Improving air quality associated with slower cognitive decline in women

Improvements in air quality are associated with slower cognitive decline in women, according to a new study led by Diana Younan, of the University of Southern California publishing February 3^rd in the journal PLOS Medicine.

Some studies have shown that late-in-life exposure to outdoor air pollution is a risk factor for dementia. However, it was not known whether improving air quality could stave off dementia by slowing the cognitive decline associated with aging. Younan and her colleagues investigated this question using a cohort of 2,232 older women who were free of dementia when they entered the study. The researchers followed the women for up to 20 years, giving them two different cognitive tests annually. They also estimated local changes in air quality and used statistical tests to see if a reduction in air pollution was associated with slower cognitive decline.

The analysis revealed that women living in areas with greater improvements in air quality tended to have a slower decline, as indicated by the results on both cognitive tests. The reduced rate of decline was equivalent to being about one or one and a half years younger, depending on the test.

The new findings reinforce previous studies suggesting that outdoor air pollution contributes to cognitive decline. Cleaner air is already known to improve heart and respiratory health and reduce a person's overall risk of death. But the new work highlights the potential benefits of reducing air pollution levels to maintain brain health as well. Dementia is estimated to cost the U.S. economy $159–$215 billion annually.

Younan adds, “We found that reducing air pollution exposure can promote healthier brain aging in older women by slowing cognitive decline. These benefits were seen in older women of all ages, levels of education, geographic regions of residence, and cardiovascular histories.”

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In your coverage, please use this URL to provide access to the freely available paper in PLOS Medicine:

http://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1003893

Citation: Younan D, Wang X, Millstein J, Petkus AJ, Beavers DP, Espeland MA, et al. (2022) Air quality improvement and cognitive decline in community-dwelling older women in the United States: A longitudinal cohort study. PLoS Med 19(2): e1003893. https://doi.org/10.1371/journal.pmed.1003893

Author Countries: United States

Funding: This study is supported by the National Institute of Environmental Health Sciences (R01ES025888; J-C.C. and J.D.K.; and 5P30ES007048), the National Institute on Aging (NIA) (RF1AG054068; J-C.C.), and the Alzheimer’s Disease Research Center at USC (NIA; P50AG005142 and P30AG066530). D.Y. and J-C.C. are supported in part by the NIA (P01AG055367). D.Y. is also supported by a grant from the Alzheimer’s Association (AARF-19-591356). The air pollution models were developed under a STAR research assistance agreement, No. RD831697 (MESA Air) and RD-83830001 (MESA Air Next Stage), awarded by the US Environmental Protection Agency (EPA). M.A.E. receives funding from the Wake Forest Alzheimer’s Disease Core Center (P30AG049638–01A1). S.M.R. is supported by the Intramural Research Program, NIA, NIH. The WHI program is funded by the National Heart, Lung, and Blood Institute, National Institutes of Health, U.S. Department of Health and Human Services through contracts HHSN268201600018C, HHSN268201600001C, HHSN268201600002C, HHSN268201600003C, and HHSN268201600004C. A list of contributors to WHI is available at https://www-whi-org.s3.us-west-2.amazonaws.com/wp-content/uploads/WHI-Investigator-Long-List.pdf. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.