A retrospective cohort of 39.7 million fee-for-service Medicare beneficiaries was followed from 2005 to 2019 for incident Alzheimer's disease and all-cause dementia. Annual high-resolution estimates of smoke and non-smoke PM2.5 were assigned and fitted in stratified Cox models. Per microgram per cubic metre, smoke PM2.5 was associated with incident Alzheimer's disease (HR 1.015) and with all dementia (1.029). The association was stronger for the smoke carbonaceous fraction, at 1.090 for all dementia. The authors attribute 11,142 dementia cases a year to smoke PM2.5, although exposure was modelled rather than measured.
Why it is interesting: The study separates wildfire smoke from background PM2.5 and resolves the dementia association to its carbonaceous fraction. Smoke carried the higher hazard per unit mass but the lower per interquartile range, which bears on wildfire-smoke health-impact assessments.
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