Skip to main content

Lund University Publications

LUND UNIVERSITY LIBRARIES

Long-term exposure to air pollution and validated cases of Alzheimer's disease and vascular dementia in the Malmö diet and cancer cohort

Alzhrani, Abdullah J. LU orcid ; Stockfelt, Leo ; Xu, Yiyi LU ; Harari, Florencia ; Gustafsson, Susanna ; Engström, Gunnar LU ; Hansson, Oskar LU orcid and Oudin, Anna LU orcid (2025) In Journal of Alzheimer's Disease 107(1). p.337-347
Abstract

Background: Dementia is a global public health challenge, with Alzheimer's disease (AD) and vascular dementia (VaD) being the most prevalent subtypes. Air pollution is a potential risk factor for dementia, but few studies separate AD and VaD. Objective: This study aims to investigate whether exposure to air pollution is associated with the incidence of AD and VaD. Methods: This study involved 30,247 participants from the Malmö Diet and Cancer Study (1991–2014), with 1216 AD cases (including mixed type) and 531 VaD cases, clinically validated. Long-term exposure to PM2.5and NOxwas modeled using the past 5-years or 10-year mean concentration with 50m × 50 m spatial resolution at residential addresses. The association... (More)

Background: Dementia is a global public health challenge, with Alzheimer's disease (AD) and vascular dementia (VaD) being the most prevalent subtypes. Air pollution is a potential risk factor for dementia, but few studies separate AD and VaD. Objective: This study aims to investigate whether exposure to air pollution is associated with the incidence of AD and VaD. Methods: This study involved 30,247 participants from the Malmö Diet and Cancer Study (1991–2014), with 1216 AD cases (including mixed type) and 531 VaD cases, clinically validated. Long-term exposure to PM2.5and NOxwas modeled using the past 5-years or 10-year mean concentration with 50m × 50 m spatial resolution at residential addresses. The association between AD and VaD and air pollution was assessed using adjusted Cox-proportional hazards. Results: For AD the hazard ratios (HRs (95% CIs) were 1.06 (0.89–1.27) for PM2.5and 1.08 (0.96–1.22) for NOxper interquartile range (IQR) increase in past 10-year mean pollution-levels. Nonsignificant associations were observed in two-pollutant models. For past 5-year exposure, we observed a statistically significant association between NOxand AD 1.14 (1.00–1.30). For VaD, we found no evidence for associations in any models. Conclusions: We found that while both PM2.5and NOxseemed linked to increased AD risk in single-pollutant models, only the associations with NOxremained in two-pollutant models, particularly for exposures in the past five years. No associations were observed for VaD. The results underscore the importance of distinguishing dementia subtypes, identifying critical exposure windows, and applying multi-pollutant models in future studies.

(Less)
Please use this url to cite or link to this publication:
author
; ; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
air pollution, Alzheimer's disease, epidemiology, particulate matter, vascular dementia
in
Journal of Alzheimer's Disease
volume
107
issue
1
pages
11 pages
publisher
SAGE Publications
external identifiers
  • scopus:105013891436
  • pmid:40692315
ISSN
1387-2877
DOI
10.1177/13872877251360225
language
English
LU publication?
yes
id
01d43df9-af22-4315-9b45-9d0f0e483c61
date added to LUP
2025-10-20 11:18:31
date last changed
2025-11-03 12:12:52
@article{01d43df9-af22-4315-9b45-9d0f0e483c61,
  abstract     = {{<p>Background: Dementia is a global public health challenge, with Alzheimer's disease (AD) and vascular dementia (VaD) being the most prevalent subtypes. Air pollution is a potential risk factor for dementia, but few studies separate AD and VaD. Objective: This study aims to investigate whether exposure to air pollution is associated with the incidence of AD and VaD. Methods: This study involved 30,247 participants from the Malmö Diet and Cancer Study (1991–2014), with 1216 AD cases (including mixed type) and 531 VaD cases, clinically validated. Long-term exposure to PM<sub>2.5</sub>and NO<sub>x</sub>was modeled using the past 5-years or 10-year mean concentration with 50m × 50 m spatial resolution at residential addresses. The association between AD and VaD and air pollution was assessed using adjusted Cox-proportional hazards. Results: For AD the hazard ratios (HRs (95% CIs) were 1.06 (0.89–1.27) for PM<sub>2.5</sub>and 1.08 (0.96–1.22) for NO<sub>x</sub>per interquartile range (IQR) increase in past 10-year mean pollution-levels. Nonsignificant associations were observed in two-pollutant models. For past 5-year exposure, we observed a statistically significant association between NO<sub>x</sub>and AD 1.14 (1.00–1.30). For VaD, we found no evidence for associations in any models. Conclusions: We found that while both PM<sub>2.5</sub>and NO<sub>x</sub>seemed linked to increased AD risk in single-pollutant models, only the associations with NO<sub>x</sub>remained in two-pollutant models, particularly for exposures in the past five years. No associations were observed for VaD. The results underscore the importance of distinguishing dementia subtypes, identifying critical exposure windows, and applying multi-pollutant models in future studies.</p>}},
  author       = {{Alzhrani, Abdullah J. and Stockfelt, Leo and Xu, Yiyi and Harari, Florencia and Gustafsson, Susanna and Engström, Gunnar and Hansson, Oskar and Oudin, Anna}},
  issn         = {{1387-2877}},
  keywords     = {{air pollution; Alzheimer's disease; epidemiology; particulate matter; vascular dementia}},
  language     = {{eng}},
  month        = {{07}},
  number       = {{1}},
  pages        = {{337--347}},
  publisher    = {{SAGE Publications}},
  series       = {{Journal of Alzheimer's Disease}},
  title        = {{Long-term exposure to air pollution and validated cases of Alzheimer's disease and vascular dementia in the Malmö diet and cancer cohort}},
  url          = {{http://dx.doi.org/10.1177/13872877251360225}},
  doi          = {{10.1177/13872877251360225}},
  volume       = {{107}},
  year         = {{2025}},
}