Little is known about the impact of long-term ambient air pollution (AP) and noise exposure on change in cognitive function over years in the elderly. In this study, we wanted to examine the association between long-term exposure to AP and noise with the rate of cognitive decline in a population aged 50 and older and susceptible groups with mild cognitive impairment or at a genetically higher risk of Alzheimer's disease (Apolipoprotein E ε4 positive). Participants in the German population-based Heinz Nixdorf Recall study carried out five neuropsychological tests. Individual tests scores at the first (T₁ = 2006–2008) and second (T₂ = 2011–2015) follow-up for each test were used as outcomes after standardization using predicted means adjusted for age and education. Global cognitive score (GCS) was defined as sum of five standardized scores of individual tests. Long-term exposures to particulate matter (PM_2.5, PM₁₀, PM_2.5 absorbance), accumulation mode particle number (PN_acc), a proxy of ultrafine particles, and nitrogen dioxide were estimated by the land-use regression and chemistry transport models. Noise exposures were assessed as outdoor weighted nighttime road traffic noise (L_night) means. We performed linear regression analyses adjusted for sex, age, individual and neighborhood socio-economic status, and lifestyle variables. Effect modification in vulnerable groups was estimated using multiplicative interaction terms between exposure and a modifier. Overall, 2554 participants (49.5% men, median age is 63 (IQR = 12)) were included. We found weak associations between higher exposure to PM₁₀ and PM_2.5 with faster decline in the immediate verbal memory test. Adjustment for potential confounders and for co-exposures did not change the results. We saw no effects on GCS, and no effect of noise exposure. In susceptible groups, higher AP and noise exposure were tended to be associated with faster decline in GCS. Our results suggest that AP exposure may accelerate cognitive decline in older ages, particularly in susceptible groups.

关于长期环境空气污染 (AP) 和噪声暴露对老年人认知功能变化的影响知之甚少。在这项研究中，我们想检查长期暴露于 AP 和噪音与 50 岁及以上人群以及具有轻度认知障碍或阿尔茨海默氏病遗传风险较高的易感人群认知能力下降率之间的关联（载脂蛋白E ε4 阳性）。以德国人群为基础的亨氏尼克多夫召回研究的参与者进行了五项神经心理学测试。第一次 (T ₁  = 2006–2008) 和第二次 (T ₂ = 2011–2015）每个测试的后续行动被用作标准化后的结果，使用根据年龄和教育调整的预测方法。全球认知评分 (GCS) 被定义为五个标准化个人测试分数的总和。长期暴露于颗粒物（PM _2.5、PM ₁₀、PM _2.5吸光度）、累积模式颗粒数 (PN _acc )、超细颗粒的替代物和二氧化氮是通过土地利用回归和化学传输模型估算的。噪声暴露评估为室外加权夜间道路交通噪声（L _night） 方法。我们进行了针对性别、年龄、个人和社区社会经济状况以及生活方式变量进行调整的线性回归分析。使用暴露和修饰符之间的乘法交互项估计弱势群体的影响修改。总体而言，包括 2554 名参与者（49.5% 男性，中位年龄为 63 岁 (IQR = 12)）。_{我们发现较高的 PM 10}和 PM _2.5暴露之间存在微弱关联随着即时语言记忆测试的快速下降。对潜在混杂因素和共同暴露的调整并未改变结果。我们没有看到对 GCS 的影响，也没有看到噪声暴露的影响。在易感人群中，更高的 AP 和噪音暴露往往与 GCS 更快下降有关。我们的结果表明，暴露于 AP 可能会加速老年人的认知能力下降，特别是在易感人群中。