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The effects of heatwave on cognitive impairment among older adults: Exploring the combined effects of air pollution and green space

百分位 归一化差异植被指数 置信区间 环境科学 微粒 危险系数 广义加性模型 环境卫生 人口学 医学 统计 气候变化 化学 数学 生态学 有机化学 社会学 生物
作者
Wensu Zhou,Qiong Wang,Rui Li,Zhirong Zhang,Wenjuan Wang,Fenfen Zhou,Li Ling
出处
期刊:Science of The Total Environment [Elsevier BV]
卷期号:904: 166534-166534 被引量:21
标识
DOI:10.1016/j.scitotenv.2023.166534
摘要

The association between heatwaves and cognitive impairment in older adults, especially the joint effect of air pollution and green space on this association, remains unknown. The present cohort study used data from waves of the Chinese Longitudinal Healthy Longevity Survey (CLHLS) from 2008 to 2018. Heatwaves were defined as having daily maximum temperature ≥ 92.5th, 95th and 97.5th percentile that continued at least two, three and four days, measured as the one-year heatwave days prior to the participants' incident cognitive impairment. Data on the annual average air pollutant concentrations of fine particulate matter (PM2.5) and ozone (O3) as well as green space exposure (according to the Normalized Difference Vegetation Index (NDVI)) were collected. Time-varying Cox proportional hazards models were constructed to examine the independent effect of heatwaves on cognitive impairment and the combined effect of heatwaves, air pollution, and green space on cognitive impairment. Potential multiplicative interactions were examined by adding a product term of air pollutants and NDVI with heatwaves in the models. The relative excess risk due to interaction (RERI) was calculated to reflect additive interactions. We found that heatwave exposure was associated with higher risks of cognitive impairment, with hazard ratios (HRs) and 95 % confidence intervals (CIs) ranging from 1.035 (95 % CI: 1.016-1.055) to 1.058 (95 % CI: 1.040-1.075). We observed a positive interaction of PM2.5 concentrations, O3 concentrations, lack of green space, and heatwave exposure on a multiplicative scale (HRs for product terms >1). Furthermore, we found a synergistic interaction of PM2.5 concentrations, O3, lack of green space, and heatwave exposure on an additive scale, with RERIs >0. These results suggest that extreme heat exposure may be a potential risk factor for cognitive impairment in older adults. Additionally, coexposure to air pollution and lack of green space exacerbated the adverse effects of heatwaves on cognitive function.
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