UCL Discovery
UCL home » Library Services » Electronic resources » UCL Discovery

The effect of China's Clean Air Act on cognitive function in older adults: a population-based, quasi-experimental study

Yao, Y; Lv, X; Qiu, C; Li, J; Wu, X; Zhang, H; Yue, D; ... Zeng, Y; + view all (2022) The effect of China's Clean Air Act on cognitive function in older adults: a population-based, quasi-experimental study. The Lancet Healthy Longevity , 3 (2) e98-e108. 10.1016/S2666-7568(22)00004-6. Green open access

[thumbnail of china clean air act 2022.pdf]
Preview
Text
china clean air act 2022.pdf - Published Version

Download (1MB) | Preview

Abstract

Background: Air pollution might accelerate cognitive ageing; it is unclear whether large-scale interventions, such as China's Clean Air Act (CCAA), can mitigate cognitive deterioration. We aimed to evaluate the effect of CCAA on changes in cognitive function in older adults. / Methods: In this population-based, quasi-experimental study, we did a difference-in-differences analysis of the data collected during the 2014 and 2018 waves of the Chinese Longitudinal Healthy Longevity Survey (CLHLS). The study design used a counterfactual analysis feature by dividing CLHLS participants into two groups. The intervention group included participants who lived in areas where the provincial government set a target of reducing particulate matter (PM) by at least 5% annually from 2014 onward, whereas the control group consisted of individuals who lived in areas without a PM reduction target. Global cognitive function was measured using the Mini-Mental State Examination (MMSE). We used fixed-effects models to examine the between-group differences in MMSE score changes before and after CCAA implementation. We associated longitudinal changes in MMSE scores with changes in concentrations of PM with a diameter of less than 2·5 μm (PM2·5) concentration and other regulated pollutants. We used alternative models and sensitivity analyses to evaluate the robustness of the results from the main models. / Findings: 2812 individuals participated in the 2014 and 2018 surveys (mean age 81·0 years [SD 9·3] in 2014; 1408 [50·1%] female and 1404 [49·9%] male). 2251 (80·0%) were included in the intervention group and 561 (20·0%) in the control group. After controlling for potential confounders, the intervention group had a significantly smaller decline in MMSE scores from 2014 to 2018 compared with the control group: the mean between-group difference was 2·45 points (95% CI 1·32–3·57). Interquartile increases in PM2·5 were associated with a significant MMSE score decline of 0·83 points (95% CI 0·24–1·42); similarly, increases in SO2 were also associated with a significant MMSE score decline of 0·80 points (0·32–1·29). / Interpretation: Implementing stringent clean air policies might mitigate the risk of air pollutant-associated cognitive ageing in older people. / Funding: National Natural Sciences Foundation of China, National Key R&D Program of China, China Postdoctoral Science Foundation funded project, the Duke/Duke-National University of Singapore Collaboration Pilot Project, the National Institute on Aging and Peking University-Baidu Fund, Energy Foundation, and the Fundamental Research Funds for the Central Universities.

Type: Article
Title: The effect of China's Clean Air Act on cognitive function in older adults: a population-based, quasi-experimental study
Open access status: An open access version is available from UCL Discovery
DOI: 10.1016/S2666-7568(22)00004-6
Publisher version: https://doi.org/10.1016/S2666-7568(22)00004-6
Language: English
Additional information: This is an Open Access article published under a Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0) Licence (https://creativecommons.org/licenses/by-nc-nd/4.0/).
UCL classification: UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Division of Psychiatry
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL
URI: https://discovery.ucl.ac.uk/id/eprint/10143558
Downloads since deposit
12Downloads
Download activity - last month
Download activity - last 12 months
Downloads by country - last 12 months

Archive Staff Only

View Item View Item