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Relation
Zhang X, Chen X, Zhang X. The effects of exposure to air pollution on cognitive performance.Proc Natl Acad Sci USA. 2018;115(37):9193-9197.
Objective
To determine how cognitive performance is affected by cumulative and transient exposures to air pollution with age.
Draft
observational study; Air quality data was cross-referenced with cognitive tests, matching time and geographic locations.
Participant
China Family Panel Studies (CFPS) is a nationally representative longitudinal survey of Chinese communities, families, and individuals conducted in 2010 (baseline) and 2014 by the Institute of Social Science Survey (ISSS), Peking University, China. In 2010 and 2014, there were 25,486 unique respondents (>9 years) for a total of 50,972 comparison data points. After removing individuals with incomplete data (n=282) and all data without usable Air Pollution Index (API), weather information, or household demographics, a total of 31,955 dataset points (i.e., observation points) were analyzed.
Study parameters assessed
The CFPS survey in 2010 and 2014 contained 24 standardized math questions and 34 word recognition questions, each in ascending order of difficulty. A test result was determined if the participant answered 3 questions incorrectly in a row, with the last correct answer recorded as the test result.
Daily measurements of air quality were based on the Air Pollution Index (API), which measures sulfur dioxide (SO2), nitrogen dioxide (NO2) and fine dust with a diameter of less than 10 microns (PM10). The API is issued by the Chinese Ministry of Environmental Protection. The study used city-level API measurements to measure the air quality of counties where CFPS surveys were conducted over 1-day, 7-day, 30-day, 90-day, 1-year, 2-year, and 3-year exposures.
Primary outcome measures
change in cognitive performance over time as measured by mathematical and verbal tests; API measurements in respondents' geographic areas at specific times were matched with test result patterns to determine the impact of pollution. To assess how air pollution affects cognitive performance in older people, the study examined the cumulative effects of both types of tests in different age cohorts: 25-34, 35-44, 45-54, 55-64 and over 65 years.
Key insights
There were 3 significant general findings from this study:
- Die Luftverschmutzung entsprach einer Verschlechterung der Testergebnisse. Dies war für alle Datenpunkte statistisch signifikant, mit Ausnahme der mathematischen Testergebnisse für 1-tägige und 7-tägige Luftverschmutzungsexposition.
- Je länger das Expositionsfenster gegenüber Luftverschmutzung ist, desto größer ist der Rückgang der kognitiven Leistungsfähigkeit.
- Luftverschmutzung scheint einen größeren negativen Einfluss auf die verbale als auf die mathematische Testleistung zu haben.
There were also statistically significant gender differences, reflecting an increased susceptibility of men to air pollution. The pattern of verbal ratings highlighted the decline in performance in the older cohorts, while also showing a more pronounced decline in verbal ability in men with a widening of the gender gap in older people.
In conclusion, in this study, the aging brain was negatively affected by air pollution - particularly in older or less educated men - as demonstrated by cognitive performance on mathematical and verbal tests.
Practice implications
The aging of the world's population at a time of deteriorating air quality1has serious implications for health and social welfare. Cognitive challenges affect functionality to varying degrees and become more pronounced with age; Physical aging and cognitive decline often occur simultaneously. The study reviewed here did not rule out other medical conditions that may have contributed to the observed cognitive decline, such as: B. Lung and cardiovascular diseases, diabetes, neurological or psychiatric disorders and dementia.2
The authors suggest that a possible mechanism for the disparity in gender performance is the stronger effect of air pollution on white matter (more required by verbal testing), since there are gender differences in white and gray matter.3
The pattern of verbal ratings highlighted the decline in performance in the older cohorts, while also showing a more pronounced decline in verbal ability in men with a widening of the gender gap in older people.
Because men are generally less likely to seek preventive medical advice4and are more susceptible to cognitive impairment from exposure to air pollution than women, it is important to highlight the risks early and often in medical encounters with them.
When advising patients about how to reduce harm from air pollution, the primary focus should be on minimizing exposure and overall risk:5
- Überwachen Sie Ihre Luft. Wenden Sie sich an lokale oder nationale Quellen zu den täglichen Luftverschmutzungswerten, um festzustellen, ob Höhenangaben darauf hindeuten, dass Sie Outdoor-Aktivitäten oder Verschmutzungsschwerpunkte einschränken.
- Planen Sie Ihre Outdoor-Aktivitäten. Achten Sie morgens und am frühen Abend auf Spitzenwerte des Berufsverkehrs und versuchen Sie, Zeiten zu vermeiden, in denen die Luftverschmutzung am höchsten ist.
- Kenne deine Umgebung. Hinweise aus anderen Studien deuten auf mehr gesundheitliche Schwachstellen bei Menschen hin, die in der Nähe von stark befahrenen Autobahnen und Kreuzungen leben.
- Vermeiden Sie das Fahren in Bereichen mit hohem Verkehrsaufkommen und zu Stoßzeiten. Abgaswerte können zu einer verminderten Luftqualität in Autos führen.
- Bestimmen Sie Ihr Risiko. Bewerten Sie das Gesamtanfälligkeitsrisiko basierend auf den bestehenden Bedingungen, damit Sie die Risiken laufender und zukünftiger Expositionen abwägen können.
- Persönlichen Schutz verwenden. Manchen Menschen sollte geraten werden, eine Gesichtsmaske mit wirksamer Filterung für die schädlichsten Feinstaubpartikel (PM2,5) zu verwenden.