Researchers have suggested that reducing air pollution could reduce the number of people with vascular dementia seeking community mental health services.
A team from King’s College London studied the use of community mental health services over a nine-year period by 5,024 people aged 65 and over.
All of the patients lived in four south London boroughs – Croydon, Lambeth, Lewisham or Southwark – after their initial dementia diagnosis between 2008 and 2012.
More than half of those involved had Alzheimer’s disease (54%), 20% had vascular dementia, and 26.5% had unspecified dementia.
Vascular dementia results from problems with the blood supply to the brain and can be caused by high blood pressure, stroke or heart problems.
The study, published in the medical journal BMJ Mental Health, measured cognitive function and health and social functioning at three time points – up to 12 months after diagnosis, up to five years after diagnosis and up to nine years after diagnosis.
They then examined the quarterly published estimates for two major air pollutants — nitrogen dioxide (NO2) and particulate matter — covering the areas around patients’ homes over the same period.
Reducing exposure to pollutants could reduce the use of mental health services by people with dementia, thereby freeing up resources in mental health services that are already severely overstretched
In the first year, higher exposure to both air pollutants was associated with increased use of community mental health services by people with dementia.
The researchers said, “Based on the evidence presented, we believe that air pollution could be considered an important population-level target to reduce the use of mental health services among people with dementia, particularly those with vascular dementia.”
Those in areas with higher NO2 levels were 27% more likely to use community mental health services than those living in areas with the lowest NO2 levels, while those exposed to the highest levels of particulate matter were 33% more likely to use them .
The researchers said that while air pollution was not associated with cognitive function on the scale they used, exposure to NO2 was associated with poorer health and social functioning scores, including the ability to perform routine and daily living.
They added that because the study was an observational study, “no firm conclusions about cause and effect can be drawn.”
However, they suggested that if annual exposure to inhalable particulate matter in London was reduced, as recommended by the World Health Organization (WHO), the number of contacts patients with dementia have with community mental health services could fall by 13%.
“These estimates are also likely to apply to other major cities in high-income countries with heavy diesel traffic,” researchers said.
The team added: “Reducing air pollution, and NO2 in particular, through public health measures such as expanding ultra-low emission zones could potentially improve functioning and disease progression in people with dementia.”
“Reducing exposure to pollutants could reduce the use of mental health services by people with dementia, thereby freeing up resources in the already severely overstretched mental health services.”
dr Susan Mitchell, head of policy at charity Alzheimer’s Research UK, said the government was “hesitating” in implementing stricter air quality standards and changes could be “a decade too late”.
She added: “If this Government is serious about improving lifelong health and reducing the burden on our NHS, it cannot continue to turn a blind eye to air pollution.”
“Poor air quality is a significant public health concern and this new research shows it is negatively impacting the already overstretched health services and lives of people with dementia.
“Alongside urgent action to lower levels, there is also an urgent need to find out more about exactly how air pollution affects the risk of dementia. These insights will allow government and policymakers to design actions that can reduce the impact of air pollution on people at risk of developing dementia and those living with the disease.”
https://www.standard.co.uk/news/health/government-southwark-lewisham-lambeth-croydon-b1099227.html Tackling air pollution ‘could ease pressure on mental health services’