Long-term exposure to polluted air, such as fine dust, increases the risk of dementia

Long-term exposure to polluted air, such as fine dust, increases the risk of dementia

Dec 18, 2024Ehotyshamull Joy

 

Age-related dementia

 

The biggest cause of memory decline is aging. When most people reach the age of uncertainty, they may not be able to remember things from the past or remember the names of people or things right away. At first, you don't think it's a big deal, but when the same thing happens repeatedly, you start to think about whether you have dementia. This situation is known as the 'senior moment' in the West.


However, this 'forgetfulness' continues to deteriorate in some people and progresses to dementia, while in others it remains as they grow older. The problem is that there is no easy and definitive way to distinguish between "high-risk dementia" progressing to dementia and "successful aging" that progresses from simple forgetfulness to memory retention.

 

Controlling risk factors for developing dementia can prevent dementia

Currently, about 50 million people worldwide suffer from dementia, and it is estimated that this number will increase to 75 million by 2030 and 132 million by 2050. Sadly, there will be no cure for this disease in the near future, but we cannot simply wait helplessly for the disease to take over.

According to population medicine research over the past 20 years, it has been found that the pathological changes that cause dementia begin to appear in the early 40sand the symptoms begin to appear only in the twilight of life after a long incubation period of 20~30 years. In other words, the time to prevent the occurrence or progression of dementia is 20~30 years.

One silver lining is that one-third of dementia cases can be prevented by controlling the risk factors for developing dementia that we can identify. Efforts to maintain a healthy lifestyle can prevent the onset of dementia, and even if it has already begun, it can be slowed down or prevented from progressing further from its current state.

Genetic and environmental risk factors for dementia

The most common causative disease that causes dementia is Alzheimer's disease, which we are familiar with. It has been called a modern incurable disease because no breakthrough treatment has yet been developed, but little by little, the possibility of a cure is emerging.


Most Alzheimer's diseases are sporadic Alzheimer's disease that develops after the age of 65. It means that it is not a hereditary disease, but in fact, there is a lot of genetic predisposition involved in sporadic Alzheimer's disease. If there is an Alzheimer's disease in the family, the offspring have a 40% higher risk of developing Alzheimer's disease than those who have no family history. In addition, the gene for apolipoprotein E, a protein involved in cholesterol metabolism and transport, is present on chromosome 19, and everyone is born with two of the E2, E3, and E4 alleles.

In other words, the genotype falls into one of six categories: APOE 2/2, APOE 2/3, APOE 2/4, APOE 3/3, APOE 3/4, and APOE 4/4. However, depending on which APOE gene you have, your risk of developing Alzheimer's disease varies. Of all the known genetic risk factors, the most potent other than aging is the APOE genotype. If you have one APOE 4 gene, the risk of developing Alzheimer's disease increases by 4~6 times, and if you have two, the risk of developing Alzheimer's disease increases by 10~12 times.

Unlike genetic risks, which we can't control, environmental risk factors can be reduced by our efforts. However, from metal ions and toxins dissolved in drinking water, to pesticides in food, to the polluted air we breathe every day, the environment around us is full of substances that can harm our health.


We will focus on how environmental pollution plays an important role in the development of dementia, which is more feared than 'cancer' for us living in the modern age, and in particular, the danger of ultrafine dust, which is getting worse day by day.

 

Dementia caused by fine dust

'Dust' is particulate matter that floats or is blown down into the atmosphere. The World Health Organization (WHO) defines fine dust (PM10 ) as fine dust with a diameter of 10μm or less, and ultrafine dust (PM2.5) with a diameter of 2.5μm or less. However, this fine dust also has a very serious effect on the nervous system.

Children and the elderly are the most vulnerable to fine dust and air pollution. PM2.5 has been shown to reduce IQ, increase the risk of attention deficit hyperactivity disorder (ADHD) and autism, and reduce the volume of white matter in the left side of the brain in children aged 3 to 9 years. In addition, children born to mothers who are repeatedly exposed to ultrafine dust during pregnancy will have developmental disabilities and incomplete cognitive development.


In a study of children who lived in the air-polluted northern city of Mexico City for more than three years, they performed poorly on psychomotor stability, motor coordination, and resonse time tests. It is speculated that this phenomenon is due to the decrease in a substance called brain-derived neurotrophic factor (BDNF)* due to the inhalation of ultrafine particulate matter.

*BDNF: Critical to maintaining the activity of neurons and synapses in the hippocampus, cerebral cortex, and basal forebrain, which enable learning, memory, and higher-order thinking.

Adults exposed to polluted air for long periods of time have also been shown to experience accelerated cognitive decline. Chronic exposure to PM2.5 in adults increases the risk of developing all dementia diseases, including Alzheimer's disease. As a result of a study of seniors aged 65 and older living in areas with high air pollution in China and Mexico, the scores of the Simplified Mental State Test (MMSE), a representative dementia screening tool, were significantly lower than those living in places with relatively good air quality.


Among them, the concentration of black carbon and PM2.5, which are the components of diesel engine soot, were significantly correlated with the MMSE score. Another study showed that for every 10 ug/mm3 increase in the concentration of black carbon, cognitive ability declined for two years.

A study from Ontario, Canada, published in The Lancet in 2017, is even more interesting
.It is easy to imagine that the distance a residence is from major highways has a bearing on the level of air pollution. The research team led by Dr. Chen investigated the incidence of degenerative brain diseases in people who lived within 50 meters of arterial roads, 50~100 meters, 100~200 meters, 200~300 meters, and 300 meters or more for more than 5 years.


The conclusion was that the farther away you lived from arterial roads, the lower your risk of developing dementia. There was no significant difference in the incidence of Parkinson's disease or multiple sclerosis, which the team examined together.


Earlier, I talked about APOE 4, a genetic risk factor for Alzheimer's diseasePeople with this genetic predisposition are more susceptible to air pollution. Even when exposed to the same concentration of air pollution, people with the APOE 4 gene may experience a more severe inflammatory response than those without it, which can lead to more cognitive decline.

 

 

 



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