Washington DC [US], August 13 (ANI): According to a study published in the open-access journal BMJ Mental Health, exposure to relatively high levels of air pollution is linked to a rise in the use of community mental health services by dementia patients.

The researchers propose that lowering levels of nitrogen dioxide and particulate matter could lower demand in metropolitan areas and thus free up resources in overburdened psychiatric facilities.

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In the UK, there are currently an estimated 850,000 people living with dementia, and as the population ages, that figure is expected to rise to 2 million by 2050. According to experts, dementia is already the main cause of death in the UK.

According to them, a lot of research has been done on how air pollution affects older people, particularly how it might contribute to dementia and cognitive decline.

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The majority of these studies have concentrated on hospital services rather than community care, which is where the majority of individuals with the condition are handled in the UK, even though air pollution has been related to greater use of health services by persons with dementia.

The researchers examined the use of community mental health services over a nine-year period by 5024 senior citizens (65 and over) residing in four South London boroughs after receiving their initial dementia diagnosis between 2008 and 2012 in an effort to close this knowledge gap.

Over half (54 per cent, 2718) had been identified as having Alzheimer's disease, which is brought on by plaque and tangle formation in the brain. Twenty per cent, 1022, had been identified as having vascular dementia, which is brought on by damage to the brain's blood vessels.

For the years 2008 to 2012, quarterly reports on two significant air pollutants—nitrogen dioxide (NO2) and particulate matter (PM2.5 and PM10)—covering the vicinity of participants' houses were connected to their anonymized mental health information.

Patients with vascular dementia had the highest exposure to air pollutants, whereas Alzheimer's patients had the lowest.

Three-time points were designated for the monitoring period: up to 12 months, up to 5 years, and up to 9 years following diagnosis.

After taking into account any potential influencing factors, higher exposure to all air pollutants was linked, in the first year of monitoring, to an increase in the use of community mental health services by people with dementia.

The use of these services increases with exposure level, especially for NO2 exposure. This was particularly obvious in patients with vascular dementia.

The likelihood of using these services was 27% higher in areas with the highest levels of NO2 exposure compared to areas with the lowest levels of exposure.

Additionally, those who were most exposed to PM2.5 had a 33 per cent higher likelihood of using mental health services.

For those with Alzheimer's disease and vascular dementia, the relationships between PM2.5 and more frequent use of mental health services were still present 5 and 9 years later but were most obvious in those with vascular dementia.

The Mini-Mental State Examination (MMSE) and the Health of the Nation Outcomes Scale (HoNOS65+) were used to assess participants' physical and social functioning during the study period.

At all time points, exposure to NO2 was linked to higher HoNOS65+ scores, which indicate worsened social and cognitive functioning but not worsened health and ability to carry out everyday tasks. The results for particle matter were similar.

Over the course of the trial, there was no correlation between air pollution and MMSE findings, which measure brain function. However, exposure to NO2 was linked to greater HoNOS65+ scores across all time points, which indicates worsening health and social functioning, including the ability to carry out daily tasks. For PM2.5, similar results were discovered.

Since this study is an observational one, no definitive conclusions about cause and effect can be made. Additionally, the researchers recognise that they were unable to evaluate the effects of early life exposure to pollutants, variations in exposure over the course of nine years, or changes in exposure brought on by residential movement or extended absence from home.

However, based on their findings, they predict that the number of contacts between people with dementia and community mental health services could be cut by 13 per cent annually if the annual PM2.5 exposure in London (11.6 g/m3 in 2019) was reduced to 5 g/m3.

Similarly to this, lowering annual NO2 levels (39 g/m3 in 2019) to the advised limit of 10 g/m3 could cut annual interactions with mental health services by 38 per cent.

These calculations suggest that other large cities in high-income nations with significant diesel traffic may also be affected.

“Based on the evidence presented, we contend that air pollution could be considered an important population-level target to reduce mental health service use in people with dementia, particularly for those with vascular dementia,” they wrote.

They added, “The reduction in air pollution and particularly NO2  through public health interventions such as the expansion of ultra-low emission zones could potentially improve functioning and disease trajectories for people with dementia.

“Reducing pollutant exposure might reduce the use of mental health services in people with dementia, freeing up resources in already considerably stretched psychiatric services.” (ANI)

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