Work

Air pollution and cognitive performance in late life: the role of lipid profile – results from the Multi-Ethnic Study of Atherosclerosis (MESA)

Year: 2025

Type: article

Abstract: IntroductionEvidence on blood lipids in the air pollutant-cognition relationship is scarce. In this study, we identified the role of blood lipids in the air pollutant-cognition relationship in the Multi-Ethnic Study of Atherosclerosis (MESA) cohort.MethodsThe study sample consisted of 1,518 adults who participated in MESA Exams 1-6 (2000-2018). Outcome were three composite scores of the Cognitive Abilities Screening Instrument (CASI) test, the Digit Symbol Coding test (DSC), and the Digit Span (DS) test at Exam 6. Outdoor residential concentrations of PM2.5, NO2, and NOx between Exams 1 and 5 were assessed using validated spatiotemporal models. Total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-C) concentrations in blood at Exam 5 were evaluated as mediators or modifiers using linear regression models. Models assessed gender and race/ethnicity related heterogeneity in air pollutant-cognition and blood lipid-cognition associations.ResultsThe direct effect of NO2 and NOx on DSC scores was significant (ß=-2.64 95% CI -4.87 to -0.40 for NO2; ß=-3.01 95% CI -5.20 to -0.83 for NOx, per interquartile range increase), but there was no evidence of mediation by cholesterol levels. The association of CASI scores with NO2 and NOx was modified by LDL-C (β=0.03 for NO2; β=0.02 for NOx). The association of DSC with NO2 and NOx was only significant for Black (ß = -7.11 for NO2; ß = -6.18 for NOx).DiscussionTC and LDL-C were not mediators or clinically meaningful modifiers in the air pollutant-cognition relationship. The adverse association of air pollutants with the DSC scores differed by racial identity.

Source: Environment International

DOI: 10.1016/j.envint.2025.109730