Associations between air pollution and mental health service use in dementia: a retrospective cohort study.
BMJ Ment Health
; 26(1)2023 Jul.
Article
em En
| MEDLINE
| ID: mdl-37550086
ABSTRACT
BACKGROUND:
Little is known about the role of air pollution in how people with dementia use mental health services.OBJECTIVE:
We examined longitudinal associations between air pollution exposure and mental health service use in people with dementia.METHODS:
In 5024 people aged 65 years or older with dementia in South London, high resolution estimates of nitrogen dioxide (NO2) and particulate matter (PM2.5 and PM10) levels in ambient air were linked to residential addresses. Associations between air pollution and Community Mental Health Team (CMHT) events (recorded over 9 years) were examined using negative binomial regression models. Cognitive function was measured using the Mini Mental State Examination (MMSE) and health and social functioning was measured using the Health of the Nation Outcomes Scale (HoNOS65+). Associations between air pollution and both MMSE and HoNOS65+ scores were assessed using linear regression models.FINDINGS:
In the first year of follow-up, increased exposure to all air pollutants was associated with an increase in the use of CMHTs in a dose-response manner. These associations were strongest when we compared the highest air pollution quartile (quartile 4 Q4) with the lowest quartile (Q1) (eg, NO2 adjusted incidence rate ratio (aIRR) 1.27, 95% CI 1.11 to 1.45, p<0.001). Dose-response patterns between PM2.5 and CMHT events remained at 5 and 9 years. Associations were strongest for patients with vascular dementia. NO2 levels were linked with poor functional status, but not cognitive function.CONCLUSIONS:
Residential air pollution exposure is associated with increased CMHT usage among people with dementia. CLINICAL IMPLICATIONS Efforts to reduce pollutant exposures in urban settings might reduce the use of mental health services in people with dementia, freeing up resources in already considerably stretched psychiatric services.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Demência Vascular
/
Poluentes Atmosféricos
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Poluição do Ar
/
Serviços de Saúde Mental
Tipo de estudo:
Etiology_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Humans
Idioma:
En
Revista:
BMJ Ment Health
Ano de publicação:
2023
Tipo de documento:
Article
País de afiliação:
Reino Unido