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<p>Previous studies have indicated increased dementia risk associated with fine particulate matter (PM<sub>2.5</sub>) exposure; however, the findings are inconsistent. In this systematic review, we assessed the association between long-term PM<sub>2.5</sub> exposure and dementia outcomes using the Burden of Proof meta-analytic framework, which relaxes log-linear assumptions to better characterize relative risk functions and quantify unexplained between-study heterogeneity (PROSPERO, ID CRD42023421869). Here we report a meta-analysis of 28 longitudinal cohort studies published up to June 2023 that investigated long-term PM<sub>2.5</sub> exposure and dementia outcomes. We derived risk–outcome scores (ROSs), highly conservative measures of effect size and evidence strength, mapped onto a 1–5-star rating from ‘weak and/or inconsistent evidence’ to ‘very strong and/or consistent evidence’. We identified a significant nonlinear relationship between PM<sub>2.5</sub> exposure and dementia, with a minimum 14% increased risk averaged across PM<sub>2.5</sub> levels between 4.5 and 26.9 µg m<sup>−3</sup> (the 15th to 85th percentile exposure range across included studies), relative to a reference of 2.0 µg m<sup>−3</sup> (<i>n</i> = 49, ROS = 0.13, two stars). We found a significant association of PM<sub>2.5</sub> with Alzheimer’s disease (<i>n</i> = 12, ROS = 0.32, three stars) but not with vascular dementia. Our findings highlight the potential impact of air pollution on brain aging.</p>

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A systematic review with a Burden of Proof meta-analysis of health effects of long-term ambient fine particulate matter (PM2.5) exposure on dementia

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年3月21日

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  • Xinmei Huang,
  • Jaimie Steinmetz,
  • Elizabeth K. Marsh,
  • Aleksandr Y. Aravkin,
  • Charlie Ashbaugh,
  • Christopher J. L. Murray,
  • Fanghan Yang,
  • John S. Ji,
  • Peng Zheng,
  • Reed J. D. Sorensen,
  • Sarah Wozniak,
  • Simon I. Hay,
  • Susan A. McLaughlin,
  • Vanessa Garcia,
  • Michael Brauer,
  • Katrin Burkart

摘要

Previous studies have indicated increased dementia risk associated with fine particulate matter (PM2.5) exposure; however, the findings are inconsistent. In this systematic review, we assessed the association between long-term PM2.5 exposure and dementia outcomes using the Burden of Proof meta-analytic framework, which relaxes log-linear assumptions to better characterize relative risk functions and quantify unexplained between-study heterogeneity (PROSPERO, ID CRD42023421869). Here we report a meta-analysis of 28 longitudinal cohort studies published up to June 2023 that investigated long-term PM2.5 exposure and dementia outcomes. We derived risk–outcome scores (ROSs), highly conservative measures of effect size and evidence strength, mapped onto a 1–5-star rating from ‘weak and/or inconsistent evidence’ to ‘very strong and/or consistent evidence’. We identified a significant nonlinear relationship between PM2.5 exposure and dementia, with a minimum 14% increased risk averaged across PM2.5 levels between 4.5 and 26.9 µg m−3 (the 15th to 85th percentile exposure range across included studies), relative to a reference of 2.0 µg m−3 (n = 49, ROS = 0.13, two stars). We found a significant association of PM2.5 with Alzheimer’s disease (n = 12, ROS = 0.32, three stars) but not with vascular dementia. Our findings highlight the potential impact of air pollution on brain aging.