Association between solid cooking fuel use and dementia in older Chinese adults: the mediating effect of depression

ABSTRACT

This study aimed to explore the association between household solid cooking fuel use and dementia prevalence and the mediating effect of depression on this association. A total of 3404 (2018) and 1379 (2015 to 2018) older participants (≥65) from the China Health and Retirement Longitudinal Study (CHARLS) were enrolled in the cross-sectional and retrospective longitudinal analyses, respectively. The results showed that solid cooking fuel use was associated with an increased dementia prevalence (adjusted OR = 1.44) from 2015 to 2018. The indirect effect of depression on this association explained 7.14% and 13.11% variances in the cross-sectional and longitudinal mediating model, respectively. Thus, household solid cooking fuel use is a risk factor for the development of dementia, and depressive symptoms partially accounted for this association. The use of improved cookstoves and clean fuel in households and air cleaners and early intervention in depression may reduce the incidence of dementia.

KEYWORDS:

• Dementia
• solid fuel use
• indoor air pollution
• depression
• mediating effect

Acknowledgments

The authors thank the China Center for Economic Research, National School of Development at Peking University for providing the CHARLS data. The data collection of the CHARLS was supported by the National Institute on Aging (grants 1R21AG031372, 1R01AG037031, R03TW008358, R03AG049144, and R01AG053228), the Word Bank (contracts 7145915 and 71459234), the National Natural Science Foundation of China (grant number 70773002, 70910107022, 71130002, and 71450001), and Peking University. We are grateful to all of the individuals who agreed to participate in the CHARLS study

Disclosure statement

The authors declare no actual or potential conflicts of interest, including any financial, personal, or other relationships with other people or organizations.

Statement of ethics

This study used the free data from the China Health and Retirement Longitudinal Study (CHARLS). The CHARLS was conducted following The Code of Ethics of the World Medical Association (World Medical Association Declaration of Helsinki) for experiments involving humans. Ethical approval was granted from the Biomedical Ethics Review Committee of Peking University (approval id. IRB00001052–11015), and all participants provided informed consent.

Data statement

The raw data used in this study are freely available from the China Health and Retirement Longitudinal Study (CHARLS; https://charls.charlsdata.com/pages/data/111/zh-cn.html), a nationally representative longitudinal survey of the population in China organized by Peking University National School of Development.

Additional information

Funding

This work was supported by the General project of National Social Science Foundation of China (21BGL229) and the National Key R&D Program of China (2020YFC2008803). The funding agencies have no role in the design, analysis, interpretation, or writing of this study.