Annual dementia incidence and monetary burden attributable to fine particulate matter (PM2.5) exposure in Sweden

Abstract

Background Alzheimer’s disease (AD) and other dementias currently represent the fifth most common cause of death in the world, according to the World Health Organization, with a projected future increase as the proportion of the elderly in the population is growing. Air pollution has emerged as a plausible risk factor for AD, but studies estimating dementia cases attributable to exposure to fine particulate matter (PM2.5) air pollution and resulting monetary estimates are lacking. Methods We used data on average population-weighted exposure to ambient PM2.5 for the entire population of Sweden above 30 years of age. To estimate the annual number of dementia cases attributable to air pollution in the Swedish population above 60 years of age, we used the latest concentration response functions (CRF) between PM2.5 exposure and dementia incidence, based on ten longitudinal cohort studies, for the population above 60 years of age. To estimate the monetary burden of attributable cases, we calculated total costs related to dementia, including direct and indirect lifetime costs and intangible costs by including quality-adjusted life years (QALYs) lost. Two different monetary valuations of QALYs in Sweden were used to estimate the monetary value of reduced quality-of-life from two different payer perspectives. Results The annual number of dementia cases attributable to PM2.5 exposure was estimated to be 820, which represents 5% of the annual dementia cases in Sweden. Direct and indirect lifetime average cost per dementia case was estimated to correspond € 213,000. A reduction of PM2.5 by 1 μg/m3 was estimated to yield 101 fewer cases of dementia incidences annually, resulting in an estimated monetary benefit ranging up to 0.01% of the Swedish GDP in 2019. Conclusion This study estimated that 5% of annual dementia cases could be attributed to PM2.5 exposure, and that the resulting monetary burden is substantial. These findings suggest the need to consider airborne toxic pollutants associated with dementia incidence in public health policy decisions.

Associations of air pollution with all-cause dementia, Alzheimer’s disease, and vascular dementia: a prospective cohort study based on 437,932 participants from the UK biobank

“…It is plausible that air pollutants may directly reach the brain through the systemic circulation, gaining entry through the nasal pathway and crossing the blood-brain barrier (Genc et al, 2012;Mortamais et al, 2021). This process could potentially trigger microglial activation, induce inflammatory responses and vascular endothelial injury, and generate reactive oxygen species that inflict damage on the brain (Kioumourtzoglou et al, 2016;Hahad et al, 2020;Kriit et al, 2021).…”

Polyethylene terephthalate (PET) micro- and nanoplastic particles affect the mitochondrial efficiency of human brain vascular pericytes without inducing oxidative stress

“…Their dysfunctions are associated with neurodegenerative diseases such as Alzheimer’s and Parkinson’s diseases (Baloyannis and Baloyannis, 2012; Halliday et al, 2016; Lendahl et al, 2019; Quaegebeur et al, 2010; Winkler et al, 2014), which are multifactorial diseases with where environmental pollutants (e.g. neurotoxic metals, metal-nanoparticles, and pesticides) are implicated as known risk factors (Chin-Chan et al, 2015; Kriit et al, 2021). Therefore, it is important to assess whether nano and microplastic particles can interfere pericytes, hindering their neuroprotective functions, particularly through the carrier molecule capacity of nanoparticles.…”

Real-Time Low-Cost Personal Monitoring for Exposure to PM2.5 among Asthmatic Children: Opportunities and Challenges

“…Exposure to particulate matter (PM) has been identified as having an adverse impact on human health [1]. It is associated not only with respiratory diseases but also other diseases such as heart disease, type 2 diabetes and dementia [2][3][4]. Most of these studies emphasize the cumulative effects of PM exposure over an extended period time, which emphasizes the importance of personalized continuous monitoring and the need for control of indoor and outdoor PM levels in surrounding atmosphere of individuals who experience relevant symptoms [5].…”