Green space, air and light pollution and climate change and risk of dementia: a study in Modena, Northern Italy

The role of environmental factors, such as air pollution, climate factors, as well as new built environment-related determinants, has been linked to several adverse effects on human health, including a higher risk of neurodegenerative diseases. In particular, recent evidence suggests that environmental factors may play a major role in cognitive decline, thus being involved in the etiology of dementia. In this project, we aim at evaluating the effects of exposure to environmental and climate factors, namely outdoor air pollution, greenness, and artificial light at night (ALAN) on the conversion from mild cognitive impairment (MCI) to dementia. We will take advantage of a population-based cohort study of approximately 150 subjects newly-diagnosed with MCI recruited at the Neurology Cognitive Center at Modena Hospital in the period 2019-2022 with ongoing follow-up for dementia conversion up to the end of 2024 at the same center from a neurologist expert in cognitive disorders. All participants completed a detailed demographic and lifestyle questionnaire also collecting residential history, tailored to assess potential risk factors and confounders for neurogenerative diseases in collaboration between neurologists and public health professionals. With the use of a geographical information system (GIS) each participant's residence will be geocoded and exposure to outdoor air pollution, greenness, and ALAN will be assessed by environmental engineers using advanced modeling methodologies and satellite-based datasets. Data analysis will be performed by public health professionals using Cox proportional hazard models adjusted for potential confounders and using also nonlinear modeling through restricted cubic splines. Analysis will be performed taking into account both individual and combined exposure to the investigated factors in order to evaluate also dose-response relations. The project results will be extensively disseminated in both scientific community through publication in international scientific journals (in open access format) and conferences as well as at national and local level during patients and public involvement-PPI activities, e.g. meetings of associations of caregivers (e.g. Alzheimer’s Day).