Short-term associations between warm-season ambient temperature and emergency department visits for Alzheimer's disease and related dementia in five US states

Zhang, Yuzi; Ebelt, Stefanie; Shi, Liuhua; Scovronick, Noah; D’Souza, Rohan; Steenland, Kyle; Chang, Howard H.

doi:10.1016/j.envres.2022.115176

Cited by 9 publications

(7 citation statements)

References 57 publications

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“…Previous studies have reported associations between ambient high temperatures and dementia-related outcomes . Concurrently, high nighttime temperature has been identified as a significant and independent health risk factor, particularly for older adults .…”

Section: Discussionmentioning

confidence: 99%

“…Previous studies have reported associations between ambient high temperatures and dementia-related outcomes. 10 , 11 , 12 , 13 , 14 Concurrently, high nighttime temperature has been identified as a significant and independent health risk factor, particularly for older adults. 22 , 23 , 24 , 25 However, our study distinguishes itself as the first, to our knowledge, to systematically differentiate the associations of nighttime and daytime heat with dementia-related deaths.…”

Section: Discussionmentioning

confidence: 99%

“…The association between ambient temperature and dementia-related outcomes has garnered research attention. Prior studies have suggested that extreme high temperatures may be associated with elevated risk of cognitive decline and dementia-related morbidity and mortality . Various potential mechanisms have been proposed, including oxidative stress, excitotoxic effects, neuroinflammation, apoptosis, and alterations in blood flow and brain metabolism .…”

Section: Introductionmentioning

confidence: 99%

“…Prior studies have suggested that extreme high temperatures may be associated with elevated risk of cognitive decline and dementia-related morbidity and mortality. 10 , 11 , 12 , 13 , 14 Various potential mechanisms have been proposed, including oxidative stress, excitotoxic effects, neuroinflammation, apoptosis, and alterations in blood flow and brain metabolism. 15 , 16 , 17 , 18 However, existing findings are heterogenous and subject to some limitations.…”

Section: Introductionmentioning

confidence: 99%

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Heat Exposure and Dementia-Related Mortality in China

Gao,

Lin,

Yin

et al. 2024

JAMA Netw Open

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ImportanceAlthough existing research has found daily heat to be associated with dementia-related outcomes, there is still a gap in understanding the differing associations of nighttime and daytime heat with dementia-related deaths.ObjectivesTo quantitatively assess the risk and burden of dementia-related deaths associated with short-term nighttime and daytime heat exposure and identify potential effect modifications.Design, Setting, and ParticipantsThis case-crossover study analyzed individual death records for dementia across all mainland China counties from January 1, 2013, to December 31, 2019, using a time-stratified case-crossover approach. Statistical analysis was conducted from January 1, 2013, to December 31, 2019.ExposuresTwo novel heat metrics: hot night excess (HNE) and hot day excess (HDE), representing nighttime and daytime heat intensity, respectively.Main Outcomes and MeasuresMain outcomes were the relative risk and burden of dementia-related deaths associated with HNE and HDE under different definitions. Analysis was conducted with conditional logistic regression integrated with the distributed lag nonlinear model.ResultsThe study involved 132 573 dementia-related deaths (mean [SD] age, 82.5 [22.5] years; 73 086 women [55.1%]). For a 95% threshold, the median hot night threshold was 24.5 °C (IQR, 20.1 °C-26.2 °C) with an HNE of 3.7 °C (IQR, 3.1 °C-4.3 °C), and the median hot day threshold was 33.3 °C (IQR, 29.9 °C-34.7 °C) with an HDE of 0.6 °C (IQR, 0.5 °C-0.8 °C). Both nighttime and daytime heat were associated with increased risk of dementia-related deaths. Hot nights’ associations with risk of dementia-related deaths persisted for 6 days, while hot days’ associations with risk of dementia-related deaths extended over 10 days. Extreme HDE had a higher relative risk of dementia-related deaths, with a greater burden associated with extreme HNE at more stringent thresholds. At a 97.5% threshold, the odds ratio for dementia-related deaths was 1.38 (95% CI, 1.22-1.55) for extreme HNE and 1.46 (95% CI, 1.27-1.68) for extreme HDE, with an attributable fraction of 1.45% (95% empirical confidence interval [95% eCI], 1.43%-1.47%) for extreme HNE and 1.10% (95% eCI, 1.08%-1.11%) for extreme HDE. Subgroup analyses suggested heightened susceptibility among females, individuals older than 75 years of age, and those with lower educational levels. Regional disparities were observed, with individuals in the south exhibiting greater sensitivity to nighttime heat and those in the north to daytime heat.Conclusions and RelevanceResults of this nationwide case-crossover study suggest that both nighttime and daytime heat are associated with increased risk of dementia-related deaths, with a greater burden associated with nighttime heat. These findings underscore the necessity of time-specific interventions to mitigate extreme heat risk.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Heat Exposure and Dementia-Related Mortality in China

Gao,

Lin,

Yin

et al. 2024

JAMA Netw Open

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“…Climate change is already approaching the 1.5 °C threshold, and even with substantial reductions in the emissions of greenhouse gases, the magnitude of climate change cannot be contained below the threshold of 2 °C, resulting in a global temperature rise of 2 °C by 2050 2 , 3 . Non-optimal temperature exposure constitutes a growing threat to public health and outcomes, and affects multiple health outcomes directly or indirectly through different physiological mechanisms simultaneously 4 , 5 , ranging from increased risk of gestational hypertension or preterm birth 6 , 7 , ascended mortality from respiratory and circulatory disease and stroke 8 – 11 , significantly reduced the health level of workforce 12 , 13 , enhanced visits of the emergency department 14 , and the negative effects on cognitive function in older adults 15 , 16 .…”

Section: Introductionmentioning

confidence: 99%

Ambient temperatures associated with reduced cognitive function in older adults in China

Hou,

2023

Sci Rep

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The cognitive function status of older adults determines the social function and living quality of older adults, which is related to the healthy development and stability of the society. However, the impact of high or low ambient temperature on cognitive function in older adults remains unclear. Based on data from the Chinese Longitudinal Healthy Longevity Survey (CLHLS), we comprehensively assessed the impact of ambient temperature on the cognitive function of older adults in this study. The findings exhibited that for each 1 °C ascent in monthly temperature of high temperature, the examination score of global cognitive function of older adults decreased by 0.48 (95% CI 0.21–0.74), which was greater than that of 0.14 (95% CI 0.06–0.25) for each 1 °C reduction in low temperature. Overall, the detrimental effect of high temperature on cognitive function in older adults was more significant than that of low temperature, including on the five sub-cognitive functions involved. Our research provides vital technical guidance and reference for the health protection and prevention of cognitive function of older adults in specific external environmental conditions under the current climatic variation and temperature rise.

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