“I have no hesitation whatsoever to say that air pollution causes dementia.” (From 2019)
Following our early report on the link between air pollution and dementia, three economists at Arizona State University—Kelly Bishop, Nicolai Kuminoff, and Jonathan Ketcham—decided to pursue a large-scale investigation of the issue. “We found thearticle compelling,” Ketcham says. “It was informative about the plausible pathways and the need for more rigorous studies that could test causality.”
Ultimately, Bishop, Kuminoff, and Ketcham decided to link EPA air quality data to 15 years of Medicare records for 6.9 million Americans over the age of 65. Rather than simply ask if Americans exposed to more air pollution developed dementia at higher rates, the team identified a quasi-natural experiment that arbitrarily separated Americans into higher and lower air pollution exposure groups.
This quirk of different standards across the country allowed the researchers to ask if a manipulated decrease in air pollution exposure actually led to fewer cases of dementia, from Alzheimer’s or other dementing diseases, like strokes. This overcame a significant limitation of the other existing studies, which could only compare differences in exposure and disease arising “naturally” among people who lived in different places rather than by a planned intervention.
All told, Ketcham says, enforcing the EPA’s stricter air quality standard likely resulted in 140,000 fewer people living with dementia by 2014. He places the economic value of that avoided disease burden at around $163 billion. Researchers now better understand what happens in the brain when you breathe polluted air—and how that can lead to neurodegeneration years later. When you inhale pollutants, the smallest particles, emitted by cars, power plants, and other places where fuel is burned, lodge in your lungs’ sensitive tissue or pass into your bloodstream. In those places they trigger an immune response that seeks to trap, contain, and remove the invading particles.
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