Acute Air Quality, Biomarkers, and Cognition in the Elderly

Transcription

1 Acute Air Quality, Biomarkers, and Cognition in the Elderly Dustin B. Hammers, PhD, ABPP Board Certified in Clinical Neuropsychology Department of Neurology Center for Alzheimer s Care, Imaging, & Research University of Utah 09/21/2016 Center for Alzheimer s Care, Imaging and Research (CACIR)

2 Disclosures No relevant disclosures to report Funding University of Utah s Program for Air Quality, Health, and Society University of Utah s Center on Aging

3 Models of Pollution s Effect on CNS Interleukin 1β C-Reactive Protein Modified from: Genc et al., 2011, J Toxicology

4 Given what we know about the impact of air pollution on cardiovascular and pulmonary health, can poor air quality impact cognition as well? Cognitive declines seen after exposure to reduced air quality across participant age spectrum and locations Attention, problem solving/reasoning, processing speed, memory Wang et al., 2009; Calderón-Garcidueñas et al., 2008; Weuve et al., 2012; Ranft et al., 2009; Power et al., 2013)

5 However Chronic Exposure Limited data about impact of pollution in geographic areas with short, but intense, periods of poor air quality

6 Acute Air Quality, Biomarkers, and Cognition in the Elderly Prospective assessment of relationship between air quality and cognition during periods of poor air quality Evaluated non-demented individuals over age of 65 Exclusions: smoking, pulmonary, cardiovascular, psychiatric, autoimmune, rheumatological, and neurological disease Air quality measurements (PM2.5 in μg/m 3 ) were be monitored on a daily basis through the State of Utah s Division of Air Quality website (

7 Procedure Participants were scheduled for a series of 3 appointments over an 8 month period, lasting two hours each

8 Procedure For each appointment: Testing of cognition for assessment of attention, reaction time, executive functioning, and memory Completion of paperwork about medications, health, sleep, and mood Blood draw of to measure C-Reactive Protein (CRP) and Interleukin 1β (IL-1β) Diary related to the amount of time spent outdoors and types of activities completed each night one week prior to the appointment

9 Participant Enrollment Recruitment: From community talks (UPHE), Cognitive Disorders Clinic research database, fliers in libraries and senior living facilities, tv/radio interviews about the study Screening: 91 screened 58 screen passed Completed Visits Visit 1: 51 Visit 2: 43 Visit 3: 43

10 Participant s Home Location

11 Air Quality Fall 2015 to Summer 2016

12 PM 2.5 During Winter Testing

13 Participant Exposure Before Winter Testing

14 Next Step Clean air quality data and cognitive data for abnormalities and quality assurance Future Analyses Changes in cognition based on air quality Changes in inflammatory markers based on air quality What Have We Learned? Prospective air quality research in Northern Utah is possible Hard work and luck Large level of interest from local Utahns about participant and importance of understanding air quality s impact on health

15 Acknowledgements Support: Dr. Rob Paine Dr. Mark Supiano Dr. Norman Foster Dr. Kevin Duff Phlebotomy Josh Amaro Jenny Felter Stacey Larrinaga Research Team: Bonnie Dalley Taylor Atkinson Kayla Suhrie

16 Primary Study Variables Cognition CogState Computerized Cognitive Battery International Shopping List (Shopping List Learning) Groton Maze (Find the Hidden Pathway) Detection (Has the Card Turned Over?) Identification (Is the Card Red?) One Card Learning (Have You Seen This Card Before in This Task?) One Back Task (Is the Previous Card the Same?) Two Back Task (Is the Card the Same as That Shown 2 Cards Ago?) Continuous Paired Association Test (In What Location do These Pictures Belong?) Maze- Delay (Find the Hidden Pathway Recall) International Shopping List- Delay (Shopping List Recall) WAIS-IV Matrix Reasoning Stroop Color and Word Test

17 Blood Measurements Interleukin 1β levels C-reactive Protein levels Mood and Health Pulmonary Functioning Questionnaire ESS Questionnaire PSSQ Questionnaire Positive and Negative Affect Scale (PANAS) Questionnaire Zung Anxiety Questionnaire GDS Questionnaire Outdoor Exposure Journal

18 Hypotheses Hypothesis #1: Working memory and executive functioning will worsen when air quality is poorer, as measured by Particulate Matter 2.5, after controlling for other variables that affect cognition (e.g., age, education) using multiple regression analyses Hypothesis #2: Serum C-Reactive Protein and Interleukin 1β levels will rise when air quality is poorer, after controlling for other variables that affect cognition using multiple regression analyses these changes are expected to mediate the relationship between air pollution levels and working memory

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