title: Association of air pollution with cognitive functions and its modification by APOE gene variants in elderly women.
abstract: BACKGROUND
  Epidemiological studies have shown effects of long-term exposure to air pollution on cardiovascular and respiratory health. However, studies investigating the effects of air pollution on cognition and brain function are limited. We investigated if neurocognitive functions are associated with air pollution exposure and whether apolipoprotein E (ApoE) alleles modify the association of air pollution exposure with cognition.
  
  
  METHODS
  We investigated 789 women from the SALIA cohort during the 22-year follow-up examination (2008-2009). Exposure to particulate matter (PM) size fractions and nitrogen oxides (NOx) were assigned to home addresses. Traffic indicators were used to assess residential proximity to high traffic load. Level of cognitive performance was assessed using the CERAD-Plus test. Air pollution effects on cognitive functioning were estimated cross-sectionally using adjusted linear regression models.
  
  
  RESULTS
  Air pollution was negatively associated with cognitive function and cognitive performance in the subtests for semantic memory and visuo-construction. Significant associations could be observed for figure copying with an interquartile range increase of NO2 (β=-0.28 (95%CI:-0.44;-0.12)), NOx (β=-0.25 (95%CI:-0.40;-0.09)), PM10 (β=-0.14 (95%CI:-0.26;-0.02)) and PM2.5 (β=-0.19 (95%CI:-0.36;-0.02)). The association with traffic load was significant in carriers of one or two ApoE ɛ4 risk alleles.
  
  
  CONCLUSIONS
  In this study of elderly women, markers of air pollution were associated with cognitive impairment in the visuospatial domain. The association of traffic exposure is significant in participants carrying the ApoE ε4 risk allele.
authors.affiliation: IUF- Leibniz Research Institute for Environmental Medicine (IUF), Auf'm Hennekamp 50, 40225 Düsseldorf, Germany; Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Switzerland. Electronic address: Tamara.schikowski@IUF-Duesseldorf.de.
authors.forename: Tamara
authors.initials: T
authors.lastname: Schikowski
authors.affiliation: IUF- Leibniz Research Institute for Environmental Medicine (IUF), Auf'm Hennekamp 50, 40225 Düsseldorf, Germany.
authors.forename: Mohammad
authors.initials: M
authors.lastname: Vossoughi
authors.affiliation: IUF- Leibniz Research Institute for Environmental Medicine (IUF), Auf'm Hennekamp 50, 40225 Düsseldorf, Germany.
authors.forename: Andrea
authors.initials: A
authors.lastname: Vierkötter
authors.affiliation: Department of Psychiatry and Psychotherapy, Heinrich Heine University Düsseldorf, Germany.
authors.forename: Thomas
authors.initials: T
authors.lastname: Schulte
authors.affiliation: Institute for Clinical Diabetology, German Diabetes Center, Leibniz Centre for Diabetes Research at Heinrich Heine University Düsseldorf, Düsseldorf, Germany; German Center for Diabetes Research (DZD), partner site Düsseldorf, Germany.
authors.forename: Tom
authors.initials: T
authors.lastname: Teichert
authors.affiliation: IUF- Leibniz Research Institute for Environmental Medicine (IUF), Auf'm Hennekamp 50, 40225 Düsseldorf, Germany.
authors.forename: Dorothee
authors.initials: D
authors.lastname: Sugiri
authors.affiliation: Department of Psychiatry and Psychotherapy, Heinrich Heine University Düsseldorf, Germany.
authors.forename: Karin
authors.initials: K
authors.lastname: Fehsel
authors.affiliation: IUF- Leibniz Research Institute for Environmental Medicine (IUF), Auf'm Hennekamp 50, 40225 Düsseldorf, Germany.
authors.forename: Lilian
authors.initials: L
authors.lastname: Tzivian
authors.affiliation: Medical Faculty, Heinrich Heine University of Düsseldorf, Düsseldorf, Germany.
authors.forename: Il-seok
authors.initials: IS
authors.lastname: Bae
authors.affiliation: IUF- Leibniz Research Institute for Environmental Medicine (IUF), Auf'm Hennekamp 50, 40225 Düsseldorf, Germany.
authors.forename: Ulrich
authors.initials: U
authors.lastname: Ranft
authors.affiliation: IUF- Leibniz Research Institute for Environmental Medicine (IUF), Auf'm Hennekamp 50, 40225 Düsseldorf, Germany; Medical Faculty, Heinrich Heine University of Düsseldorf, Düsseldorf, Germany.
authors.forename: Barbara
authors.initials: B
authors.lastname: Hoffmann
authors.affiliation: Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Switzerland.
authors.forename: Nicole
authors.initials: N
authors.lastname: Probst-Hensch
authors.affiliation: Institute for Clinical Diabetology, German Diabetes Center, Leibniz Centre for Diabetes Research at Heinrich Heine University Düsseldorf, Düsseldorf, Germany; German Center for Diabetes Research (DZD), partner site Düsseldorf, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Herder
authors.affiliation: IUF- Leibniz Research Institute for Environmental Medicine (IUF), Auf'm Hennekamp 50, 40225 Düsseldorf, Germany.
authors.forename: Ursula
authors.initials: U
authors.lastname: Krämer
authors.affiliation: Department of Psychiatry and Psychotherapy, Heinrich Heine University Düsseldorf, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Luckhaus
mesh_terms: D000368:Aged; D000397:Air Pollution / Q000009:adverse effects* / Q000032:analysis; D053327:Apolipoprotein E4 / Q000235:genetics*; D003071:Cognition / Q000187:drug effects*; D015331:Cohort Studies; D003627:Data Interpretation, Statistical; D004781:Environmental Exposure / Q000009:adverse effects*; D005260:Female; D005858:Germany; D006801:Humans; D009483:Neuropsychological Tests; D010316:Particle Size; D052638:Particulate Matter / Q000009:adverse effects* / Q000032:analysis; D011110:Polymorphism, Genetic; D012424:Rural Population; D014505:Urban Population
chemical_list: D053327:Apolipoprotein E4; D052638:Particulate Matter
keywords: APOE; Air pollution; cognition