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Association between mixed exposure to multiple metal elements and cognitive decline in older adults: The moderating
Weixuan Yang1, Yadi Yang1, Wenjing Cao1
1Department of Hygiene Inspection and Quarantine, School of Public Health, Anhui Medical University, Hefei, Anhui 230032, China.
Background:
Cognitive decline among older adults has become an increasingly serious public health issue. Metal exposure may contribute to neurodegenerative processes; however, the combined effects of multiple metals and the potential moderating role of sleep quality on cognitive function remain unclear.
Objective:
To examine the associations between combined exposure to six metal elements-molybdenum (Mo), vanadium (V), nickel (Ni), strontium (Sr), arsenic (As), and cadmium (Cd)-in whole blood and cognitive function among community-dwelling older adults, and to assess whether these associations are modified by sleep quality.
Methods:
A total of 1273 older adults participated in the study. The concentrations of metal elements in whole blood were determined using Inductively coupled plasma mass spectrometer (ICP-MS). Cognitive performance was evaluated with the Mini-Mental State Examination (MMSE), while sleep quality was measured using the Pittsburgh Sleep Quality Index (PSQI). Associations between individual metals and cognitive function were examined through multivariable linear regression. The combined impact of metal mixtures was analyzed using Bayesian kernel machine regression (BKMR) and weighted quantile sum (WQS) models. Additionally, interaction effects involving sleep quality were explored.
Results:
Elevated levels of Mo, V, Ni, Sr, and Cd were significantly associated with lower MMSE scores. Significant interactions were observed between V and sleep quality and between Sr and sleep quality, suggesting that poor sleep may exacerbate the neurotoxic effects of metal exposure.
Conclusion:
Exposure to various metal elements has been linked to reduced cognitive function in older adults, with the magnitude of this association varying by sleep quality. These results highlight the need to consider both environmental metal exposure and sleep health in efforts to prevent cognitive deterioration. To establish causal relationships and clarify underlying pathways, longitudinal research incorporating objective assessments of sleep is warranted.
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