Elissa H Wilker1, Sarah R Preis2, Alexa S Beiser2, Philip A Wolf2, Rhoda Au2, Itai Kloog2, Wenyuan Li2, Joel Schwartz2, Petros Koutrakis2, Charles DeCarli2, Sudha Seshadri2, Murray A Mittleman2. 1. From the Cardiovascular Epidemiology Research Unit, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA (E.H.W., M.A.M.); Exposure, Epidemiology and Risk Program, Department of Environmental Health (E.H.W., J.S., P.K.) and Department of Epidemiology (W.L., J.S., M.A.M.), Harvard T.H. Chan School of Public Health, Boston, MA; Department of Biostatistics, School of Public Health (S.R.P., A.S.B., R.A.) and Department of Neurology, School of Medicine (A.S.B., P.A.W., S.S.), Boston University, MA; Framingham Heart Study, MA (S.R.P., A.S.B., P.A.W., S.S.); Department of Geography and Environmental Development, Ben-Gurion University of the Negev, Beer Sheva, Israel (I.K.); and Department of Neurology and Center for Neuroscience, University of California, Davis (C.D.). ewilker@bidmc.harvard.edu. 2. From the Cardiovascular Epidemiology Research Unit, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA (E.H.W., M.A.M.); Exposure, Epidemiology and Risk Program, Department of Environmental Health (E.H.W., J.S., P.K.) and Department of Epidemiology (W.L., J.S., M.A.M.), Harvard T.H. Chan School of Public Health, Boston, MA; Department of Biostatistics, School of Public Health (S.R.P., A.S.B., R.A.) and Department of Neurology, School of Medicine (A.S.B., P.A.W., S.S.), Boston University, MA; Framingham Heart Study, MA (S.R.P., A.S.B., P.A.W., S.S.); Department of Geography and Environmental Development, Ben-Gurion University of the Negev, Beer Sheva, Israel (I.K.); and Department of Neurology and Center for Neuroscience, University of California, Davis (C.D.).
Abstract
BACKGROUND AND PURPOSE: Long-term exposure to ambient air pollution is associated with cerebrovascular disease and cognitive impairment, but whether it is related to structural changes in the brain is not clear. We examined the associations between residential long-term exposure to ambient air pollution and markers of brain aging using magnetic resonance imaging. METHODS: Framingham Offspring Study participants who attended the seventh examination were at least 60 years old and free of dementia and stroke were included. We evaluated associations between exposures (fine particulate matter [PM2.5] and residential proximity to major roadways) and measures of total cerebral brain volume, hippocampal volume, white matter hyperintensity volume (log-transformed and extensive white matter hyperintensity volume for age), and covert brain infarcts. Models were adjusted for age, clinical covariates, indicators of socioeconomic position, and temporal trends. RESULTS: A 2-μg/m(3) increase in PM2.5 was associated with -0.32% (95% confidence interval, -0.59 to -0.05) smaller total cerebral brain volume and 1.46 (95% confidence interval, 1.10 to 1.94) higher odds of covert brain infarcts. Living further away from a major roadway was associated with 0.10 (95% confidence interval, 0.01 to 0.19) greater log-transformed white matter hyperintensity volume for an interquartile range difference in distance, but no clear pattern of association was observed for extensive white matter. CONCLUSIONS: Exposure to elevated levels of PM2.5 was associated with smaller total cerebral brain volume, a marker of age-associated brain atrophy, and with higher odds of covert brain infarcts. These findings suggest that air pollution is associated with insidious effects on structural brain aging even in dementia- and stroke-free persons.
BACKGROUND AND PURPOSE: Long-term exposure to ambient air pollution is associated with cerebrovascular disease and cognitive impairment, but whether it is related to structural changes in the brain is not clear. We examined the associations between residential long-term exposure to ambient air pollution and markers of brain aging using magnetic resonance imaging. METHODS: Framingham Offspring Study participants who attended the seventh examination were at least 60 years old and free of dementia and stroke were included. We evaluated associations between exposures (fine particulate matter [PM2.5] and residential proximity to major roadways) and measures of total cerebral brain volume, hippocampal volume, white matter hyperintensity volume (log-transformed and extensive white matter hyperintensity volume for age), and covert brain infarcts. Models were adjusted for age, clinical covariates, indicators of socioeconomic position, and temporal trends. RESULTS: A 2-μg/m(3) increase in PM2.5 was associated with -0.32% (95% confidence interval, -0.59 to -0.05) smaller total cerebral brain volume and 1.46 (95% confidence interval, 1.10 to 1.94) higher odds of covert brain infarcts. Living further away from a major roadway was associated with 0.10 (95% confidence interval, 0.01 to 0.19) greater log-transformed white matter hyperintensity volume for an interquartile range difference in distance, but no clear pattern of association was observed for extensive white matter. CONCLUSIONS: Exposure to elevated levels of PM2.5 was associated with smaller total cerebral brain volume, a marker of age-associated brain atrophy, and with higher odds of covert brain infarcts. These findings suggest that air pollution is associated with insidious effects on structural brain aging even in dementia- and stroke-free persons.
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