffic intensity, distance from major road and night-time noise levels (Lnight) were estimated at the postcode level. All exposure measures were linked anonymously to clinical data via residential postcode. HRs from Cox models were adjusted for age, sex, ethnicity, smoking and body mass index, with further adjustments explored for area deprivation and comorbidity.PRIMARY AND SECONDARY OUTCOME MEASURESA first recorded diagnosis of dementia and, where specified, subgroups of Alzheimer's disease and vascular dementia during 2005-2013. The average annual concentrations during 2004 of nitrogen dioxide (NO2), particulate matter with a median aerodynamic diameter ≤2.5 µm (PM2.5) and ozone (O3) were estimated at 20×20 m resolution from dispersion models. Traffic intensity, distance from major road and night-time noise levels (Lnight) were estimated at the postcode level. All exposure measures were linked anonymously to clinical data via residential postcode. HRs from Cox models were adjusted for age, sex, ethnicity, smoking and body mass index, with further adjustments explored for area deprivation and comorbidity.2181 subjects (1.7%) received an incident diagnosis of dementia (39% mentioning Alzheimer's disease, 29% vascular dementia). There was a positive exposure response relationship between dementia and all measures of air pollution except O3, which was not readily explained by further adjustment. Adults living in areas with the highest fifth of NO2 concentration (>41.5 µg/m3) versus the lowest fifth (<31.9 µg/m3) were at a higher risk of dementia (HR=1.40, 95% CI 1.12 to 1.74). Increases in dementia risk were also observed with PM2.5, PM2.5 specifically from primary traffic sources only and Lnight, but only NO2 and PM2.5 remained statistically significant in multipollutant models. Associations were more consistent for Alzheimer's disease than vascular dementia.RESULTS2181 subjects (1.7%) received an incident diagnosis of dementia (39% mentioning Alzheimer's disease, 29% vascular dementia). There was a positive exposure response relationship between dementia and all measures of air pollution except O3, which was not readily explained by further adjustment. Adults living in areas with the highest fifth of NO2 concentration (>41.5 µg/m3) versus the lowest fifth (<31.9 µg/m3) were at a higher risk of dementia (HR=1.40, 95% CI 1.12 to 1.74). Increases in dementia risk were also observed with PM2.5, PM2.5 specifically from primary traffic sources only and Lnight, but only NO2 and PM2.5 remained statistically significant in multipollutant models. Associations were more consistent for Alzheimer's disease than vascular dementia.We have found evidence of a positive association between residential levels of air pollution across London and being diagnosed with dementia, which is unexplained by known confounding factors.CONCLUSIONSWe have found evidence of a positive association between residential levels of air pollution across London and being diagnosed with dementia, which is unexplained by known confounding factors. |
| Author | Gulliver, John Strachan, David P Atkinson, Richard W Beevers, Sean D Dajnak, David Kelly, Frank J Anderson, H Ross Carey, Iain M Cook, Derek G |
| AuthorAffiliation | 1 Population Health Research Institute , St George’s, University of London , London , UK 3 UK Small Area Health Statistics Unit, MRC-PHE Centre for Environment and Health , Imperial College , London , UK 4 NIHR HealthProtection Research Unit in Health Impact of Environmental Hazards , King’s College London , London , UK 2 MRC-PHE Centre for Environment and Health , King’s College London , London , UK |
| AuthorAffiliation_xml | – name: 1 Population Health Research Institute , St George’s, University of London , London , UK – name: 4 NIHR HealthProtection Research Unit in Health Impact of Environmental Hazards , King’s College London , London , UK – name: 2 MRC-PHE Centre for Environment and Health , King’s College London , London , UK – name: 3 UK Small Area Health Statistics Unit, MRC-PHE Centre for Environment and Health , Imperial College , London , UK |
| Author_xml | – sequence: 1 givenname: Iain M orcidid: 0000-0003-1099-8460 surname: Carey fullname: Carey, Iain M organization: Population Health Research Institute, St George’s, University of London, London, UK – sequence: 2 givenname: H Ross surname: Anderson fullname: Anderson, H Ross organization: MRC-PHE Centre for Environment and Health, King’s College London, London, UK – sequence: 3 givenname: Richard W surname: Atkinson fullname: Atkinson, Richard W organization: Population Health Research Institute, St George’s, University of London, London, UK – sequence: 4 givenname: Sean D surname: Beevers fullname: Beevers, Sean D organization: MRC-PHE Centre for Environment and Health, King’s College London, London, UK – sequence: 5 givenname: Derek G surname: Cook fullname: Cook, Derek G organization: Population Health Research Institute, St George’s, University of London, London, UK – sequence: 6 givenname: David P surname: Strachan fullname: Strachan, David P organization: Population Health Research Institute, St George’s, University of London, London, UK – sequence: 7 givenname: David surname: Dajnak fullname: Dajnak, David organization: MRC-PHE Centre for Environment and Health, King’s College London, London, UK – sequence: 8 givenname: John surname: Gulliver fullname: Gulliver, John organization: UK Small Area Health Statistics Unit, MRC-PHE Centre for Environment and Health, Imperial College, London, UK – sequence: 9 givenname: Frank J surname: Kelly fullname: Kelly, Frank J organization: NIHR HealthProtection Research Unit in Health Impact of Environmental Hazards, King’s College London, London, UK |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/30206085$$D View this record in MEDLINE/PubMed |
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| ContentType | Journal Article |
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| Snippet | ObjectiveTo investigate whether the incidence of dementia is related to residential levels of air and noise pollution in London.DesignRetrospective cohort... To investigate whether the incidence of dementia is related to residential levels of air and noise pollution in London. Retrospective cohort study using... To investigate whether the incidence of dementia is related to residential levels of air and noise pollution in London.OBJECTIVETo investigate whether the... Objective To investigate whether the incidence of dementia is related to residential levels of air and noise pollution in London.Design Retrospective cohort... |
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| SubjectTerms | Aged Air pollution Air Pollution - adverse effects Air Pollution - prevention & control Alzheimer Disease - diagnosis Alzheimer Disease - epidemiology Alzheimer's disease Brain research Cohort analysis Dementia Dementia, Vascular - diagnosis Dementia, Vascular - epidemiology Disease Environmental Exposure - adverse effects Environmental Exposure - prevention & control Epidemiology Estimates Female Health risk assessment Humans London - epidemiology Male Middle Aged Nitrogen dioxide Nitrogen Dioxide - analysis noise Noise - adverse effects Noise - prevention & control Noise pollution Older people Particulate Matter - analysis Pollutants Population Primary care Primary Health Care - statistics & numerical data Residence Characteristics - statistics & numerical data Risk Factors Roads & highways Systematic review Traffic Vehicle Emissions - analysis Vehicles |
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| Title | Are noise and air pollution related to the incidence of dementia? A cohort study in London, England |
| URI | https://bmjopen.bmj.com/content/8/9/e022404.full https://www.ncbi.nlm.nih.gov/pubmed/30206085 https://www.proquest.com/docview/2127361370 https://www.proquest.com/docview/2102924194 https://pubmed.ncbi.nlm.nih.gov/PMC6144407 https://doaj.org/article/066847a6beae404dbcb18cbca2032e4f |
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