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Killin LO, Starr JM, Shiue IJ, et al. Environmental risk factors for dementia: a systematic review. BMC Geriatr. 2016;16(1):175doi: 10.1186/s12877-016-0342-y.
Killin, L. O., Starr, J. M., Shiue, I. J., & Russ, T. C. (2016). Environmental risk factors for dementia: a systematic review. BMC geriatrics, 16(1), 175. https://doi.org/10.1186/s12877-016-0342-y
Killin, Lewis O J, et al. "Environmental risk factors for dementia: a systematic review." BMC geriatrics vol. 16,1 (2016): 175. doi: https://doi.org/10.1186/s12877-016-0342-y
Killin LO, Starr JM, Shiue IJ, Russ TC. Environmental risk factors for dementia: a systematic review. BMC Geriatr. 2016 Oct 12;16(1):175. doi: 10.1186/s12877-016-0342-y. PMID: 27729011; PMCID: PMC5059894.
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BMC Geriatr. 2016 Oct 12;16(1):175. doi: 10.1186/s12877-016-0342-y.

Environmental risk factors for dementia: a systematic review.

BMC geriatrics

Lewis O J Killin, John M Starr, Ivy J Shiue, Tom C Russ

Affiliations

  1. Alzheimer Scotland Dementia Research Centre, University of Edinburgh, Edinburgh, UK.
  2. Centre for Cognitive Ageing & Cognitive Epidemiology, University of Edinburgh, Edinburgh, UK.
  3. Scottish Dementia Clinical Research Network, NHS Scotland, Perth, UK.
  4. Faculty of Health and Life Sciences, Northumbria University, Newcastle-upon-Tyne, UK.
  5. Alzheimer Scotland Dementia Research Centre, University of Edinburgh, Edinburgh, UK. [email protected].
  6. Centre for Cognitive Ageing & Cognitive Epidemiology, University of Edinburgh, Edinburgh, UK. [email protected].
  7. Centre for Dementia Prevention, University of Edinburgh, Edinburgh, UK. [email protected].
  8. Division of Psychiatry, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK. [email protected].

PMID: 27729011 PMCID: PMC5059894 DOI: 10.1186/s12877-016-0342-y

Abstract

BACKGROUND: Dementia risk reduction is a major and growing public health priority. While certain modifiable risk factors for dementia have been identified, there remains a substantial proportion of unexplained risk. There is evidence that environmental risk factors may explain some of this risk. Thus, we present the first comprehensive systematic review of environmental risk factors for dementia.

METHODS: We searched the PubMed and Web of Science databases from their inception to January 2016, bibliographies of review articles, and articles related to publically available environmental data. Articles were included if they examined the association between an environmental risk factor and dementia. Studies with another outcome (for example, cognition), a physiological measure of the exposure, case studies, animal studies, and studies of nutrition were excluded. Data were extracted from individual studies which were, in turn, appraised for methodological quality. The strength and consistency of the overall evidence for each risk factor identified was assessed.

RESULTS: We screened 4784 studies and included 60 in the review. Risk factors were considered in six categories: air quality, toxic heavy metals, other metals, other trace elements, occupational-related exposures, and miscellaneous environmental factors. Few studies took a life course approach. There is at least moderate evidence implicating the following risk factors: air pollution; aluminium; silicon; selenium; pesticides; vitamin D deficiency; and electric and magnetic fields.

CONCLUSIONS: Studies varied widely in size and quality and therefore we must be circumspect in our conclusions. Nevertheless, this extensive review suggests that future research could focus on a short list of environmental risk factors for dementia. Furthermore, further robust, longitudinal studies with repeated measures of environmental exposures are required to confirm these associations.

Keywords: Alzheimer’s disease; Dementia; Environment; Epidemiology; Risk factors

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