Document Type

Article

Publication Date

11-17-2020

Abstract

BACKGROUND/OBJECTIVES

Exposure to air pollution may contribute to both increasing depressive symptoms and decreasing episodic memory in older adulthood, but few studies have examined this hypothesis in a longitudinal context. Accordingly, we examined the association between air pollution and changes in depressive symptoms (DS) and episodic memory (EM) and their interrelationship in oldest-old (aged 80 and older) women.

DESIGN

Prospective cohort data from the Women's Health Initiative Memory Study-Epidemiology of Cognitive Health Outcomes.

SETTING

Geographically diverse community-dwelling population.

PARTICIPANTS

A total of 1,583 dementia-free women aged 80 and older.

MEASUREMENTS

Women completed up to six annual memory assessments (latent composite of East Boston Memory Test and Telephone Interview for Cognitive Status) and the 15-item Geriatric Depression Scale (GDS-15). We estimated 3-year average exposures to regional particulate matter with aerodynamic diameter below 2.5 μm (PM2.5) (interquartile range [IQR] = 3.35 μg/m3) and gaseous nitrogen dioxide (NO2) (IQR = 9.55 ppb) at baseline and during a remote period 10 years earlier, using regionalized national universal kriging.

RESULTS

Latent change structural equation models examined whether residing in areas with higher pollutant levels was associated with annual changes in standardized EM and DS while adjusting for potential confounders. Remote NO2 (β = .287 per IQR; P = .002) and PM2.5 (β = .170 per IQR; P = .019) exposure was significantly associated with larger increases in standardized DS, although the magnitude of the difference, less than 1 point on the GDS-15, is of questionable clinical significance. Higher DS were associated with accelerated EM declines (β = −.372; P = .001), with a significant indirect effect of remote NO2 and PM2.5 exposure on EM declines mediated by DS. There were no other significant indirect exposure effects.

CONCLUSION

These findings in oldest-old women point to potential adverse effects of late-life exposure to air pollution on subsequent interplay between DS and EM, highlighting air pollution as an environmental health risk factor for older women.

Comments

This is the accepted version of the following article:

Petkus, A.J., Younan, D., Wang, X., Beavers, D.P., Espeland, M.A., Gatz, M., Gruenewald, T.L., Kaufman, J.D., Chui, H.C., Manson, J.E., Resnick, S.M., Wellenius, G.A., Whitsel, E.A., Widaman, K. and Chen, J.‐C. (2020). Air pollution and the dynamic association between depressive symptoms and memory in oldest‐old women. Journal of the American Geriatrics Society, 69(2), 474-484. https://doi.org/10.1111/jgs.16889

which has been published in final form at https://doi.org/10.1111/jgs.16889. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving.

This manuscript was presented at the 2020 Virtual Annual Meeting of the International Society of Environmental Epidemiology in Washington, D.C.

Copyright

The American Geriatrics Society

Share

COinS
 
 

To view the content in your browser, please download Adobe Reader or, alternately,
you may Download the file to your hard drive.

NOTE: The latest versions of Adobe Reader do not support viewing PDF files within Firefox on Mac OS and if you are using a modern (Intel) Mac, there is no official plugin for viewing PDF files within the browser window.