title: Association between air pollutants and dementia risk in the elderly.
abstract: BACKGROUND
  The aging rate in Taiwan is the second highest in the world. As the population ages quickly, the prevalence of dementia increases rapidly. There are some studies that have explored the association between air pollution and cognitive decline, but the association between air pollution and dementia has not been directly evaluated.
  
  
  METHODS
  This was a case-control study comprising 249 Alzheimer's disease (AD) patients, 125 vascular dementia (VaD) patients, and 497 controls from three teaching hospitals in northern Taiwan from 2007 to 2010. Data of particulate matter <10 μm in diameter (PM10) and ozone were obtained from the Taiwan Environmental Protection Administration for 12 and 14 years, respectively. Blood samples were collected to determine the apolipoprotein E (APOE) ɛ4 haplotype. Bayesian maximum entropy was used to estimate the individual exposure level of air pollutants, which was then tertiled for analysis. Conditional logistic regression models were used to estimate adjusted odds ratios (AORs) and 95% confidence intervals between the association of PM10 and ozone exposure with AD and VaD risk.
  
  
  RESULTS
  The highest tertile of PM10 (≥49.23 μg/m(3)) or ozone (≥21.56 ppb) exposure was associated with increased AD risk (highest vs. lowest tertile of PM10: AOR = 4.17; highest vs. lowest tertile of ozone: AOR = 2.00). Similar finding was observed for VaD. The association with AD and VaD risk remained for the highest tertile PM10 exposure after stratification by APOE ɛ4 status and gender.
  
  
  CONCLUSIONS
  Long-term exposure to the highest tertile of PM10 or ozone was significantly associated with an increased risk of AD and VaD.
authors.affiliation: Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan.
authors.forename: Yun-Chun
authors.initials: YC
authors.lastname: Wu
authors.affiliation: Department of Bioenvironmental Systems Engineering, National Taiwan University, Taipei, Taiwan.
authors.forename: Yuan-Chien
authors.initials: YC
authors.lastname: Lin
authors.affiliation: Department of Bioenvironmental Systems Engineering, National Taiwan University, Taipei, Taiwan.
authors.forename: Hwa-Lung
authors.initials: HL
authors.lastname: Yu
authors.affiliation: Department of Geriatrics and Gerontology, National Taiwan University Hospital, Taipei, Taiwan.
authors.forename: Jen-Hau
authors.initials: JH
authors.lastname: Chen
authors.affiliation: Department of Neurology, National Taiwan University Hospital, Taipei, Taiwan.
authors.forename: Ta-Fu
authors.initials: TF
authors.lastname: Chen
authors.affiliation: Department of Neurology, En Chu Kong Hospital, Taipei, Taiwan.
authors.forename: Yu
authors.initials: Y
authors.lastname: Sun
authors.affiliation: Department of Laboratory Medicine, En Chu Kong Hospital, Taipei, Taiwan.
authors.forename: Li-Li
authors.initials: LL
authors.lastname: Wen
authors.affiliation: College of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan.
authors.forename: Ping-Keung
authors.initials: PK
authors.lastname: Yip
authors.affiliation: Department of Laboratory Medicine, Cardinal Tien Hospital, Taipei, Taiwan.
authors.forename: Yi-Min
authors.initials: YM
authors.lastname: Chu
authors.affiliation: Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan; Department of Public Health, College of Public Health, National Taiwan University, Taipei, Taiwan; Research Center for Genes, Environment and Human Health, College of Public Health, National Taiwan University, Taipei, Taiwan.
authors.forename: Yen-Ching
authors.initials: YC
authors.lastname: Chen
keywords: Air pollutant; Alzheimer's disease; Ozone; Particulate matter; The elderly; Vascular dementia