@article {8824, title = {Examining the causal mediating role of brain pathology on the relationship between diabetes and cognitive impairment: the Cardiovascular Health Study.}, journal = {J R Stat Soc Ser A Stat Soc}, volume = {183}, year = {2020}, month = {2020 Oct}, pages = {1705-1726}, abstract = {

The paper examines whether leads to incident mild cognitive impairment and dementia through brain hypoperfusion and white matter disease. We performed inverse odds ratio weighted causal mediation analyses to decompose the effect of diabetes on cognitive impairment into direct and indirect effects, and we found that approximately a third of the total effect of diabetes is mediated through vascular-related brain pathology. Our findings lend support for a common aetiological hypothesis regarding incident cognitive impairment, which is that diabetes increases the risk of clinical cognitive impairment in part by impacting the vasculature of the brain.

}, issn = {0964-1998}, doi = {10.1111/rssa.12570}, author = {Andrews, Ryan M and Shpitser, Ilya and Lopez, Oscar and Longstreth, William T and Chaves, Paulo H M and Kuller, Lewis and Carlson, Michelle C} } @article {9737, title = {Associations between toxicity-weighted concentrations and dementia risk: Results from the Cardiovascular Health Cognition Study.}, journal = {Sci Total Environ}, volume = {945}, year = {2024}, month = {2024 Oct 01}, pages = {173706}, abstract = {

BACKGROUND: Air pollution is a modifiable risk factor for dementia. Yet, studies on specific sources of air pollution (i.e., toxic chemical emissions from industrial facilities) and dementia risk are scarce. We examined associations between toxicity-weighted concentrations of industrial pollution and dementia outcomes among a large, multi-site cohort of older adults.

METHODS: Participants (n~=~2770) were~>=~65~years old (Mean~=~75.3, SD~=~5.1~years) from the Cardiovascular Health Cognition Study (1992-1999). Toxicity-weighted concentrations were estimated using the Risk Screening Environmental Indicator (RSEI) model which incorporates total reported chemical emissions with toxicity, fate, and transport models. Estimates were aggregated to participants{\textquoteright} baseline census tract, averaged across 1988-1992, and log2-transformed. Dementia status was clinically adjudicated in 1998-1999 and categorized by subtype (Alzheimer{\textquoteright}s, vascular, mixed). We assessed whether RSEI-estimated toxicity-weighted concentrations were associated with 1) odds of prevalent dementia and 2) incident dementia risk by subtype.

RESULTS: After adjusting for individual and census-tract level covariates, a doubling in toxicity-weighted concentrations was associated with 9~\% higher odds of prevalent dementia (OR~=~1.09, 95~\% CI: 1.00, 1.19). In discrete-time survival models, each doubling in toxicity-weighted concentrations was associated with a 16~\% greater hazard of vascular dementia (HR~=~1.16, 95~\% CI: 1.01, 1.34) but was not significantly associated with all-cause, Alzheimer{\textquoteright}s disease, or mixed dementia (p{\textquoteright}s~>~0.05).

DISCUSSION: Living in regions with higher toxicity-weighted concentrations was associated with higher odds of prevalent dementia and a higher risk of incident vascular dementia in this large, community-based cohort of older adults. These findings support the need for additional studies to examine whether toxic chemical emissions from industrial and federal facilities may be a modifiable target for dementia prevention.

}, keywords = {Aged, Aged, 80 and over, Air Pollutants, Air Pollution, Dementia, Environmental Exposure, Female, Humans, Male, Risk Factors}, issn = {1879-1026}, doi = {10.1016/j.scitotenv.2024.173706}, author = {Crane, Breanna M and Moored, Kyle D and Donahue, Patrick T and Corrigan, Anne E and Curriero, Frank C and Shields, Timothy M and Desjardins, Michael R and Richards, Emily A and Rosso, Andrea L and Lovasi, Gina S and Odden, Michelle C and Lopez, Oscar L and Biggs, Mary Lou and Newman, Anne B and Andrews, Ryan M and Carlson, Michelle C} }