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@ARTICLE{Aretz:274051,
      author       = {Aretz, Benjamin and Doblhammer, Gabriele and Heneka,
                      Michael},
      title        = {{T}he role of leukocytes in cognitive impairment due to
                      long-term exposure to fine particulate matter: {A} large
                      population-based mediation analysis.},
      journal      = {Alzheimer's and dementia},
      volume       = {20},
      number       = {12},
      issn         = {1552-5260},
      address      = {Hoboken, NJ},
      publisher    = {Wiley},
      reportid     = {DZNE-2025-00032},
      pages        = {8715 - 8727},
      year         = {2024},
      abstract     = {Our understanding of how fine particulate matter (PM2.5)
                      impacts cognitive functioning is limited. Systemic
                      inflammation processes may play a role in mediating this
                      effect.This prospective cohort study used data from 66,254
                      participants aged 18+ between 2006 and 2015 from the Dutch
                      Lifelines Cohort Study and Biobank. Causal mediation
                      analysis was conducted to examine the impact of ambient
                      PM2.5 exposure on cognitive processing time (CPT), using the
                      change in white blood cell (WBC) count and its subtypes as
                      potential mediators.Heightened PM2.5 exposure was associated
                      with slower CPT (total effect = 81.76 × 10-3, $95\%$
                      confidence interval [CI] 59.51 × 10-3-105.31 × 10-3). The
                      effect was partially mediated via increased WBC count
                      (indirect effect [IE] = 0.42 × 10-3, $95\%$ CI 0.07 ×
                      10-3-0.90 × 10-3), particularly driven by an increase in
                      monocytes (IE = 0.73 × 10-3, $95\%$ CI 0.24 × 10-3-1.31 ×
                      10-3).Systemic inflammation processes may partially explain
                      the harmful effects of PM2.5 on cognitive functioning, why
                      lower levels of systemic inflammation may help contain its
                      neurotoxic effects.The pathways leading to the neurotoxic
                      effects of fine particulate matter (PM2.5) are poorly
                      understood. We analyzed data from over 66,000 participants
                      using causal pathway analysis. Increased white blood cell
                      (WBC) count mediates the effect of PM2.5 on cognitive
                      functioning. Monocyte count played a crucial role in this
                      low-pollution setting. Systemic inflammation may contribute
                      to the neurotoxic effects of PM2.5.},
      keywords     = {Humans / Particulate Matter: adverse effects / Male /
                      Female / Cognitive Dysfunction / Prospective Studies /
                      Middle Aged / Mediation Analysis / Leukocytes: drug effects
                      / Environmental Exposure: adverse effects / Netherlands:
                      epidemiology / Adult / Aged / Inflammation / Leukocyte Count
                      / Air Pollution: adverse effects / Air Pollution: statistics
                      $\&$ numerical data / Cohort Studies / Air Pollutants:
                      adverse effects / causal mediation analysis (Other) /
                      cognitive functioning (Other) / fine particulate matter
                      (Other) / leukocytes (Other) / systemic inflammation (Other)
                      / white blood cell count (Other) / Particulate Matter (NLM
                      Chemicals) / Air Pollutants (NLM Chemicals)},
      cin          = {AG Doblhammer},
      ddc          = {610},
      cid          = {I:(DE-2719)1012002},
      pnm          = {354 - Disease Prevention and Healthy Aging (POF4-354)},
      pid          = {G:(DE-HGF)POF4-354},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:39412000},
      pmc          = {pmc:PMC11667545},
      doi          = {10.1002/alz.14320},
      url          = {https://pub.dzne.de/record/274051},
}