| Title: | The role of cardiovascular disease as a mediator in mitigating the impact of ambient PM2.5 on dementia risk |
| Journal: | Environmental Epidemiology |
| Published: | 4 Nov 2025 |
| Pubmed: | https://pubmed.ncbi.nlm.nih.gov/41200148/ |
| DOI: | https://doi.org/10.1097/ee9.0000000000000436 |
Publication 19037
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Abstract
Background: Previous research suggested that stricter ambient particulate matter with an aerodynamic diameter less than or equal to 2.5 μm (PM2.5) standards would reduce the risk of dementia, but immediate reductions in PM2.5 levels are not always feasible. Limited studies have quantified the extent to which cardiovascular disease (CVD) interventions could mitigate the effect of not achieving stricter PM2.5 standards on dementia risk.</p>
Methods: This study included 283,813 participants in the UK Biobank cohort aged ≥60 years without dementia diagnosis or CVD hospitalization at baseline (2015). We applied the longitudinal targeted maximum likelihood estimation to estimate the total effect of no PM2.5 intervention compared with hypothetical PM2.5 interventions on the 5-year risk of dementia. We also estimated the controlled direct effect by setting all participants free from CVD hospitalization in both scenarios.</p>
Results: Compared with the hypothetical intervention of reducing PM2.5 exposure by 10% if it is above the standard of 10 µg/m3, the total effect of no PM2.5 intervention increased the 5-year dementia risk by 3.77 (95% confidence interval [CI] = 1.47, 4.39) cases per 1000 participants. By setting all participants free from CVD hospitalization, the controlled direct effect was an increase of 2.82 (95% CI = 0.74, 3.30) cases per 1000 participants. The proportion of the total effect that could be mitigated by preventing CVD hospitalization was 25.27% (95% CI = 17.49%, 49.42%) among all eligible participants.</p>
Conclusion: Part of the effect of not achieving stricter ambient PM2.5 standards on dementia risk could be mitigated by preventing CVD hospitalization in the UK Biobank cohort. This finding indicates the potential of promoting cardiovascular health to reduce dementia burden.</p>
5 Authors
- Chengyi Lin
- Yechi Zhang
- Andrew T. DeWan
- Laura Forastiere
- Kai Chen
Enabling scientific discoveries that improve human health