title: Is air pollution associated with increased risk of cognitive decline? A systematic review.
abstract: BACKGROUND
  exposure to air pollution has been shown to increase risk of inflammatory processes and risk of cardiovascular mortality. Such exposure may therefore also be a risk factor for cognitive impairment/dementia.
  
  
  METHODS
  a systematic review of the literature was conducted with databases searched using keywords for air pollution, cognitive decline and dementia. All identified abstracts and potentially relevant articles were double read. For those papers meeting the inclusion criteria, summary tables were prepared and papers quality assessed.
  
  
  RESULTS
  from 1,551 abstracts identified, 10 articles were retrieved of which two were rejected. Of the eight remaining six reported prevalent cognitive assessment with historical pollution exposure and two incident cognitive decline, also with historical pollution exposure. In general, an association was reported between exposure and poorer prevalent measures of cognitive function. Data were mixed for incident cognitive decline with one study finding an association and the other not. Reports were limited by a lack of detailed reporting, use of proxy measures of pollution exposure and a lack of clarity regarding cognitive testing methodology and analysis.
  
  
  CONCLUSIONS
  this systematic review highlights that there is some evidence of a potential association between air pollution and subsequent cognitive decline. Further work is clearly required and longitudinal analysis of ongoing cohort studies or new research would add much needed clarity to this area.
authors.affiliation: Imperial College London, London, UK.
authors.forename: Ruth
authors.initials: R
authors.lastname: Peters
authors.affiliation: Imperial College London, London, UK.
authors.forename: Jean
authors.initials: J
authors.lastname: Peters
authors.affiliation: Imperial College London, London, UK.
authors.forename: Andrew
authors.initials: A
authors.lastname: Booth
authors.affiliation: Imperial College London, London, UK.
authors.forename: Ian
authors.initials: I
authors.lastname: Mudway
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000397:Air Pollution / Q000009:adverse effects*; D003071:Cognition; D003072:Cognition Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D015995:Prevalence; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors
keywords: air pollution; black carbon; cognitive decline; dementia; older people; particulate matter; systematic review