@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} } @article {9614, title = {Associations of Neurological Biomarkers in Serum with Gait Measures: The Cardiovascular Health Study.}, journal = {J Gerontol A Biol Sci Med Sci}, year = {2024}, month = {2024 Feb 09}, abstract = {

BACKGROUND: Gait impairment leads to increased mobility decline and may have neurological contributions. This study explores how neurological biomarkers are related to gait in older adults.

METHODS: We studied participants in the Cardiovascular Health Study, a population-based cohort of older Americans, who underwent a serum biomarker assessment from samples collected in 1996-97 for neurofilament light-chain (NfL), glial fibrillary acidic protein (GFAP), ubiquitin carboxy-terminal hydrolase L1 (UCH-L1), and total tau (n=1959, mean age=78.0 years, 60.8\% female). In a subsample (n=380), cross-sectional associations with quantitative gait measures were explored. This subsample was assessed on a mat for gait speed, step length, double support time, step time, step length variability and step time variability. Gait speed was also measured over a 15-ft walkway annually from 1996-97 to 1998-99, for longitudinal analyses. Linear regression models assessed cross-sectional associations of biomarkers with gait measures, while mixed effects models assessed longitudinal gait speed change from baseline to 1998-99.

RESULTS: NfL was significantly associated with annual gait speed decline (standardized β = -0.64 m/s, 95\% CI: [-1.23, -0.06]) after adjustment for demographic and health factors. Among gait mat-assessed phenotypes, NfL was also cross-sectionally associated with gait speed (β = 0.001 m/s [0.0003, 0.002]) but not with other gait measures. None of the remaining biomarkers were significantly related to gait in either longitudinal or cross-sectional analyses.

CONCLUSION: Higher NfL levels were related to greater annual gait speed decline. Gait speed decline may be related to axonal degeneration. The clinical utility of NfL should be explored.

}, issn = {1758-535X}, doi = {10.1093/gerona/glae043}, author = {Nadkarni, Abhijay and Mukamal, Kenneth J and Zhu, Xiaonan and Siscovick, David and Brach, Jennifer S and Jacob, Mini and Seshadri, Sudha and Abe, Temidayo and Rosano, Caterina and Djouss{\'e}, Luc and Rosso, Andrea L} } @article {9904, title = {Association between spatial social polarisation and high blood pressure in older adults.}, journal = {J Epidemiol Community Health}, year = {2025}, month = {2025 Mar 24}, abstract = {

BACKGROUND: Using data from the Cardiovascular Health Study (CHS) and the REasons for Geographic And Racial Differences in Stroke (REGARDS) study, we investigate the association between socioeconomic polarisation and blood pressure outcomes in black and white adults. We also validate previous findings that joint racial/ethnic and income measures of spatial social polarisation (SSP) outperform single domain measures.

METHODS: We conducted a cross-sectional analysis using a retrospective cohort combining CHS (recruited 1989-1990 and 1992-1993) and REGARDS (recruited 2003-2007). The study included 5888 CHS participants aged >=65 years and 30 183 REGARDS participants aged >=45 years. SSP was measured using the Index of Concentration at the Extremes for education, race/ethnicity, income, home ownership, and joint race/ethnicity and income at ZIP code, census tract and county levels. The SSP measures were modelled against the presence of high blood pressure and systolic blood pressure.

RESULTS: The sample had a mean age of 66 (SD: 9), was majority female (56\%), white/other (63\%), and at least high school graduates (85\%). A total of 26\% had high blood pressure, with a mean systolic blood pressure of 129 mm Hg (SD: 18). Census tract-level models showed low-income black areas had 25\% (95\% CI 11\%-40\%) higher odds of high blood pressure and 1.8 mm Hg (95\% CI 1.0-2.5) higher mean systolic blood pressure than high-income White areas.

CONCLUSION: Greater SSP is associated with a higher risk of high blood pressure and higher systolic blood pressure. Further investigating and reducing polarisation could help mitigate cardiovascular health disparities, improving outcomes for socioeconomically deprived communities.

}, issn = {1470-2738}, doi = {10.1136/jech-2024-223191}, author = {Abdel Magid, Hoda S and Jaros, Samuel and Lovasi, Gina S and Rosso, Andrea L and Tan, Annabel X and Rehkopf, David H and Nelson, Lorene M and Carlson, Michelle and Judd, Suzanne E and Odden, Michelle C} }