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Association between indoor air pollution and cognitive function of older adults in India: a cross-sectional multilevel analysis

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Abstract

Aim

Over half the world’s population, mostly from developing countries, use solid fuel for domestic purposes and are exposed to very high concentrations of harmful air pollutants with potential health effects. The effect of indoor air pollution becomes much more severe for older adults because of their weakened immune system with multiple health risk factors. Compared with ambient air pollution, little is known about cognitive health in relation to indoor air pollution. Therefore, this study explores the association between indoor air pollution due to solid fuel use and cognitive function of older adults in India.

Subject and methods

The study used data from wave 1 of the WHO Study on global AGEing and adult health (SAGE). Bivariate analysis and a two-stage multilevel linear regression model were applied.

Results

Our findings indicated that indoor air pollution is strongly associated with cognitive function. Results show lower cognitive function scores among older adults in households using solid fuel, women with lower or no education, and belonging to the disadvantaged section of the society. Older adults from poor socioeconomic backgrounds were more exposed to indoor air pollution compared to their counterparts, which indirectly increases the risk of poor cognitive function.

Conclusion

Indoor air pollution from solid fuel use may be a salient factor for the cognitive health of older adults in India. A large proportion of India’s population relies on solid fuel pointing to the need for urgent intervention programmes to reduce the usage of solid fuel in the country.

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References

  • Ailshire JA, Crimmins EM (2014) Fine particulate matter air pollution and cognitive function among older US adults. Am J Epidemiol 180:359–366

    Article  PubMed  PubMed Central  Google Scholar 

  • Akunne AF, Louis VR, Sanon M, Sauerborn R (2006) Biomass solid fuel and acute respiratory infections: the ventilation factor. Int J Hygiene Environ Health 209:445–450

    Article  Google Scholar 

  • Arokiasamy P, Parasuraman S, Sekher TV, Lhungdim H (2013) Study on global AGEing and adult health (SAGE) wave 1, India National Report. International Institute for Population Sciences. World Health Organization, Geneva

    Google Scholar 

  • Balakrishnan K, Ghosh S, Ganguli B, Sambandam S, Bruce N, Barnes DF, Smith KR (2013) State and national household concentrations of PM 2.5 from solid cookfuel use: results from measurements and modeling in India for estimation of the global burden of disease. Environ Health 12:77

    Article  PubMed  PubMed Central  Google Scholar 

  • Borooah VK, Sabharwal NS, Thorat S (2012) Gender and caste-based inequality in health outcomes in India. Indian Institute of Dalit Studies, New Delhi

  • Cagney KA, Lauderdale DS (2002) Education, wealth, and cognitive function in later life. J Gerontol Series B: Psychol Sci Social Sci 57:163–172

    Article  Google Scholar 

  • Calderón-Garcidueñas L, Calderón-Garcidueñas A, Torres-Jardón R (2013) Megacity air pollution and the impact on the central nervous system. Functional Neurol Rehab Ergonomics 3:447

    Google Scholar 

  • Chen JC, Schwartz J (2009) Neurobehavioral effects of ambient air pollution on cognitive performance in US adults. Neurotoxicol 30:231–239

    Article  CAS  Google Scholar 

  • Chen C, Zhao B (2011) Review of relationship between indoor and outdoor particles: I/O ratio, infiltration factor and penetration factor. Atmospheric Environ 45:275–288

    Article  CAS  Google Scholar 

  • Christensen K, Thinggaard M, Oksuzyan A, Steenstrup T, Andersen-Ranberg K, Jeune B, McGue M, Vaupel JW (2013) Physical and cognitive functioning of people older than 90 years: a comparison of two Danish cohorts born 10 years apart. Lancet 382:1507–1513

    Article  PubMed  Google Scholar 

  • de Champlain J, Wu R, Girouard H, Karas M, El Midaoui A, Laplante MA, Wu L (2004) Oxidative stress in hypertension. Clin Experiment hypertension 26:593–601

    Article  Google Scholar 

  • DESA U (2019) United Nations, Department of Economic and Social Affairs, Population Division. World Population Prospects 2019: Highlights. https://www.un.org/development/desa/publications/world-population-prospects-2019-highlights.html

  • Desai S, Kulkarni V (2008) Changing educational inequalities in India in the context of affirmative action. Demography 45:245–270

    Article  PubMed  PubMed Central  Google Scholar 

  • Dix-Cooper L, Eskenazi B, Romero C, Balmes J, Smith KR (2012) Neurodevelopmental performance among school age children in rural Guatemala is associated with prenatal and postnatal exposure to carbon monoxide, a marker for exposure to woodsmoke. Neurotoxicology 33:246–254

    Article  CAS  PubMed  Google Scholar 

  • Duflo E, Greenstone M, Hanna R (2008) Cooking stoves, indoor air pollution and respiratory health in rural Orissa. Econ Politic Weekly 43:71–76

    Google Scholar 

  • Elder A, Gelein R, Silva V, Feikert T, Opanashuk L, Carter J, Potter R, Maynard A, Ito Y, Finkelstein J, Oberdörster G (2006) Translocation of inhaled ultrafine manganese oxide particles to the central nervous system. Environ Health Perspect 114:1172–1178

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Gatto NM, Henderson VW, Hodis HN, John JA, Lurmann F, Chen JC, Mack WJ (2014) Components of air pollution and cognitive function in middle-aged and older adults in Los Angeles. Neurotoxicology 40:1–7

    Article  CAS  PubMed  Google Scholar 

  • Grodstein F (2007) Cardiovascular risk factors and cognitive function. Alzheimers Dement 3:16–S22

    Article  Google Scholar 

  • Gupta A, Vyas S, Hathi P, Khalid N, Srivastav N, Spears D, Coffey D (2020) Persistence of solid fuel use in rural North India. Econ Politic Weekly 55:55

    Google Scholar 

  • Hopkins LE, Laing EA, Peake JL et al (2018) Repeated iron–soot exposure and nose-to-brain transport of inhaled ultrafine particles. Toxicologic Pathol 46:75–84

    Article  CAS  Google Scholar 

  • Huq M, Dasgupta S, Khaliquzzaman V, Pandey K, Wheeler D (2004) Indoor air quality for poor families: new evidence from Bangladesh. Indoor Air 16:426–44. https://doi.org/10.1111/j.1600-0668.2006.00436.x

  • IIPS I (2017) National Family Health Survey (NFHS-4). International Institute for Population Sciences (IIPS), Mumbai, pp 2015–2016

    Google Scholar 

  • International Energy Agency (2019) SDG7: data and projections. IEA, Paris https://www.iea.org/reports/sdg7-data-and-projections. Accessed 15 April 2020

    Google Scholar 

  • Kalaria RN, Maestre GE, AR Arizaga et al (2008) Alzheimer’s disease and vascular dementia in developing countries: prevalence, management, and risk factors. Lancet Neurol 7:812–826

    Article  PubMed  PubMed Central  Google Scholar 

  • Kowal P, Chatterji S, Naidoo N et al (2012) Data resource profile: the World Health Organization study on global AGEing and adult health (SAGE). Int J Epidemiol 41:1639–1649

    Article  PubMed  PubMed Central  Google Scholar 

  • Kramer AF, Colcombe S (2018) Fitness effects on the cognitive function of older adults: a meta-analytic study—revisited. Perspect Psychol Sci 13:213–217

    Article  PubMed  Google Scholar 

  • Krishnamoorthy Y, Sarveswaran G, Sivaranjini K, Sakthivel M, Majella MG, Kumar SG (2018) Association between indoor air pollution and cognitive impairment among adults in rural Puducherry, South India. J Neurosci Rural Pract 9:529

    Article  PubMed  PubMed Central  Google Scholar 

  • Lee J, Shih R, Feeney K, Langa KM (2014) Gender disparity in late-life cognitive functioning in India: findings from the longitudinal aging study in India. J Gerontol Series B: Psychol Sci Social Sci 69:603–611

    Article  Google Scholar 

  • Lei X, Hu Y, McArdle JJ, Smith JP, Zhao Y (2012) Gender differences in cognition among older adults in China. J Human Resources 47:951–971

    Google Scholar 

  • Leung DY (2015) Outdoor-indoor air pollution in urban environment: challenges and opportunity. Frontiers Environ Sci 2:69

    Article  Google Scholar 

  • Liu Q, Sasco AJ, Riboli E, Hu MX (1993) Indoor air pollution and lung cancer in Guangzhou, People’s Republic of China. Am J Epidemiol 137:145–154

    Article  CAS  PubMed  Google Scholar 

  • Lyu J, Kim HY (2016) Gender-specific incidence and predictors of cognitive impairment among older Koreans: findings from a 6-year prospective cohort study. Psychiatry Investig 13:473

    Article  PubMed  PubMed Central  Google Scholar 

  • Mishra V, Smith KR, Retherford RD (2005) Effects of cooking smoke and environmental tobacco smoke on acute respiratory infections in young Indian children. Population Environ 26:375–396

    Article  Google Scholar 

  • Oudin A, Forsberg B, Adolfsson AN, Lind N, Modig L, Nordin M, Nordin S, Adolfsson R, Nilsson LG (2016) Traffic-related air pollution and dementia incidence in northern Sweden: a longitudinal study. Environ Health Perspect 124:306–312

    Article  CAS  PubMed  Google Scholar 

  • Power MC, Weisskopf MG, Alexeeff SE, Coull BA, Spiro A III, Schwartz J (2011) Traffic-related air pollution and cognitive function in a cohort of older men. Environ Health Perspect 119:682–687

    Article  CAS  PubMed  Google Scholar 

  • Qiu Y, Yang FA, Lai W (2019) The impact of indoor air pollution on health outcomes and cognitive abilities: empirical evidence from China. Population Environ 40:388–410

    Article  Google Scholar 

  • Saenz JL, Wong R, Ailshire JA (2018) Indoor air pollution and cognitive function among older Mexican adults. J Epidemiol Community Health 72:21–26

    Article  PubMed  Google Scholar 

  • Sathianathan R, Kantipudi SJ (2018) The dementia epidemic: Imp0 act, prevention, and challenges for India. Indian J Psychiatry 60:165

    Article  PubMed  PubMed Central  Google Scholar 

  • Sharma D, Mazta SR, Parashar A (2013) Prevalence of cognitive impairment and related factors among elderly: a population-based study. J Dr NTR Univ Health Sci 2:171

    Article  Google Scholar 

  • Simoni M, Jaakkola MS, Carrozzi L, Baldacci S, Di Pede F, Viegi G (2003) Indoor air pollution and respiratory health in the elderly. European Respiratory J 21:15–20

    Article  Google Scholar 

  • Singh AL, Jamal S (2012) A study of risk factors associated with indoor air pollution in the low income households in Aligarh city, India. J Environ Res Manag 3:1–8

    CAS  Google Scholar 

  • Singh P, Govil D, Kumar V, Kumar J (2017) Cognitive impairment and quality of life among elderly in India. Appl Research Qual Life 12:963–979

    Article  Google Scholar 

  • Singh PK, Jasilionis D, Oksuzyan A (2018) Gender difference in cognitive health among older Indian adults: a cross-sectional multilevel analysis. SSM-Population Health 5:180–187

    Article  PubMed  PubMed Central  Google Scholar 

  • Sousa RM, Ferri CP, Acosta D et al (2010) The contribution of chronic diseases to the prevalence of dependence among older people in Latin America, China and India: a 10/66 dementia research group population-based survey. BMC Geriatr 10:53

    Article  PubMed  PubMed Central  Google Scholar 

  • Terzano C, Di Stefano F, Conti V, Graziani E, Petroianni A (2010) Air pollution ultrafine particles: toxicity beyond the lung. Eur Rev Med Pharmacol Sci 14:809–821

    CAS  PubMed  Google Scholar 

  • Tonne C, Elbaz A, Beevers S, Singh-Manoux A (2014) Traffic-related air pollution in relation to cognitive function in older adults. Epidemiology 25:674

    Article  PubMed  PubMed Central  Google Scholar 

  • Upadhyay AK, Singh A, Kumar K, Singh A (2015) Impact of indoor air pollution from the use of solid fuels on the incidence of life threatening respiratory illnesses in children in India. BMC Public Health 15:300

    Article  PubMed  PubMed Central  Google Scholar 

  • Walker JD, Maxwell CJ, Hogan DB, Ebly EM (2004) Does self-rated health predict survival in older persons with cognitive impairment? J Am Geriatrics Soc 52:1895–1900

    Article  Google Scholar 

  • Wang S, Zhang J, Zeng X, Zeng Y, Wang S, Chen S (2009) Association of traffic-related air pollution with children’s neurobehavioral functions in Quanzhou, China. Environ Health Perspect 117:1612–1618

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Weuve J, Puett RC, Schwartz J, Yanosky JD, Laden F, Grodstein F (2012) Exposure to particulate air pollution and cognitive decline in older women. Arch Internal Med 172:219–227

    Article  Google Scholar 

  • World Health Organization (2010) Global recommendations on physical activity for health. World Health Organization, Geneva, p 60

    Google Scholar 

  • World Health Organization (2016) Household air pollution and health. http://www.who.int/mediacentre/factsheets/fs292/en/. Accessed 15 April 2020

  • World Health Organization (2020) Dementia. WHO. http://www.who.int/mediacentre/factsheets/fs362/en/. Accessed 15 Apr 2020

  • Wu F, Guo Y, Zheng Y, Ma W, Kowal P, Chatterji S, Wang L (2016) Social-economic status and cognitive performance among Chinese aged 50 years and older. PLoS One 11:0166986

    Article  Google Scholar 

  • Xu H, Ostbye T, Vorderstrasse AA, Dupre ME, Wu B (2018) Place of residence and cognitive function among the adult population in India. Neuroepidemiology 50:119–127

    Article  PubMed  Google Scholar 

  • Yao YH, Xu RF, Tang HD et al (2010) Cognitive impairment and associated factors among the elderly in the Shanghai suburb: findings from a low-education population. Neuroepidemiology 34:245–252

    Article  PubMed  Google Scholar 

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Availability of data and material

Data are available online at http://apps.who.int/healthinfo/systems/surveydata/index.php/catalog/63.

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The author(s) received no financial support for the research, authorship, and/or publication of this article.

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Authors

Contributions

Ritu Rani: conceptualization, methodology, writing – original draft, data curation, methodology. Perianayagam Arokiasamy: investigation, supervision, validation, writing – Reviewing and Editing. Wahengbam Bigyananda Meitei: data curation, methodology, writing – reviewing and editing. Ankit Sikarwar: conceptualization, writing – reviewing and editing, validation.

Corresponding author

Correspondence to Ritu Rani.

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Rani, R., Arokiasamy, P., Meitei, W.B. et al. Association between indoor air pollution and cognitive function of older adults in India: a cross-sectional multilevel analysis. J Public Health (Berl.) 31, 369–379 (2023). https://doi.org/10.1007/s10389-021-01521-1

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  • DOI: https://doi.org/10.1007/s10389-021-01521-1

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