Use of open fires or closed solid fuel appliances for residential heating and cognitive decline in older adults

Use of solid fuel appliances is a major contributor to air pollution. Indoor solid fuel burning for cooking and heating in lower-middle income countries is associated with lower cognitive function and faster decline. Less is known, however, about the potential risk to brain health from burning solid fuels in open fires and closed appliances for heating purposes only, particularly in higher income countries. The current study aimed to investigate the association between burning solid fuels for home heating and cognitive decline in older Irish adults, also testing whether results differ by sex/gender.

The sample consisted of 4,537 participants aged 50 and older from The Irish Longitudinal Study on Ageing, a population-based cohort study. Participants were surveyed every two years between 2012 and 2018. Solid fuel use in 2012 (Wave 2) and cognitive function (word recall and verbal fluency) at waves 2, 3, 4 and 5 were analysed. Hierarchical linear mixed effects regression models were used to examine the association between solid fuel use and cognitive decline, controlling for multiple confounders.

There was a significant main effect of solid fuel use on cognitive function, such that individuals who reported using a solid fuel appliance or open fire as a main source of heating had lower cognitive scores than those who did not report such use at all waves, but there was no difference in the slope of the trajectory over time and no clear sex differences.

Older Irish adults who reported burning solid fuels (in an open fire or closed appliance) as a main way source of home heating had lower observed cognitive function across 6 years in TILDA but no evident faster decline than non-users. These findings further expand the evidence base on indoor air pollution and brain health.