Sex difference in the association between solid fuel use and cognitive function in rural China

Abstract Background Whether indoor air pollution from solid fuel use is associated with cognitive function remains unclear. Objective This study aims to examine the association of solid fuel use with the risk of cognitive impairment in males and females. Methods The data was from the China Health and Retirement Longitudinal Study (CHARLS). Self-reported heating and cooking fuel were categorized as clean fuel (solar, liquefied gas, natural gas, or electricity) and solid fuel (coal, biomass charcoal, wood, or straw). Cognitive function, including orientation and attention, episodic memory, and visuospatial abilities, was assessed using standardized questionnaires. Results A total of 7824 individuals were included in our study (aged 57.0 ± 9.3, 46.2% female), with 47.0% and 76.0% used solid fuel for cooking and heating, respectively. There was an interaction between sex and solid fuel use for cooking (P=0.008) for the progress of cognitive impairment. Solid fuel use for cooking was associated with a larger decrease in cognitive function score in females (β=−0.832; 95% CI: −1.043, −0.622; P  Conclusion In conclusion, solid fuel use for cooking and heating was significantly associated with a higher risk of cognitive impairment. Furthermore, for the first time, we found that the effect of solid fuel use on cognitive function in females was greater than in males.