Search

Objective: This study aimed to examine the impact of greenness and fine particulate matter <2.5 μm (PM 2.5 ) on overweight/obesity among older adults in China., Methods: A total of 21,355 participants aged ≥65 years were included from the Chinese Longitudinal Healthy Longevity Survey between 2000 and 2018. Normalized difference vegetation index (NDVI) with a radius of 250 m and PM 2.5 in a 1 × 1-km grid resolution were calculated around each participant's residence. Cox proportional hazards models were used to estimate the effects of NDVI and PM 2.5 on overweight/obesity. Interaction and mediation analyses were conducted to explore combined effects., Results: The study observed 1895 incident cases of overweight/obesity over 109,566 person-years. For every 0.1-unit increase in NDVI the hazard ratio of overweight/obesity was 0.91 (95% CI: 0.88-0.95), and for every 10-μg/m 3 increase in PM 2.5 the hazard ratio was 1.11 (95% CI: 1.07-1.14). The effect of NDVI on overweight/obesity was partially mediated by PM 2.5 , with a relative mediation proportion of 20.10% (95% CI: 1.63%-38.57%)., Conclusions: Greenness exposure appears to lower the risk of overweight/obesity in older adults in China, whereas PM 2.5 , acting as a mediator, partly mediated this protective effect., (© 2023 The Obesity Society.)

Background: The association between fine particular matter (PM2.5) and frailty is less studied, and the national burden of PM2.5-related frailty in China is unknown., Objective: To explore the association between PM2.5 exposure and incident frailty in older adults, and estimate the corresponding disease burden., Design: Chinese Longitudinal Healthy Longevity Survey from 1998 to 2014., Setting: Twenty-three provinces in China., Subjects: A total of 25,047 participants aged ≥65-year-old., Methods: Cox proportional hazards models were performed to evaluate the association between PM2.5 and frailty in older adults. A method adapted from the Global Burden of Disease Study was used to calculate the PM2.5-related frailty disease burden., Results: A total of 5,733 incidents of frailty were observed during 107,814.8 person-years follow-up. A 10 μg/m3 increment of PM2.5 was associated with a 5.0% increase in the risk of frailty (Hazard Ratio = 1.05, 95% confidence interval = [1.03-1.07]). Monotonic, but non-linear exposure-response, relationships of PM2.5 with risk of frailty were observed, and slopes were steeper at concentrations >50 μg/m³. Considering the interaction between population ageing and mitigation of PM2.5, the PM2.5-related frailty cases were almost unchanged in 2010, 2020 and 2030, with estimations of 664,097, 730,858 and 665,169, respectively., Conclusions: This nation-wide prospective cohort study showed a positive association between long-term PM2.5 exposure and frailty incidence. The estimated disease burden indicated that implementing clean air actions may prevent frailty and substantially offset the burden of population ageing worldwide., (© The Author(s) 2023. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For permissions, please email: journals.permissions@oup.com.)

Background: Research on the relationship between long-term exposure to particulate matter with aerodynamic diameter ≤ 2.5 μ m ( PM 2.5 ) and poor cognitive function is lacking in developing countries, especially in highly polluted areas., Objectives: We evaluated associations of long-term exposure to PM 2.5 with poor cognitive function in a diverse, national sample of older adults in China., Methods: This analysis included data on 13,324 older adults (5,879 who were 65-79 years of age, 3,052 who were 80-89 years of age, 2,634 who were 90-99 years of age, and 1,759 who were ≥ 100  years of age) with normal cognitive function at baseline from March 2002 to September 2014, with 64,648 person-years of follow-up. We used a geographic information system analysis to estimate the annual average satellite-derived PM 2.5 concentration for the geocoded location of the participants' baseline residences. Poor cognitive function was defined as a score of less than 18 on the Chinese version of the Mini-Mental State Examination (MMSE). Competing risk models were performed to explore the association of PM 2.5 with poor cognitive function., Results: Each 10 - μ g / m 3 increase in PM 2.5 was associated with a 5.1% increased risk of poor cognitive function [adjusted hazard ratio (HR): 1.051; 95% confidence interval (CI): 1.023, 1.079]. Compared to the lowest quartile of PM 2.5 ( < 41.4   μ g / m 3 ), adjusted HR values were 1.20 (95% CI: 1.09, 1.33), 1.27 (95% CI: 1.15, 1.41), and 1.21 (95% CI: 1.09, 1.34) for the second ( ≥ 41.4 - 50.3  ug / m 3 ), third ( ≥ 50.3 - 60.7 μ g / m 3 ), and fourth ( ≥ 60.7   μ g / m 3 ) quartiles of PM 2.5 , respectively ( p for trend < 0.001 ). Subgroup analyses suggested stronger associations between PM 2.5 and poor cognitive impairment in men than women. The association was positive in the 65- to 79- and ≥ 100 - y age group but not significant and positive in the other two age groups with similar results., Conclusion: PM 2.5 was identified as a risk factor for poor cognitive function in Chinese older adults. Improving air quality may reduce the future population burden of poor cognitive function, especially in areas with high air pollution. https://doi.org/10.1289/EHP5304.

Currently the Chinese government has adopted World Health Organization interim target-1 values as the national ambient air quality standards values. However, the population-based evidence was insufficient, especially for the oldest old (aged 80+). We evaluated the association of fine particulate matters (PM 2.5 ) exposure and incidence of disability in activities of daily living (ADL) in 15 453 oldest old in 886 counties/cities in China from 2002 to 2014 using Cox model with penalized splines and competing risk models to evaluate the linear or non-linear association. After adjusting for potential confounders, a J-shaped association existed between PM 2.5 exposure with a threshold concentration of 33 μg/m 3 , and incident disability in ADL. Above this threshold, the risk magnitude significantly increased with increase of PM 2.5 concentrations; compared to 33 μg/m 3 , the hazard ratio ranged from 1.03 (1.00-1.06) at 40 μg/m 3 to 2.25 (1.54-3.29) at 110 μg/m 3 . The risk magnitude was not significantly changed below this threshold. Each 10 μg/m 3 increase in PM 2.5 exposure corresponded to a 7.7% increase in the risk of disability in ADL (hazard ratio 1.077, 95% CI 1.051-1.104). Men, smokers, and participants with cognitive impairment might be more vulnerable to PM 2.5 exposure. The study provided limited population-based evidence for the oldest old and detected a threshold of 33 μg/m 3 , and supported that reduction to current World Health Organization interim target-1value (35 μg/m 3 ) and Chinese national ambient air quality standards (35 μg/m 3 ) or lower may be associated with lower risk of disability in ADL., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

Background: Air pollution and its adverse effects on public health remain a considerable problem in China, where policies have been implemented to improve the situation. We aimed to estimate the disease burden associated with particulate matter (PM) 2·5 across China for 2020 and 2030 to identify the populations and regions most at risk, quantify the health benefits of air quality improvement targets, and determine the effect of population growth and ageing on this disease burden., Methods: In this modelling study, we investigated premature deaths associated with PM 2·5 across China on the basis of air quality scenarios proposed by the expert group involved in the formulation of the 13th Five-Year Plan for Eco-Environmental Protection and population scenarios based on the Shared Socioeconomic Pathways of the Intergovernmental Panel on Climate Change. We used the integrated exposure-response model used for the Global Burden of Disease Study to estimate the number of PM 2·5 -related premature deaths under each scenario., Findings: The projected health benefits of the air-quality-improving targets are substantial, and could reduce the number of PM 2.5 -related premature deaths in China by approximately 129 278 by 2020 and 217 988 by 2030, compared with 2010. However, since China's population is increasing and ageing, the number of PM 2.5 -related premature deaths was estimated to increase by 84 102 by 2020 and by 244 191 by 2030, indicating that the health benefits induced by air quality improvements could be offset by the effect of the population increasing in size and ageing., Interpretation: To reduce the future disease burden in China, targets that are stricter than the interim target and stringent policies to improve air quality and protect public health are needed, especially for at-risk population groups, such as older individuals (aged >55 years) and patients with cardiovascular diseases, particularly in regions with a high disease burden., Funding: National Key Research and Development Program of China, National Natural Science Foundation of China, Beijing Natural Science Foundation, National High-level Talents Special Support Plan of China for Young Talents, and Special Foundation of Basic Science and Technology Resources Survey of Ministry of Science and Technology of China., (Copyright © 2019 The Author(s). Published by Elsevier Ltd. This is an Open Access article under CC BY-NC-ND 4.0 license. Published by Elsevier Ltd.. All rights reserved.)

Currently the Chinese government has adopted World Health Organization interim target-1 values as the national ambient air quality standards values. However, the population-based evidence was insufficient, especially for the oldest old (aged 80+). We evaluated the association of fine particulate matters (PM 2.5) exposure and incidence of disability in activities of daily living (ADL) in 15 453 oldest old in 886 counties/cities in China from 2002 to 2014 using Cox model with penalized splines and competing risk models to evaluate the linear or non-linear association. After adjusting for potential confounders, a J-shaped association existed between PM 2.5 exposure with a threshold concentration of 33 μg/m3, and incident disability in ADL. Above this threshold, the risk magnitude significantly increased with increase of PM 2.5 concentrations; compared to 33 μg/m3, the hazard ratio ranged from 1.03 (1.00–1.06) at 40 μg/m3 to 2.25 (1.54–3.29) at 110 μg/m3. The risk magnitude was not significantly changed below this threshold. Each 10 μg/m3 increase in PM 2.5 exposure corresponded to a 7.7% increase in the risk of disability in ADL (hazard ratio 1.077, 95% CI 1.051–1.104). Men, smokers, and participants with cognitive impairment might be more vulnerable to PM 2.5 exposure. The study provided limited population-based evidence for the oldest old and detected a threshold of 33 μg/m3, and supported that reduction to current World Health Organization interim target-1value (35 μg/m3) and Chinese national ambient air quality standards (35 μg/m3) or lower may be associated with lower risk of disability in ADL. Image 1 • The dose-response relationship between long-term PM 2.5 exposure and ADL was J-shaped. • The identification of a threshold of 33 μg/m3 for PM 2.5 and ADL disability incidence. • The first cohort study to demonstrate effect of PM 2.5 on ADL for the oldest old. • Air pollution reduction may reduce the public health burden of disability in the elderly. A J-shaped association existed between long-term PM 2.5 exposure with a threshold concentration of 33 μg/m3 and incident disability in ADL. [ABSTRACT FROM AUTHOR]