학술논문

Racial/Ethnic Disparities in Alzheimer’s Disease Risk: Role of Exposure to Ambient Fine Particles
Document Type
article
Source
The Journals of Gerontology Series A. 77(5)
Subject
Dementia
Behavioral and Social Science
Alzheimer's Disease
Aging
Mental Health
Alzheimer's Disease including Alzheimer's Disease Related Dementias (AD/ADRD)
Neurosciences
Acquired Cognitive Impairment
Brain Disorders
Neurodegenerative
Cardiovascular
Prevention
Clinical Research
Good Health and Well Being
Aged
Air Pollutants
Air Pollution
Alzheimer Disease
Environmental Exposure
Female
Humans
Particulate Matter
Prospective Studies
Air pollution
Epidemiology
Incidence
Clinical Sciences
Gerontology
Language
Abstract
BackgroundWhether racial/ethnic disparities in Alzheimer's disease (AD) risk may be explained by ambient fine particles (PM2.5) has not been studied.MethodWe conducted a prospective, population-based study on a cohort of Black (n = 481) and White (n = 6 004) older women (aged 65-79) without dementia at enrollment (1995-1998). Cox models accounting for competing risk were used to estimate the hazard ratio (HR) for racial/ethnic disparities in AD (1996-2010) defined by Diagnostic and Statistical Manual of Mental Disorders, 4th edition and the association with time-varying annual average PM2.5 (1999-2010) estimated by spatiotemporal model.ResultsOver an average follow-up of 8.3 (±3.5) years with 158 incident cases (21 in Black women), the racial disparities in AD risk (range of adjusted HRBlack women = 1.85-2.41) observed in various models could not be explained by geographic region, age, socioeconomic characteristics, lifestyle factors, cardiovascular risk factors, and hormone therapy assignment. Estimated PM2.5 exposure was higher in Black (14.38 ± 2.21 µg/m3) than in White (12.55 ± 2.76 µg/m3) women, and further adjustment for the association between PM2.5 and AD (adjusted HRPM2.5 = 1.18-1.28) slightly reduced the racial disparities by 2%-6% (HRBlack women = 1.81-2.26). The observed association between PM2.5 and AD risk was ~2 times greater in Black (HRPM2.5 = 2.10-2.60) than in White (HRPM2.5 = 1.07-1.15) women (range of interaction ps: