Association between long-term ambient air pollution exposure and cognitive disorders among older adults in China: the mediating role of lifestyle.
5 affiliations
- 1Department of Preventive Medicine, School of Public Health, Shihezi University, Shihezi, Xinjiang, China.
- 2University of Melbourne, Melbourne, Victoria, Australia.
- 3Key Laboratory for Prevention and Control of Crucial Emerging Infectious Diseases and Public Health Security of The Xinjiang Production and Construction Corps, Shihezi, Xinjiang, China.
- 4Key Laboratory of Preventive Medicine, Shihezi University, Shihezi, Xinjiang, China.
- 5Key Laboratory of Xinjiang Endemic and Ethnic Diseases (Ministry of Education), School of Medicine, Shihezi University, Shihezi, Xinjiang, China.
Abstract
Background
Cognitive disorders (CDs) are a major public health concern in ageing societies. The association between air pollution and CDs has received considerable attention; however, the moderating role of lifestyle remains unclear. We aimed to explore the complex associations among lifestyle, its dynamic changes, ambient air pollution exposure, and CDs in older adults.Methods
We included data from the Chinese Longitudinal Healthy Longevity Study. We used Cox proportional hazards models, Bayesian weighted quantile sum models, and mediation analysis to explore associations between lifestyle, air pollution, and CDs risk.Results
Per 10 μg/m³ increase in exposure to particulate matter with diameters ≤2.5 μm (hazard ratio (HR) = 1.005; 95% confidence interval (CI) = 1.001-1.009), sulphates (HR = 1.030; 95% CI = 1.003-1.056), ozone (HR = 1.006; 95% CI = 1.001-1.011), nitrates (HR = 1.020; 95% CI = 1.003-1.037), and ammonium (HR = 1.033; 95% CI = 1.005-1.062) was associated with an increased risk of CDs. The mixture exposure showed a significant positive association with CDs (odds ratio = 1.028; 95% CI = 1.006-1.040). Adherence to both intermediate (HR = 0.732; 95%CI = 0.569-0.940) and favourable (HR = 0.488; 95%CI = 0.336-0.710) lifestyles was associated with a reduced risk of CDs compared to an unfavourable lifestyle, and the protective effect was more significant at high pollution exposure levels (about 52% lower risk). Lifestyle mediated the effect by 8.4-9.4% in the association between single pollutants and CDs, and 9.1-9.5% in the association between mixed pollutants and CDs. Ozone had the highest weight in the pollution mixture.Conclusions
Air pollution increased the risk of CDs among older adults, which was partially offset by a healthy lifestyle. Lifestyle interventions may help address some challenges inherent in controlling air pollution in ageing societies.
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BibTeX
@article{zhang2026association,
title = {{Association between long-term ambient air pollution exposure and cognitive disorders among older adults in China: the mediating role of lifestyle.}},
author = {Yu Zhang and Jiaqi Yang and Yixin Zhang and Quan Yuan and Yanan Li and Ruizheng Ding and Guanling Song and Qiang Niu and Yunhua Hu and Yizhong Yan},
journal = {Journal of global health},
year = {2026},
month = oct,
doi = {10.7189/jogh.16.04307},
url = {https://europepmc.org/article/MED/42895283},
note = {CC BY},
}
RIS
TY - JOUR
TI - Association between long-term ambient air pollution exposure and cognitive disorders among older adults in China: the mediating role of lifestyle.
AU - Yu Zhang
AU - Jiaqi Yang
AU - Yixin Zhang
AU - Quan Yuan
AU - Yanan Li
AU - Ruizheng Ding
AU - Guanling Song
AU - Qiang Niu
AU - Yunhua Hu
AU - Yizhong Yan
PY - 2026
DA - 2026/10/19
JO - Journal of global health
DO - 10.7189/jogh.16.04307
UR - https://europepmc.org/article/MED/42895283
AB - Background Cognitive disorders (CDs) are a major public health concern in ageing societies. The association between air pollution and CDs has received considerable attention; however, the moderating role of lifestyle remains unclear. We aimed to explore the complex associations among lifestyle, its dynamic changes, ambient air pollution exposure, and CDs in older adults.Methods We included data from the Chinese Longitudinal Healthy Longevity Study. We used Cox proportional hazards models, Bayesian weighted quantile sum models, and mediation analysis to explore associations between lifestyle, air pollution, and CDs risk.Results Per 10 μg/m³ increase in exposure to particulate matter with diameters ≤2.5 μm (hazard ratio (HR) = 1.005; 95% confidence interval (CI) = 1.001-1.009), sulphates (HR = 1.030; 95% CI = 1.003-1.056), ozone (HR = 1.006; 95% CI = 1.001-1.011), nitrates (HR = 1.020; 95% CI = 1.003-1.037), and ammonium (HR = 1.033; 95% CI = 1.005-1.062) was associated with an increased risk of CDs. The mixture exposure showed a significant positive association with CDs (odds ratio = 1.028; 95% CI = 1.006-1.040). Adherence to both intermediate (HR = 0.732; 95%CI = 0.569-0.940) and favourable (HR = 0.488; 95%CI = 0.336-0.710) lifestyles was associated with a reduced risk of CDs compared to an unfavourable lifestyle, and the protective effect was more significant at high pollution exposure levels (about 52% lower risk). Lifestyle mediated the effect by 8.4-9.4% in the association between single pollutants and CDs, and 9.1-9.5% in the association between mixed pollutants and CDs. Ozone had the highest weight in the pollution mixture.Conclusions Air pollution increased the risk of CDs among older adults, which was partially offset by a healthy lifestyle. Lifestyle interventions may help address some challenges inherent in controlling air pollution in ageing societies.
SN - 2047-2978
SN - 2047-2986
ER -