AS252 - Environmental determinants of cognitive aging in WHIMS

Investigator Names and Contact Information

Jiu-Chiuan` (JC) Chen

Introduction/Intent

Specific Aims

Accumulating neuroscientific and toxicological data have provided the pathophysiological and neurobiological basis of the hypothesized link of cognitive aging with ambient air pollution, supporting its role in the development and progression of neurocognitive disorders. Various in vivo experiments with exposures to ozone, particulate matter (PM), or particles-ozone mixtures have collectively presented a constellation of pertinent effects on central nervous system (CNS) in different animal models 1-14. These studies demonstrate not only the direct effect on memory impairment, but also the enhanced or selective neurotoxicity of air pollution on the hippocampus (the neuroanatomical target of Alzheimer's disease), the characteristic histopathological lesions (e.g., plaques formation, β-amyloid accumulation, neurofibrillary triangles) indicative of neurodegeneration, and pathophysiological processes (neuroinflammation, central oxidative stress, activation of stress axis) as well as molecular pathways (e.g., increased activities of neurodegenerative protease calpain, neurochemical disturbance) involved in the neurobiology of cognitive aging and pathogenesis of dementia. No previous human studies have examined the effects of ambient air pollutants on cognitive impairment and dementia in the elderly.

The primary goal of this research project is to investigate ambient air pollutants as novel environmental determinants of neurocognitive disorders in elderly women. We will leverage on the high-quality longitudinal data sources developed in the Women's Health Initiative Memory Study (WHIMS) and addresses this critical knowledge gap in a cost-efficient manner. Specifically, using geocoded residential information of all participants in WHIMS (including the subset of these participants enrolled in the Women's Health Initiative Study of Cognitive Aging – WHISCA and the Women's Health Initiative Magnetic Resonance Imaging Study – WHIMS-MRI), we will link their outcome data (cognitive declines, mild cognitive impairment [MCI], dementia, and MRI measures of ischemic lesion volumes and regional brain volumes) with environmental characteristics of residential neighborhoods to assess the adverse neurocognitive effects of long-term exposures to ambient air pollutants, with primary focus on PM10, PM2.5 (PM with aerodynamic diameter ≤10 and 2.5 μm), diesel exhaust particles (DEP) and ozone. The proposed investigation of neurodegenerative effects of long-term exposures to ambient air pollutants is in accord with the National Research Council's recommendation that "studies to determine the potential of PM to have long-term effects on the CNS in both healthy and susceptible people are needed." 15 To this end, we submit the following specific aims:

1. Ambient air pollution and incidence of all-cause dementia and mild cognitive impairment

Investigate whether long-term exposures to ambient air pollutants (PM10/PM2; DEP; ozone) increase the risk for all-cause dementia and mild cognitive impairment (MCI) in a geographically-diverse population of elderly women, adjusting for potential confounders.

Hypothesis 1: (H1) Residing in places with high exposures to ambient air pollutants is associated with increased risks for all-cause dementia and MCI, adjusting for spatial variability, individual demographics, socioeconomic positions, personal biophysical and psychosocial attributes, and other potential confounders.

2. Ambient air pollution and cognitive function

Examine whether long-term exposures to ambient air pollutants (PM10/PM2; DEP; ozone) correlate with cognitive function (global and within specific domains) and predict cognitive declines in elderly women, adjusting for potential confounders.

Hypothesis 2: (H2) Estimated residence-specific exposures to ambient air pollutants averaged over 1-year are negatively associated with global and specific cognitive function at baseline and follow-up and positively associated with cognitive declines, adjusting for spatial variability, individual demographics, socioeconomic positions, personal biophysical and psychosocial attributes, and other potential confounders.

**3. Ambient air pollution and radiographic neuropathology of cognitive aging **

Examine whether long-term exposures to ambient air pollutants (PM10/PM2; DEP; ozone) correlate with ischemic lesion volumes and regional brain volumes measured by MRI in elderly women, adjusting for potential confounders and total intracranial volume.

Hypothesis 3: (H3) Residing in places with high exposures to ambient air pollutants is associated with larger ischemic lesion volumes and lower regional volumes, adjusting for spatial variability, individual demographics, socioeconomic positions, personal biophysical and psychosocial attributes, total intracranial volume and other potential confounders.

4. Determinants of population susceptibility to adverse neurocognitive effects of air pollution

Investigate the population variability in the associations of all-cause dementia, MCI, and declines of global cognitive function with long-term exposure to ambient air pollution. Identify susceptible population subgroups defined by individual's cardiovascular risk profiles and hematological biomarkers, adjusting for potential confounders.

Hypothesis 4: (H4) Elderly women with indicators of population susceptibility (histories of stroke, diabetes mellitus, or hypertension; obesity; high while blood cell count) are more likely to have adverse neurocognitive effects of to ambient air pollution than those without these characteristics.

Related Papers

Air pollution is linked to divergent cortical thickness patterns in brain regions vulnerable to Alzheimer’s disease

Approved Manuscript, Salminen, Lauren et al., 2024/12 MSID: 5195
Keywords: Air Pollution; Cortical Thickness; Alzheimer’S Disease; Gender Difference; Age Difference
Related Studies: 252

Geographic disparities in cognitive aging of older women: Evidence from the Women’s Health Initiative Memory Study

Approved Manuscript, Chen, Jiu-Chiuan et al., 2015/4 MSID: 2431
Keywords: Health Disparities; Brain Aging; Geography; Stroke Belt
Related Studies: 252

Fine particulate air pollutants and cognitive declines in older women

Approved Proposal, Chen, Jiu-Chiuan et al., 2014/6 MSID: 2478
Keywords: Brain Aging; Air Pollution; Neurotoxicity
Related Studies: 252

Gene X environment interactions in brain aging

Approved Proposal, Driscoll, Ira et al., 2014/1 MSID: 2345
Keywords: Aging; Genes; Environment; Particulate Matter; Pollution; Cognitive Impairment; Brain Volume; Brain Lesions; Mri
Related Studies: 250, 252

Exposures to ambient fine particles and risk of dementia in older women

Approved Proposal, Chen, Jiu-Chiuan et al., 2013/9 MSID: 2249
Keywords: Brain Aging; Air Pollution; Vehicular Emissions; Geographic Locations
Related Studies: 252

Long-term exposure to ambient air pollution and small vessel ischemic disease in the WHIMS-MRI cohort

Approved Proposal, Kulick, Erin et al., MSID: 3907
Keywords: Brain Aging; Air Pollution; Neurotoxicity; Geographic Locations
Related Studies: 252

Environmental determinants of brain volume and ischemia in older women: Role of diesel exhaust particulate matter

Approved Proposal, Chen, Jiu-Chiuan et al., 2012/8 MSID: 1914
Keywords: Brain Aging; Air Pollution; Vehicular Emissions; Geographic Locations
Related Studies: 252

Heterogenous air pollution exposure effects on the dynamic association between depressive symptoms and episodic memory in women aged 80 and older

Approved Manuscript, Chen, Jiu-Chiuan et al., 2020/5 MSID: 4160
Related Studies: 252

Associations between air quality improvement and trajectories of cognitive domain function in older women

Approved Proposal, Chen, Jiu-Chiuan et al., MSID: 4428
Related Studies: 252

Social resources, brain reserve, and risk of cognitive decline and incident MCI or dementia in the Women’s Health Initiative Memory Study

Approved Proposal, Gruenewald, Tara et al., 2019/11 MSID: 4054
Keywords: Social Support; Social Strain; Cognitive Function; Mild Cognitive Impairment; Dementia
Related Studies: 39, 103, 252, 262

PM 2.5 associated with gray matter atrophy reflecting increased Alzheimers risk in older women

Diana Younan et al., 2020/11 PubMed #33208540 MSID: 3514
Objective: To examine whether late-life exposure to PM2.5 (particulate matter with aerodynamic diameters <2.5-µm) contributes to progressive brain atrophy predictive of Alzheimer's disease (AD) using a community-dwelling cohort of women (aged 70-89) with up to two brain MRI scans (MRI-1: 2005-6; MRI-2: 2010-11). Methods: AD pattern similarity (AD-PS) scores, developed by supervised machine learning and validated with MRI data from the AD Neuroimaging Initiative, was used to capture high-dimensio...
Keywords: Ambient Fine Particles; Alzheimer’S Disease; Neuroimaging; Epidemiologic Studies; Cognitive Reserve
Related Studies: 252

Associations between air pollution exposure and empirically-derived profiles of cognitive performance in older women

Approved Manuscript, Petkus, Andrew J. et al., 2021/4 MSID: 4470
Related Studies: 252

Particulate air pollutants and trajectories of depressive symptoms in older women

Andrew J. Petkus et al., 2019/5 PubMed #31311712 MSID: 2557
OBJECTIVES: Although several environmental factors contribute to the etiology of late-life depressive symptoms, the role of ambient air pollution has been understudied. Experimental data support the neurotoxicity of airborne particulate matter with aerodynamic diameter of =2.5 µm (PM2.5), but it remains unclear whether long-term exposure is associated with late-life depressive symptoms. Our secondary aim was to explore whether the observed associations between exposure and depressive symptoms ar...
Keywords: Air Pollution; Emotion Brain; Neurocognitive Disorders; Older Women
Related Studies: 252

Particulate air pollutants, APOE alleles and their contributions to cognitive impairment in older women and to amyloidogenesis in experimental models

Mafalda Cacciottolo et al., 2017/1 PubMed #28140404 MSID: 2865
Exposure to particulate matter (PM) in the ambient air and its interactions with APOE alleles may contribute to the acceleration of brain aging and the pathogenesis of Alzheimer's disease (AD). Neurodegenerative effects of particulate air pollutants were examined in a US-wide cohort of older women from the Women's Health Initiative Memory Study (WHIMS) and in experimental mouse models. Residing in places with fine PM exceeding EPA standards increased the risks for global cognitive decline and al...
Related Studies: 250, 252

Racial-ethnic disparities in alzheimer’s risk: Role of exposure to ambient fine particles

Approved Manuscript, Younan, Diana et al., 2019/10 MSID: 3600
Keywords: Alzheimer’S Disease; Dementia; Cognitive Decline; Neuroimaging; Brain Aging; Environment; Nutrition; Ambient Fine Particles; Diet
Related Studies: 252

Ambient air pollution and trajectories of positive and negative affect in older women

Approved Proposal, Petkus, Andrew J. et al., 2022/4 MSID: 4690
Keywords: Air Pollution; Emotional Aging; Cognitive Aging; Depressive Symptoms; And Alzheimer’S Disease And Related Dementia
Related Studies: 252

Erythrocyte omega-3 index, ambient fine particle exposure and brain aging

Jiu-Chiuan Chen et al., 2020/7 PubMed #32669395 MSID: 3369
Objective: To examine whether LCn3PUFA levels modify the potential neurotoxic effects of PM2.5 exposure on normal-appearing brain volumes among dementia-free elderly women. Methods: A total of 1,315 women (aged 65 to 80 years) free of dementia were enrolled in an observational study between 1996-9 and underwent structural brain MRI in 2005-6. Based on prospectively collected and geocoded participant addresses, we used a spatiotemporal model to estimate the 3-year average PM2.5 exposure before th...
Related Studies: 39, 183, 252

Moderating effect of antioxidant intakes on brain aging associated with particulate air pollution exposure in older women

Approved Proposal, He, Ka et al., 2017/5 MSID: 3370
Related Studies: 39, 183, 252

B vitamin intakes modify the association between particulate air pollutants and incidence of all-cause dementia: Findings from the Women’s Health Initiative Memory Study

Cheng Chen et al., 2022/2 PubMed #35103387 MSID: 3371
Introduction: Particulate air pollutants may induce neurotoxicity by increasing homocysteine levels, which can be lowered by high B vitamin intakes. Therefore, we examined whether intakes of three B vitamins (folate, B12 , and B6 ) modified the association between PM2.5 exposure and incidence of all-cause dementia. Methods: This study included 7183 women aged 65 to 80 years at baseline. B vitamin intakes from diet and supplements were estimated by food frequency questionnaires at baseline. The 3...
Keywords: Cognition Disorders; Dementia; Air Pollution; Postmenopausal Women; Diet; B Vitamins
Related Studies: 39, 183, 252

20-year depressive symptoms, dementia, and structural neuropathology in older women

Andrew J. Petkus et al., 2024/4 PubMed #38591250 MSID: 4944
Introduction: The course of depressive symptoms and dementia risk is unclear, as are potential structural neuropathological common causes. Methods: Utilizing joint latent class mixture models, we identified longitudinal trajectories of annually assessed depressive symptoms and dementia risk over 21 years in 957 older women (baseline age 72.7 years old) from the Women's Health Initiative Memory Study. In a subsample of 569 women who underwent structural magnetic resonance imaging, we examined whe...
Keywords: Cognitive Reserve; Cognitive Aging; Dementia; Depression; Brain Pathology
Related Studies: 252

Association between late-life air pollution exposure and medial temporal lobe atrophy in older women

Xinhui Wang et al., 2023/11 PubMed #38077091 MSID: 4736
Background: Ambient air pollution exposures increase risk for Alzheimer's disease (AD) and related dementias, possibly due to structural changes in the medial temporal lobe (MTL). However, existing MRI studies examining exposure effects on the MTL were cross-sectional and focused on the hippocampus, yielding mixed results. Method: To determine whether air pollution exposures were associated with MTL atrophy over time, we conducted a longitudinal study including 653 cognitively unimpaired communi...
Related Studies: 252

Associations between air pollution exposure and physical performance: mediation by structural brain atrophy

Approved Proposal, Wang, Xinhui et al., 2023/3 MSID: 4882
Keywords: Air Pollution; Physical Function; Cortical Thickness; Mediation; Cognitive Aging
Related Studies: 252

Alzheimer's related neurodegeneration mediates air pollution effects on medial temporal lobe atrophy

Andrew J. Petkus et al., 2023/11 PubMed #38076972 MSID: 4737
Exposure to ambient air pollution, especially particulate matter with aerodynamic diameter <2.5 μm (PM2.5) and nitrogen dioxide (NO2), are environmental risk factors for Alzheimer's disease and related dementia. The medial temporal lobe (MTL) is an important brain region subserving episodic memory that atrophies with age, during the Alzheimer's disease continuum, and is vulnerable to the effects of cerebrovascular disease. Despite the importance of air pollution it is unclear whether exposure le...
Related Studies: 252

Neighborhood socioeconomic status, green space, and walkability and risk for falls among postmenopausal women: The Women’s Health Initiative

Marilyn Wende et al., 2023/5 PubMed #37149415 MSID: 4068
Purpose: This study estimated associations between neighborhood socioeconomic status (NSES), walkability, green space, and incident falls among postmenopausal women and evaluated modifiers of these associations, including study arm, race and ethnicity, baseline household income, baseline walking, age at enrollment, baseline low physical functioning, baseline fall history, climate region, and urban-rural residence. Methods: The Women's Health Initiative recruited a national sample of postmenopaus...
Keywords: Built Environment; Neighborhood; Falls; Physical Activity; Injury
Related Studies: 140, 220, 251, 252, 264, 315, 442, 481

How neighborhood socioeconomic status, green space, and walkability are associated with risk for fracture among postmenopausal women: The Women’s Health Initiative

Marilyn Wende et al., 2023/7 PubMed #37149415 MSID: 4069
Purpose: This study estimated associations between neighborhood socioeconomic status (NSES), walkability, green space, and incident falls among postmenopausal women and evaluated modifiers of these associations, including study arm, race and ethnicity, baseline household income, baseline walking, age at enrollment, baseline low physical functioning, baseline fall history, climate region, and urban-rural residence. Methods: The Women's Health Initiative recruited a national sample of postmenopaus...
Keywords: Neighborhood Socioeconomic Status; Walkability; Green Space; Fracture; Postmenopausal
Related Studies: 140, 220, 251, 252, 264, 315, 442, 481

Ambient air pollution and neurotoxicity on brain structure: Evidence from Women's Health Initiative Memory Study

Jiu-Chiuan Chen et al., 2015/7 PubMed #26075655 MSID: 2349
The aim of this study was to examine the putative adverse effects of ambient fine particulate matter (PM2.5 : PM with aerodynamic diameters <2.5µm) on brain volumes in older women.We conducted a prospective study of 1,403 community-dwelling older women without dementia enrolled in the Women's Health Initiative Memory Study, 1996-1998. Structural brain magnetic resonance imaging scans were performed at the age of 71-89 years in 2005-2006 to obtain volumetric measures of gray matter (GM) and norma...
Keywords: Brain Aging; Air Pollution; Neurotoxicity; Geographic Locations
Related Studies: 252

General and domain-specific cognitive reserve, mild cognitive impairment, and dementia risk in older women

Andrew J. Petkus et al., 2019/4 PubMed #31011622 MSID: 3511
Introduction: In a geographically diverse sample of women, we asked whether cognitive reserve (CR) is best viewed as a general or cognitive domain-specific construct and whether some cognitive reserve domains but not others exert protective effects on risk of developing mild cognitive impairment (MCI) or dementia. Methods: Estimates of general and domain-specific CR were derived via variance decomposition in 972 cognitively intact women from the Women's Health Initiative Study of Cognitive Aging...
Keywords: Cognitive Reserve; Cognitive Aging; Dementia; Depression; Brain Pathology
Related Studies: 252

A voxel-based morphometry study reveals local brain structural alterations associated with ambient fine particles in older women

Ramon Casanova et al., 2016/10 PubMed #27790103 MSID: 2549
Objective: Exposure to ambient fine particulate matter (PM2.5: PM with aerodynamic diameters < 2.5 µm) has been linked with cognitive deficits in older adults. Using fine-grained voxel-wise analyses, we examined whether PM2.5 exposure also affects brain structure. Methods: Brain MRI data were obtained from 1365 women (aged 71-89) in the Women's Health Initiative Memory Study and local brain volumes were estimated using RAVENS (regional analysis of volumes in normalized space). Based on geocoded ...
Keywords: Brain Aging; Air Pollution; Neurotoxicity; Geographic Locations
Related Studies: 39, 233, 252

Ambient air pollution and long-term trajectories of episodic memory decline among older women in the WHIMS-ECHO cohort

Xinhui Wang et al., 2021/9 PubMed #34516296 MSID: 4183
Background: Episodic memory decline varies by age and underlying neuropathology. Whether ambient air pollution contributes to the heterogeneity of episodic memory decline in older populations remains unclear. Objectives: We estimated associations between air pollution exposures and episodic memory decline according to pollutant, exposure time window, age, and latent class subgroups defined by episodic memory trajectories. Methods: Participants were from the Women's Health Initiative Memory Stud...
Related Studies: 252

Exposure to fine particulate matter and temporal dynamics of episodic memory and depressive symptoms in older women

Andrew J. Petkus et al., 2020/2 PubMed #31881430 MSID: 3883
Abstract BACKGROUND: Emerging data suggests PM2.5 (particulate matter with aerodynamic diameter <2.5 µm) may be associated with both earlier declines in episodic memory (EM) and increased depressive symptoms in older adults. Although late-life depressive symptoms are associated with EM, no longitudinal studies have examined the inter-relationship among PM2.5, depressive symptoms and EM. METHODS: Older women (n = 2,202; aged 67-83 in 1999) enrolled in the Women's Health Initiative Study of Cognit...
Related Studies: 252

Outdoor air pollution exposure and inter-relation of global cognitive performance and emotional distress in older women

Andrew J. Petkus et al., 2020/12 PubMed #33385889 MSID: 4084
The interrelationships among long-term ambient air pollution exposure, emotional distress and cognitive decline in older adulthood remain unclear. Long-term exposure may impact cognitive performance and subsequently impact emotional health. Conversely, exposure may initially be associated with emotional distress followed by declines in cognitive performance. Here we tested the inter-relationship between global cognitive ability, emotional distress, and exposure to PM2.5 (particulate matter with ...
Related Studies: 252

Ambient air pollution and the dynamic association between trajectories of positive and negative affect and episodic memory in older women

Approved Proposal, Petkus, Andrew J. et al., 2022/4 MSID: 4691
Keywords: Air Pollution; Emotional Aging; Cognitive Aging; Depressive Symptoms; And Alzheimer’S Disease And Related Dementia
Related Studies: 252

Adherence to a MIND-like dietary pattern, long-term exposure to fine particulate matter air pollution, and MRI-based measures of brain volume: The Women's Health Initiative Memory Study-MRI

Cheng Chen et al., 2021/12 PubMed #34939828 MSID: 1426
Background: Previous studies suggest that certain dietary patterns and constituents may be beneficial to brain health. Airborne exposures to fine particulate matter [particulate matter with aerodynamic diameter ≤ 2.5 μ m ( PM 2.5 )] are neurotoxic, but the combined effects of dietary patterns and PM 2.5 have not been investigated. Objectives: We examined whether previously reported association between PM 2.5 exposure and lower white matter volume (WMV) differed between women whose usual diet dur...
Keywords: Cognition Disorders; Dementia; Air Pollution; Geographic Locations; Diet; Nutrition
Related Studies: 39, 183, 252

Particulate matter and episodic memory decline mediated by early neuroanatomic biomarkers of Alzheimer’s disease

Diana Younan et al., 2019/11 PubMed #31746986 MSID: 3788
Evidence suggests exposure to particulate matter with aerodynamic diameter <2.5 µm (PM2.5) may increase the risk for Alzheimer's disease and related dementias. Whether PM2.5 alters brain structure and accelerates the preclinical neuropsychological processes remains unknown. Early decline of episodic memory is detectable in preclinical Alzheimer's disease. Therefore, we conducted a longitudinal study to examine whether PM2.5 affects the episodic memory decline, and also explored the potential med...
Keywords: Ambient Fine Particles; Alzheimer’S Disease; Neuroimaging; Epidemiologic Studies; Cognitive Reserve
Related Studies: 252

Air quality improvement and cognitive decline in community-dwelling older women in the United States: A longitudinal cohort study

Diana Younan et al., 2022/2 PubMed #35113870 MSID: 4350
Background: Late-life exposure to ambient air pollution is a modifiable risk factor for dementia, but epidemiological studies have shown inconsistent evidence for cognitive decline. Air quality (AQ) improvement has been associated with improved cardiopulmonary health and decreased mortality, but to the best of our knowledge, no studies have examined the association with cognitive function. We examined whether AQ improvement was associated with slower rate of cognitive decline in older women aged...
Related Studies: 252

Associations between ambient air pollution and psychiatric symptoms in women at high risk for alzheimer’s disease and related dementia

Approved Proposal, Petkus, Andrew J. et al., 2022/4 MSID: 4692
Keywords: Air Pollution; Emotional Aging; Cognitive Aging; Depressive Symptoms; And Alzheimer’S Disease And Related Dementia
Related Studies: 252

Comparison of PM2.5 air pollution exposures and health effects associations using 11 different modeling approaches in the Women's Health Initiative Memory Study (WHIMS)

Melinda Power et al., 2024/1 PubMed #38226465 MSID: 4126
Background: Many approaches to quantifying air pollution exposures have been developed. However, the impact of choice of approach on air pollution estimates and health-effects associations remains unclear. Objectives: Our objective is to compare particulate matter with aerodynamic diameter ≤ 2.5 μ m ( PM 2.5 ) concentrations and resulting health effects associations using multiple estimation approaches previously used in epidemiologic analyses. Methods: We assigned annual PM 2.5 exposure estimat...
Keywords: Air Pollution; Particulate Matter; Ozone; Environmental Health; Environmental Epidemiology
Related Studies: 140, 150, 226, 251, 252, 264, 315, 552

Ambient air pollution exposure and increasing depressive symptoms in older women: The mediating role of the prefrontal cortex and insula

Andrew J. Petkus et al., 2022/2 PubMed #35122843 MSID: 4257
Exposures to fine particulate matter (PM2.5) and nitrogen dioxide (NO2) have been associated with the emergence of depressive symptoms in older adulthood, although most studies used cross-sectional outcome measures. Elucidating the brain structures mediating the adverse effects can strengthen the causal role between air pollution and increasing depressive symptoms. We evaluated whether smaller volumes of brain structures implicated in late-life depression mediate associations between ambient air...
Keywords: Air Pollution; Brain Aging; Depression; Structural Magnetic Resonance Imaging
Related Studies: 252

Objectively defined subtle cognitive decline (OBJ-SCD) and associations with air pollution

Approved Proposal, Petkus, Andrew J. et al., 2022/12 MSID: 4843
Keywords: Air Pollution; Cognitive Aging; Structural Magnetic Resonance Imaging; Mild Cognitive Impairment; And Alzheimer’S Disease And Related Dementia
Related Studies: 39, 103, 183, 244, 252