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Zhang Y, Wu T, Yu H, Fu J, Xu J, Liu L, Tang C, Li Z. Green spaces exposure and the risk of common psychiatric disorders: A meta-analysis. SSM Popul Health 2024; 25:101630. [PMID: 38405164 PMCID: PMC10885792 DOI: 10.1016/j.ssmph.2024.101630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2024] [Revised: 02/07/2024] [Accepted: 02/13/2024] [Indexed: 02/27/2024] Open
Abstract
Objective To explore the effects of green spaces exposure on common psychiatric disorders. Methods PubMed, Embase, Web of Science and MEDLINE were screened and articles published prior to November 15, 2023 were included. Analyses were performed on common psychiatric disorders, categorized into depression, anxiety, dementia, schizophrenia, and attention deficit hyperactivity disorder (ADHD). And the subgroup analyses were conducted for depression, anxiety, dementia, and schizophrenia. Results In total, 2,0064 studies were retrieved, 59 of which were included in our study; 37 for depression, 14 for anxiety, 8 for dementia, 7 for schizophrenia and 5 for ADHD. Green spaces were found to benefit the moderation of psychiatric disorders (OR = 0.91, 95% CI: 0.89 to 0.92). Green spaces positively influence depression (OR = 0.89, 95% CI: 0.86 to 0.93), regardless of the cross-sectional or cohort studies. Green spaces can also help mitigate the risk of anxiety (OR = 0.94, 95%CI:0.92 to 0.96). As an important index for measuring green spaces, a higher normalized difference vegetation index (NDVI) level related to a lower level of depression (OR = 0.95, 95%CI:0.91 to 0.98) and anxiety (OR = 0.95, 95%:0.92 to 0.98). The protection was also found in dementia (OR = 0.95, 95% CI: 0.93 to 0.96), schizophrenia (OR = 0.74, 95% CI: 0.67 to 0.82), and ADHD (OR = 0.89, 95% CI: 0.86 to 0.92) results. Conclusion Green spaces decrease the risk of psychiatric disorders, including depression, anxiety, dementia, schizophrenia, and ADHD. Further studies on green spaces and psychiatric disorders are needed, and more green spaces should be considered in city planning.
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Affiliation(s)
- Yimin Zhang
- School of Public Health, Health Science Center, Ningbo University, Ningbo, China
| | - Tongyan Wu
- School of Public Health, Health Science Center, Ningbo University, Ningbo, China
| | - Hao Yu
- Department of Urology, The Second Affiliated Hospital of Nanjing Medical University, Nanjing, China
- Department of Urology, The Second Clinical Medical College of Nanjing Medical University, Nanjing, China
| | - Jianfei Fu
- Department of Medical Records and Statistics, Ningbo First Hospital, Ningbo, China
| | - Jin Xu
- School of Public Health, Health Science Center, Ningbo University, Ningbo, China
| | - Liya Liu
- School of Public Health, Health Science Center, Ningbo University, Ningbo, China
| | - Chunlan Tang
- School of Public Health, Health Science Center, Ningbo University, Ningbo, China
| | - Zhen Li
- School of Public Health, Health Science Center, Ningbo University, Ningbo, China
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Hu X, Wang J, Yang T, Jin J, Zeng Q, Aboubakri O, Feng XL, Li G, Huang J. Role of residential greenspace in the trajectory of major neurological disorders: A longitudinal study in UK Biobank. Sci Total Environ 2024; 912:168967. [PMID: 38042194 DOI: 10.1016/j.scitotenv.2023.168967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 11/26/2023] [Accepted: 11/26/2023] [Indexed: 12/04/2023]
Abstract
BACKGROUND Stroke and dementia are major neurological disorders that contribute significantly to disease burden and are interlinked in terms of risk. Nevertheless, there is currently no study investigating the influence of residential greenspace on the trajectory of these neurological disorders. METHODS This longitudinal study utilized data from the UK Biobank. Exposure to residential greenspace was measured by the percentage of total greenspace coverage within a 300-meter buffer zone surrounding the participants' residences. A multistate model was employed to illustrate the trajectory of major neurological disorders, and a piecewise Cox regression model was applied to explore the impact of residential greenspace on different time courses of disease transitions. RESULTS With 422,649 participants and a median follow-up period of 12.5 years, 8568 (2.0 %), 5648 (1.3 %), and 621 (0.1 %) individuals developed incident stroke, dementia, and comorbidity of both conditions, respectively. An increase in residential greenspace by one interquartile range was associated with reduced risks of transitions from baseline to stroke, dementia, and death, as well as from stroke to comorbidity. The corresponding hazard ratios (HRs) were 0.967 (95 % CI: 0.936, 0.998), 0.928 (0.892, 0.965), 0.925 (0.907, 0.942), and 0.799 (0.685, 0.933), respectively. Furthermore, the protective effect of residential greenspace on the transition from stroke or dementia to comorbidity was particularly pronounced within the first year and over 5 years after stroke and during the 2 to 3 years after dementia onset, with HRs of 0.692 (0.509, 0.941), 0.705 (0.542, 0.918), and 0.567 (0.339, 0.949), respectively. CONCLUSION This study observed a protective role of residential greenspace in the trajectory of major neurological disorders and contributed to identifying critical progression windows. These findings underscore the significance of environment-health interactions in the prevention of neurological disorders.
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Affiliation(s)
- Xin Hu
- Department of Occupational and Environmental Health Sciences, Peking University School of Public Health, 38 Xueyuan Road, Haidian District, Beijing 100191, China
| | - Jiawei Wang
- Department of Occupational and Environmental Health Sciences, Peking University School of Public Health, 38 Xueyuan Road, Haidian District, Beijing 100191, China
| | - Teng Yang
- Department of Occupational and Environmental Health Sciences, Peking University School of Public Health, 38 Xueyuan Road, Haidian District, Beijing 100191, China
| | - Jianbo Jin
- Department of Occupational and Environmental Health Sciences, Peking University School of Public Health, 38 Xueyuan Road, Haidian District, Beijing 100191, China
| | - Qiang Zeng
- Institute of Occupational Disease Control and Prevention, Tianjin Centers for Disease Control and Prevention, Tianjin 300011, China
| | - Omid Aboubakri
- Environmental Health Research Center, Kurdistan University of Medical Science, Sanandaj, Kurdistan 7616913555, Iran
| | - Xing Lin Feng
- Peking University School of Public Health, 38 Xueyuan Road, Haidian District, Beijing 100191, China
| | - Guoxing Li
- Department of Occupational and Environmental Health Sciences, Peking University School of Public Health, 38 Xueyuan Road, Haidian District, Beijing 100191, China; Environmental Research Group, Faculty of Medicine, School of Public Health, Imperial College, London W12 0BZ, UK.
| | - Jing Huang
- Department of Occupational and Environmental Health Sciences, Peking University School of Public Health, 38 Xueyuan Road, Haidian District, Beijing 100191, China; Institute for Global Health and Development, Peking University, 5 Yiheyuan Road, Haidian District, Beijing 100871, China.
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Tondelli M, Chiari A, Vinceti G, Galli C, Salemme S, Filippini T, Carbone C, Minafra C, De Luca C, Prandi R, Tondelli S, Zamboni G. Greenness and neuropsychiatric symptoms in dementia. Environ Res 2024; 242:117652. [PMID: 37980996 DOI: 10.1016/j.envres.2023.117652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 11/10/2023] [Accepted: 11/11/2023] [Indexed: 11/21/2023]
Abstract
OBJECTIVES It is acknowledged that living in a green environment may help mental well-being and this may be especially true for vulnerable people. However, the relationship between greenness and neuropsychiatric symptoms in dementia has not been explored yet. METHODS We collected clinical, neuropsychiatric, and residential data from subjects with dementia living in the province of Modena, Northern Italy. Neuropsychiatric symptoms were measured with the Neuropsychiatry Inventory, a questionnaire administered to the caregiver who assesses the presence and severity of neuropsychiatric symptoms, including delusions, hallucinations, agitation/aggression, dysphoria/depression, anxiety, euphoria/elation, apathy/indifference, disinhibition, irritability/lability, aberrant motor behaviors, sleep disturbances, and appetite/eating changes. Normalized Difference Vegetation Index (NDVI) was used as a proxy of greenness. Regression models were constructed to study the association between greenness and neuropsychiatric features. RESULTS 155 patients with dementia were recruited. We found that greenness is variably associated with the risk of having neuropsychiatric symptoms. The risk of apathy was lower with lower levels of greenness (OR = 0.42, 95% CI 0.19-0.91 for NDVI below the median value). The risk of psychosis was higher with lower levels of greenness but with more imprecise values (OR = 1.77, 95% CI 0.84-3.73 for NDVI below the median value). CONCLUSION Our results suggest a possible association between greenness and neuropsychiatric symptoms in people with dementia. If replicated in larger samples, these findings will pave the road for identifying innovative greening strategies and interventions that can improve mental health in dementia.
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Affiliation(s)
- Manuela Tondelli
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy; Neurology Unit, Baggiovara Hospital, AOU Modena, Modena, Italy.
| | - Annalisa Chiari
- Neurology Unit, Baggiovara Hospital, AOU Modena, Modena, Italy
| | - Giulia Vinceti
- Neurology Unit, Baggiovara Hospital, AOU Modena, Modena, Italy
| | - Chiara Galli
- Primary Care Department, AUSL Modena, Modena, Italy
| | - Simone Salemme
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Tommaso Filippini
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy; Environmental, Genetic and Nutritional Epidemiology Research Center (CREAGEN), Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy; School of Public Health, University of California Berkeley, Berkeley, CA, USA
| | - Chiara Carbone
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Claudia Minafra
- Department of Architecture, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Claudia De Luca
- Department of Architecture, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Riccardo Prandi
- Department of Biological, Geological and Environmental Sciences (BiGeA), Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Simona Tondelli
- Department of Architecture, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Giovanna Zamboni
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy; Neurology Unit, Baggiovara Hospital, AOU Modena, Modena, Italy
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Villoz F, Filippini T, Ortega N, Kopp-Heim D, Voortman T, Blum MR, Del Giovane C, Vinceti M, Rodondi N, Chocano-Bedoya PO. Dairy Intake and Risk of Cognitive Decline and Dementia: A Systematic Review and Dose-Response Meta-Analysis of Prospective Studies. Adv Nutr 2024; 15:100160. [PMID: 38043604 PMCID: PMC10788406 DOI: 10.1016/j.advnut.2023.100160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 11/20/2023] [Accepted: 11/27/2023] [Indexed: 12/05/2023] Open
Abstract
Dairy intake may influence cognition through several molecular pathways. However, epidemiologic studies yield inconsistent results, and no dose-response meta-analysis has been conducted yet. Therefore, we performed a systematic review with a dose-response meta-analysis about the association between dairy intake and cognitive decline or incidence of dementia. We investigated prospective studies with a follow-up ≥6 mo on cognitive decline or dementia incidence in adults without known chronic conditions through a systematic search of Embase, Medline, Cochrane Library, Web of Science, and Google Scholar from inception to 11 July 2023. We evaluated the dose-response association using a random-effects model. We identified 15 eligible cohort studies with >300,000 participants and a median follow-up of 11.4 y. We observed a negative nonlinear association between cognitive decline/dementia incidence and dairy intake as assessed through the quantity of consumption, with the nadir at ∼150 g/d (risk ratio: 0.88; 95% confidence interval: 0.78, 0.99). Conversely, we found an almost linear negative association when we considered the frequency of consumption (risk ratio for linear trend: 0.84; 95% confidence interval: 0.77, 0.92 for 1 time/d increase of dairy products). Stratified analysis by dairy products showed different shapes of the association with linear inverse relationship for milk intake, whereas possibly nonlinear for cheese. The inverse association was limited to Asian populations characterized by generally lower intake of dairy products, compared with the null association reported by European studies. In conclusion, our study suggests a nonlinear inverse association between dairy intake and cognitive decline or dementia, also depending on dairy types and population characteristics, although the heterogeneity was still high in overall and several subgroup analyses. Additional studies should be performed on this topic, including a wider range of intake and types of dairy products, to confirm a potential preventing role of dairy intake on cognitive decline and identify ideal intake doses. This review was registered at PROSPERO as CRD42020192395.
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Affiliation(s)
- Fanny Villoz
- Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland; Department of General Internal Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Tommaso Filippini
- Section of Public Health, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy; School of Public Health, University of California Berkeley, Berkeley, CA, United States
| | - Natalia Ortega
- Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland; Population Health Laboratory, University of Fribourg, Fribourg, Switzerland
| | - Doris Kopp-Heim
- Public Health and Primary Care Library, University Library of Bern, University of Bern, Bern, Switzerland
| | - Trudy Voortman
- Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - Manuel R Blum
- Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland; Department of General Internal Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Cinzia Del Giovane
- Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland; Population Health Laboratory, University of Fribourg, Fribourg, Switzerland; Department of Medical and Surgical Sciences for Children and Adults, University-Hospital of Modena and Reggio Emilia, Modena, Italy
| | - Marco Vinceti
- Section of Public Health, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy; Department of Epidemiology, Boston University School of Public Health, Boston, MA, United States
| | - Nicolas Rodondi
- Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland; Department of General Internal Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Patricia O Chocano-Bedoya
- Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland; Population Health Laboratory, University of Fribourg, Fribourg, Switzerland.
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Xu Z, Han Z, Wang J, Jin R, Li Z, Wu Z, Zhao Z, Lv S, Zhao X, Liu Y, Guo X, Tao L. Association Between Long-Term Exposure to Fine Particulate Matter Constituents and Progression of Cerebral Blood Flow Velocity in Beijing: Modifying Effect of Greenness. Geohealth 2023; 7:e2023GH000796. [PMID: 37449300 PMCID: PMC10337285 DOI: 10.1029/2023gh000796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Revised: 05/23/2023] [Accepted: 06/13/2023] [Indexed: 07/18/2023]
Abstract
Few studies have explored the effects of fine particulate matter (PM2.5) and its constituents on the progression of cerebral blood flow velocity (BFV) and the potential modifying role of greenness. In this study, we investigated the association of PM2.5 and its constituents, including sulfate (SO4 2-), nitrate (NO3 -), ammonium (NH4 +), organic matter (OM), and black carbon (BC), with the progression of BFV in the middle cerebral artery. Participants from the Beijing Health Management Cohort who underwent at least two transcranial Doppler sonography examinations during 2015-2020 were recruited. BFV change and BFV change rate were used to define the progression of cerebral BFV. Linear mixed effects models were employed to analyze the data, and the weighted quantile sum regression assessed the contribution of PM2.5 constituents. Additionally, greenness was examined as a modifier. Among the examined constituents, OM exhibited the strongest association with BFV progression. An interquartile range increase in PM2.5 and OM exposure concentrations was associated with a decrease of -16.519 cm/s (95% CI: -17.837, -15.201) and -15.403 cm/s (95% CI: -16.681, -14.126) in BFV change, and -10.369 cm/s/year (95% CI: -11.387, -9.352) and -9.615 cm/s/year (95% CI: -10.599, -8.632) in BFV change rate, respectively. Furthermore, stronger associations between PM2.5 and BFV progression were observed in individuals working in areas with lower greenness, those aged under 45 years, and females. In conclusion, reducing PM2.5 levels in the air, particularly the OM constituent, and enhancing greenness could potentially contribute to the protection of cerebrovascular health.
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Affiliation(s)
- Zongkai Xu
- Beijing Municipal Key Laboratory of Clinical EpidemiologyDepartment of Epidemiology and Health StatisticsSchool of Public HealthCapital Medical UniversityBeijingChina
| | - Ze Han
- Beijing Municipal Key Laboratory of Clinical EpidemiologyDepartment of Epidemiology and Health StatisticsSchool of Public HealthCapital Medical UniversityBeijingChina
| | - Jinqi Wang
- Beijing Municipal Key Laboratory of Clinical EpidemiologyDepartment of Epidemiology and Health StatisticsSchool of Public HealthCapital Medical UniversityBeijingChina
| | - Rui Jin
- Beijing Municipal Key Laboratory of Clinical EpidemiologyDepartment of Epidemiology and Health StatisticsSchool of Public HealthCapital Medical UniversityBeijingChina
| | - Zhiwei Li
- Beijing Municipal Key Laboratory of Clinical EpidemiologyDepartment of Epidemiology and Health StatisticsSchool of Public HealthCapital Medical UniversityBeijingChina
| | - Zhiyuan Wu
- Beijing Municipal Key Laboratory of Clinical EpidemiologyDepartment of Epidemiology and Health StatisticsSchool of Public HealthCapital Medical UniversityBeijingChina
- Center of Precision HealthSchool of Medical and Health SciencesEdith Cowan UniversityJoondalupWAAustralia
| | - Zemeng Zhao
- Beijing Municipal Key Laboratory of Clinical EpidemiologyDepartment of Epidemiology and Health StatisticsSchool of Public HealthCapital Medical UniversityBeijingChina
| | - Shiyun Lv
- Beijing Municipal Key Laboratory of Clinical EpidemiologyDepartment of Epidemiology and Health StatisticsSchool of Public HealthCapital Medical UniversityBeijingChina
| | - Xiaoyu Zhao
- Beijing Municipal Key Laboratory of Clinical EpidemiologyDepartment of Epidemiology and Health StatisticsSchool of Public HealthCapital Medical UniversityBeijingChina
| | - Yueruijing Liu
- Beijing Municipal Key Laboratory of Clinical EpidemiologyDepartment of Epidemiology and Health StatisticsSchool of Public HealthCapital Medical UniversityBeijingChina
| | - Xiuhua Guo
- Beijing Municipal Key Laboratory of Clinical EpidemiologyDepartment of Epidemiology and Health StatisticsSchool of Public HealthCapital Medical UniversityBeijingChina
| | - Lixin Tao
- Beijing Municipal Key Laboratory of Clinical EpidemiologyDepartment of Epidemiology and Health StatisticsSchool of Public HealthCapital Medical UniversityBeijingChina
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Mazzoleni E, Vinceti M, Costanzini S, Garuti C, Adani G, Vinceti G, Zamboni G, Tondelli M, Galli C, Salemme S, Teggi S, Chiari A, Filippini T. Outdoor artificial light at night and risk of early-onset dementia: A case-control study in the Modena population, Northern Italy. Heliyon 2023; 9:e17837. [PMID: 37455959 PMCID: PMC10339013 DOI: 10.1016/j.heliyon.2023.e17837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 05/15/2023] [Accepted: 06/28/2023] [Indexed: 07/18/2023] Open
Abstract
Background Dementia is a neurological syndrome characterized by severe cognitive impairment with functional impact on everyday life. It can be classified as young onset dementia (EOD) in case of symptom onset before 65, and late onset dementia (LOD). The purpose of this study is to assess the risk of dementia due to light pollution, and specifically outdoor artificial light at night (LAN). Methods Using a case-control design, we enrolled dementia patients newly-diagnosed in the province of Modena in the period 2017-2019 and a referent population from their caregivers. We geo-referenced the address of residence on the date of recruitment, provided it was stable for the previous five years. We assessed LAN exposure through 2015 nighttime luminance satellite images from the Visible Infrared Imaging Radiometer Suite (VIIRS). Using a logistic regression model adjusted for age, sex, and education, we calculated the risk of dementia associated with increasing LAN exposure, namely using <10 nW/cm2/sr as reference and considering ≥10-<40 nW/cm2/sr intermediate and ≥40 nW/cm2/sr high exposure, respectively We also implemented non-linear assessment using a spline regression model. Results We recruited 58 EOD cases, 34 LOD cases and 54 controls. Average LAN exposure levels overlapped for EOD cases and controls, while LOD cases showed higher levels. Compared with the lowest exposure, the risk of EOD associated with LAN was higher in the intermediate exposure (OR = 1.36, 95% CI 0.54-3.39), but not in the high exposure category (OR = 1.04, 95% CI 0.32-3.34). In contrast, the risk of LOD was positively associated with LAN exposure, with ORs of 2.58 (95% CI 0.26-25.97) and 3.50 (95% CI 0.32-38.87) in the intermediate and high exposure categories, respectively. The spline regression analysis showed substantial lack of association between LAN and EOD, while almost linear although highly imprecise association emerged for LOD. Conclusions Although the precision of the estimates was affected by the limited sample size and the study design did not allow us to exclude the presence of residual confounding, these results suggest a possible role of LAN in the etiology of dementia, particularly of its late-onset form.
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Affiliation(s)
- Elena Mazzoleni
- Environmental, Genetic and Nutritional Epidemiology Research Center (CREAGEN), Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Marco Vinceti
- Environmental, Genetic and Nutritional Epidemiology Research Center (CREAGEN), Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
| | - Sofia Costanzini
- DIEF Department of Engineering “Enzo Ferrari”, University of Modena and Reggio Emilia, Modena, Italy
| | - Caterina Garuti
- Environmental, Genetic and Nutritional Epidemiology Research Center (CREAGEN), Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
- Department of Medical and Surgical Sciences for Mothers, Children and Adults, Post Graduate School of Pediatrics, University of Modena and Reggio Emilia, Modena, Italy
| | - Giorgia Adani
- Environmental, Genetic and Nutritional Epidemiology Research Center (CREAGEN), Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Giulia Vinceti
- Department Center for Neurosciences and Neurotechnology, Department of Biomedical, Metabolic, and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
- Neurology Unit, Modena Policlinico-University Hospital, Modena, Italy
| | - Giovanna Zamboni
- Department Center for Neurosciences and Neurotechnology, Department of Biomedical, Metabolic, and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
- Neurology Unit, Modena Policlinico-University Hospital, Modena, Italy
| | - Manuela Tondelli
- Neurology Unit, Modena Policlinico-University Hospital, Modena, Italy
- Primary Care Department, Modena Local Health Authority, Modena, Italy
| | - Chiara Galli
- Neurology Unit, Modena Policlinico-University Hospital, Modena, Italy
- Primary Care Department, Modena Local Health Authority, Modena, Italy
- Department of Neuroscience, Psychology, Pharmacology and Child Health (NeuroFARBA), University of Florence, Florence, Italy
| | - Simone Salemme
- Department Center for Neurosciences and Neurotechnology, Department of Biomedical, Metabolic, and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
- Neurology Unit, Modena Policlinico-University Hospital, Modena, Italy
| | - Sergio Teggi
- DIEF Department of Engineering “Enzo Ferrari”, University of Modena and Reggio Emilia, Modena, Italy
| | - Annalisa Chiari
- Neurology Unit, Modena Policlinico-University Hospital, Modena, Italy
| | - Tommaso Filippini
- Environmental, Genetic and Nutritional Epidemiology Research Center (CREAGEN), Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
- School of Public Health, University of California Berkeley, Berkeley, CA, USA
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Besser LM, Jimenez MP, Reimer CJ, Meyer OL, Mitsova D, George KM, Adkins-Jackson PB, Galvin JE. Diversity of Studies on Neighborhood Greenspace and Brain Health by Racialized/Ethnic Group and Geographic Region: A Rapid Review. Int J Environ Res Public Health 2023; 20:5666. [PMID: 37174185 PMCID: PMC10178609 DOI: 10.3390/ijerph20095666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Revised: 04/16/2023] [Accepted: 04/21/2023] [Indexed: 05/15/2023]
Abstract
Studies examining associations between greenspace and Alzheimer's disease and related dementia (ADRD) outcomes are rapidly on the rise, yet no known literature reviews have summarized the racialized/ethnic group and geographic variation of those published studies. This is a significant gap given the known disparities in both greenspace access and ADRD risk between racialized/ethnic groups and between developed versus developing countries. In this rapid literature review, we (1) describe the diversity of published greenspace-brain health studies with respect to racialized/ethnic groups and geographic regions; (2) determine the extent to which published studies have investigated racialized/ethnic group differences in associations; and (3) review methodological issues surrounding studies of racialized/ethnic group disparities in greenspace and brain health associations. Of the 57 papers meeting our inclusion criteria as of 4 March 2022, 21% (n = 12) explicitly identified and included individuals who were Black, Hispanic/Latinx, and/or Asian. Twenty-one percent of studies (n = 12) were conducted in developing countries (e.g., China, Dominican Republic, Mexico), and 7% (n = 4) examined racialized/ethnic group differences in greenspace-brain health associations. None of the studies were framed by health disparities, social/structural determinants of health, or related frameworks, despite the known differences in both greenspace availability/quality and dementia risk by racialized/ethnic group and geography. Studies are needed in developing countries and that directly investigate racialized/ethnic group disparities in greenspace-brain health associations to target and promote health equity.
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Affiliation(s)
- Lilah M. Besser
- Comprehensive Center for Brain Health, Miller School of Medicine, University of Miami, Miami, FL 33433, USA
| | - Marcia Pescador Jimenez
- Department of Epidemiology, School of Public Health, Boston University, Boston, MA 02118, USA
| | - Cameron J. Reimer
- Department of Earth & Environment, Boston University, Boston, MA 02118, USA
| | - Oanh L. Meyer
- Department of Neurology, School of Medicine, University of California Davis, Sacramento, CA 95817, USA
| | - Diana Mitsova
- School of Urban and Regional Planning, Florida Atlantic University, Boca Raton, FL 33431, USA
| | - Kristen M. George
- Department of Public Health Sciences, School of Medicine, University of California Davis, Davis, CA 95817, USA
| | - Paris B. Adkins-Jackson
- Departments of Epidemiology and Sociomedical Sciences, Columbia University, New York, NY 10032, USA
| | - James E. Galvin
- Comprehensive Center for Brain Health, Miller School of Medicine, University of Miami, Miami, FL 33433, USA
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8
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Urbano T, Chiari A, Malagoli C, Cherubini A, Bedin R, Costanzini S, Teggi S, Maffeis G, Vinceti M, Filippini T. Particulate matter exposure from motorized traffic and risk of conversion from mild cognitive impairment to dementia: An Italian prospective cohort study. Environ Res 2023; 222:115425. [PMID: 36740156 DOI: 10.1016/j.envres.2023.115425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 02/01/2023] [Accepted: 02/02/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Based on epidemiologic and laboratory studies, exposure to air pollutants has been linked to many adverse health effects including a higher risk of dementia. In this study, we aimed to evaluate the effect of long-term exposure to outdoor air pollution on risk of conversion to dementia in a cohort of subjects with mild cognitive impairment (MCI). METHODS We recruited 53 Italian subjects newly-diagnosed with MCI. Within a geographical information system, we assessed recent outdoor air pollutant exposure, by modeling air levels of particulate matter with equivalent aerodynamic diameter ≤10 μm (PM10) from motorized traffic at participants' residence. We investigated the relation of PM10 concentrations to subsequent conversion from MCI to any type of dementia. Using a Cox-proportional hazards model combined with a restricted cubic spline model, we computed the hazard ratio (HR) of dementia with its 95% confidence interval (CI) according to increasing PM10 exposure, adjusting for sex, age, and educational attainment. RESULTS During a median follow up of 47.3 months, 34 participants developed dementia, in 26 cases diagnosed as Alzheimer's dementia. In non-linear restricted spline regression analysis, mean and maximum annual PM10 levels positively correlated with cerebrospinal fluid total and phosphorylated tau proteins concentrations, while they were inversely associated with β-amyloid. Concerning the risk of dementia, we found a positive association starting from above 10 μg/m3 for mean PM10 levels and above 35 μg/m3 for maximum PM10 levels. Specific estimates for Alzheimer's dementia were substantially similar. Adding other potential confounders to the multivariable model or removing early cases of dementia onset during the follow-up had little effect on the estimates. CONCLUSIONS Our findings suggest that exposure to outdoor air pollutants, PM10 in particular, may non-linearly increase conversion from MCI to dementia above a certain ambient air concentration.
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Affiliation(s)
- Teresa Urbano
- Environmental, Genetic and Nutritional Epidemiology Research Center (CREAGEN), Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Annalisa Chiari
- Neurology Unit, University Hospital of Modena, Modena, Italy
| | - Carlotta Malagoli
- Environmental, Genetic and Nutritional Epidemiology Research Center (CREAGEN), Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | | | - Roberta Bedin
- Neurology Unit, University Hospital of Modena, Modena, Italy; Center for Neurosciences and Neurotechnology, Department of Biomedical, Metabolic, and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Sofia Costanzini
- DIEF - Department of Engineering 'Enzo Ferrari', University of Modena and Reggio Emilia, Modena, Italy
| | - Sergio Teggi
- DIEF - Department of Engineering 'Enzo Ferrari', University of Modena and Reggio Emilia, Modena, Italy
| | | | - Marco Vinceti
- Environmental, Genetic and Nutritional Epidemiology Research Center (CREAGEN), Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy; Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA.
| | - Tommaso Filippini
- Environmental, Genetic and Nutritional Epidemiology Research Center (CREAGEN), Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy; School of Public Health, University of California Berkeley, Berkeley, CA, USA
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Bosi M, Malavolti M, Garuti C, Tondelli M, Marchesi C, Vinceti M, Filippini T. Environmental and lifestyle risk factors for early-onset dementia: a systematic review. Acta Biomed 2022; 93:e2022336. [PMID: 36533768 PMCID: PMC9828922 DOI: 10.23750/abm.v93i6.13279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/28/2022] [Accepted: 08/04/2022] [Indexed: 01/21/2023]
Abstract
BACKGROUND AND AIM The term early-onset dementia (EOD) encompasses several forms of neurodegenerative diseases characterized by symptom onset before 65 years and leading to severe impact on subjects already in working activities, as well as on their family and caregivers. Despite the increasing incidence, the etiology is still unknown, with possible association of environmental factors, although the evidence is still scarce. In this review, we aimed to assess how several environmental and lifestyle factors may be associated with the onset of this disease. METHODS We conducted a literature search in PubMed and EMBASE databases up to May 6, 2022, to retrieve epidemiological studies evaluating the effect of environmental and lifestyle factors on EOD risk. RESULTS We eventually included 22 studies, ten with cohort and twelve with case-control design. Traumatic injury, especially on the head/brain, some cardiovascular diseases such as atrial fibrillation and stroke, metabolic diseases including diabetes and hypercholesterolemia, and alcohol consumption have been identified as potential risk factors for EOD. Conversely, playing leisure activities including sports (without trauma), higher educational attainment and higher adherence to Mediterranean DASH-Intervention for Neurodegenerative Delay (MIND) diet appeared to be protective for EOD. CONCLUSIONS The literature on environmental risk factors for EOD has been considerably growing in recent years. Overall, it supports an association between some environmental and lifestyle factors with disease risk. However, additional high-quality research is required to confirm these relations and its causal nature (www.actabiomedica.it).
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Affiliation(s)
- Matteo Bosi
- Environmental, Genetic and Nutritional Epidemiology Research Center (CREAGEN), Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Marcella Malavolti
- Environmental, Genetic and Nutritional Epidemiology Research Center (CREAGEN), Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Caterina Garuti
- Environmental, Genetic and Nutritional Epidemiology Research Center (CREAGEN), Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy, Department of Neuroscience and Rehabilitation, Division of Neurology, University Hospital of Ferrara, Ferrara, Italy
| | - Manuela Tondelli
- Neurology Unit, Modena University Hospital, Baggiovara, Modena, Italy, Primary Care Department, Local Health Unit of Modena, Modena, Italy
| | - Cristina Marchesi
- Head Office, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Marco Vinceti
- Environmental, Genetic and Nutritional Epidemiology Research Center (CREAGEN), Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy, Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
| | - Tommaso Filippini
- Environmental, Genetic and Nutritional Epidemiology Research Center (CREAGEN), Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy, School of Public Health, University of California Berkeley, Berkeley, CA, USA
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