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J Alzheimers Dis. 2019 Feb 11. doi: 10.3233/JAD-180631. [Epub ahead of print]

Air Pollution and Dementia: A Systematic Review.

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University of New South Wales, Australia.
Neuroscience Research Australia, Australia.
School for Health and Related Research, University of Sheffield, UK.
MRC-PHE Centre for Environment and Health, NIHR Health Protection Research Unit in Health Impact of Environmental Hazards, Facility of Life Sciences and Medicine, King's College London, London, UK.



Both air pollution and dementia are current and growing global issues. There are plausible links between exposure to specific air pollutants and dementia.


To systematically review the evidence base with respect to the relationship between air pollution and later cognitive decline and dementia.


Medline, Embase, and PsychINFO® were searched from their inception to September 2018, for publications reporting on longitudinal studies of exposure to air pollution and incident dementia or cognitive decline in adults. Studies reporting on exposure to tobacco smoke including passive smoking or on occupational exposure to pollutants were excluded. Using standard Cochrane methodology, two readers identified relevant abstracts, read full text publications, and extracted data into structured tables from relevant papers, as defined by inclusion and exclusion criteria. Papers were also assessed for validity. CRD42018094299Results:From 3,720 records, 13 papers were found to be relevant, with studies from the USA, Canada, Taiwan, Sweden, and the UK. Study follow-up ranged from one to 15 years. Pollutants examined included particulate matter ≤2.5 μ (PM2.5), nitrogen dioxide (NO2), nitrous oxides (NOx), carbon monoxide (CO), and ozone. Studies varied in their methodology, population selection, assessment of exposure to pollution, and method of cognitive testing. Greater exposure to PM2.5, NO2/NOx, and CO were all associated with increased risk of dementia. The evidence for air pollutant exposure and cognitive decline was more equivocal.


Evidence is emerging that greater exposure to airborne pollutants is associated with increased risk of dementia.


Air pollutants; cognitive decline; dementia; particulate matter

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