BACKGROUND Emerging evidence links road proximity and air pollution with cognitive impairment. Joint effects of noise and greenness have not been evaluated. We investigated associations between road proximity and exposures to air pollution, and joint effects of noise and greenness, on non-Alzheimer's dementia, Parkinson's and Alzheimer's disease and multiple sclerosis within a population-based cohort. METHODS We assembled administrative health database cohorts of 45-84 year old residents (N ~ 678,000) of Metro Vancouver, Canada. Cox proportional hazards models were built to assess associations between exposures and non-Alzheimer's dementia and Parkinson's disease. Given reduced case numbers, associations with Alzheimer's disease and multiple sclerosis were evaluated in nested case-control analyses by conditional logistic regression. RESULTS Road proximity was associated with all outcomes (e.g. non-Alzheimer's dementia hazard ratio: 1.14, [95% confidence interval: 1.07-1.20], for living < 50 m from a major road or < 150 m from a highway). Air pollutants were associated with incidence of Parkinson's disease and non-Alzheimer's dementia (e.g. Parkinson's disease hazard ratios of 1.09 [1.02-1.16], 1.03 [0.97-1.08], 1.12 [1.05-1.20] per interquartile increase in fine particulate matter, Black Carbon, and nitrogen dioxide) but not Alzheimer's disease or multiple sclerosis. Noise was not associated with any outcomes while associations with greenness suggested protective effects for Parkinson's disease and non-Alzheimer's dementia. CONCLUSIONS Road proximity was associated with incidence of non-Alzheimer's dementia, Parkinson's disease, Alzheimer's disease and multiple sclerosis. This association may be partially mediated by air pollution, whereas noise exposure did not affect associations. There was some evidence of protective effects of greenness.

中文翻译：

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邻近道路，空气污染，噪音，绿地和神经系统疾病的发病率：一项基于人群的队列研究。

背景技术越来越多的证据将道路接近性和空气污染与认知障碍联系在一起。尚未评估噪音和绿色的共同影响。我们调查了以人口为基础的人群中非阿尔茨海默氏痴呆症，帕金森氏和阿尔茨海默氏病以及多发性硬化症与道路接近程度和空气污染暴露以及噪声和绿色的共同影响之间的关联。方法我们收集了加拿大大温哥华地区45-84岁居民（N〜678,000）的行政健康数据库队列。建立Cox比例风险模型来评估暴露与非阿尔茨海默氏痴呆症和帕金森氏病之间的关联。鉴于病例数减少，与阿尔茨海默氏病的关联 病情和多发性硬化症通过条件对数回归进行嵌套病例对照分析。结果道路接近度与所有结果相关（例如，在主要道路上生活在<50 m或在高速公路上生活在<150 m的情况下，非阿尔茨海默氏痴呆症的危险比：1.14，[95％置信区间：1.07-1.20]。空气污染物与帕金森氏病和非阿尔茨海默氏痴呆症的发生率相关（例如，每四分位数的细颗粒物增加，帕金森氏病的危险比分别为1.09 [1.02-1.16]，1.03 [0.97-1.08]，1.12 [1.05-1.20]，黑色碳和二氧化氮），但不包括阿尔茨海默氏病或​​多发性硬化症。噪音与任何结局无关，而与绿色的关联则表明对帕金森氏病和非阿尔茨海默氏痴呆症有保护作用。结论道路接近与非阿尔茨海默氏痴呆症，帕金森氏病，阿尔茨海默氏病和多发性硬化症的发生有关。这种关联可能部分地由空气污染介导，而噪声暴露并未影响这种关联。有一些证据证明绿色的保护作用。