Short-term associations between warm-season ambient temperature and emergency department visits for Alzheimer's disease and related dementia in five US states

Yuzi Zhang,Stefanie T Ebelt,Liuhua Shi,Noah C Scovronick,Rohan R D'Souza,Kyle Steenland,Howard H Chang

doi:10.1016/j.envres.2022.115176

Yuzi Zhang, Stefanie T Ebelt + Show 5 more

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https://doi.org/10.1016/j.envres.2022.115176

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Journal: Environmental Research	Publication Date: Dec 28, 2022
Citations: 5	License type: publisher-specific-oa

Affiliation: Emory University

Abstract

Ambient temperatures are projected to increase in the future due to climate change. Alzheimer's disease (AD) and Alzheimer's disease-related dementia (ADRD) affect millions of individuals and represent substantial health burdens in the US. High temperature may be a risk factor for AD/ADRD outcomes with several recent studies reporting associations between temperature and AD mortality. However, the link between heat and AD morbidity is poorly understood. We examined short-term associations between warm-season daily ambient temperature and AD/ADRD emergency department (ED) visits for individuals aged 45 years or above during the warm season (May to October) for up to 14 years (2005-2018) in five US states: California, Missouri, North Carolina, New Jersey, and New York. Daily ZIP code-level maximum, average and minimum temperature exposures were derived from 1km gridded Daymet products. Associations are assessed using a time-stratified case-crossover design using conditional logistic regression. We found consistent positive short-term effects of ambient temperature among 3.4 million AD/ADRD ED visits across five states. An increase of the 3-day cumulative temperature exposure of daily average temperature from the 50th to the 95th percentile was associated with a pooled odds ratio of 1.042 (95% CI: 1.034, 1.051) for AD/ADRD ED visits. We observed evidence of the association being stronger for patients 65-74 years of age and for ED visits that led to hospital admissions. Temperature associations were also stronger among AD/ADRD ED visits compared to ED visits for other reasons, particularly among patients aged 65-74 years. People with AD/ADRD may represent a vulnerable population affected by short-term exposure to high temperature. Our results support the development of targeted strategies to reduce heat-related AD/ADRD morbidity in the context of global warming.

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