Air pollutants

and
Alzheimer’s Disease

강민석 김준영 김현수

손동현 이유나
 INDEX
1. Introduction
2. Definition of AD
3. About the study
4. Study Analysis
5. Discussion
6. Interesting follow-up studies
7. Conclusion
Introduction
 Why Alzheimer’s disease?
In developed countries, Alzheimer’s Disease’s patients are gradully
increasing because of the aging( 고령화 )

　 2014 2015 2016 2017 2018 2019 2020 2021

Total number of patients (10,000people) 785 804 823 842 862 881 900 919
Number of patients on treatment (10,000people) 331 339 347 355 363 371 379 387
1)
Number of Global Alzheimer’s Disease patients development (2014-2021)

Total number of Alzheimer’s patients including mild cognitive impairment is

approximately 44 millions in 2014.
　 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024
Market size prediction (1million$) 3,111 2,655 2,623 2,683 2,830 2,903 3,791 5,819 8,873 12,612
2)
Global Market size prediction of Alzheimer’s Disease medicine (2015-2024)

Also, global market size of Alzheimer’s disease’s medicine is increasing.

In 2015, it is $3.11billions and it is expected to be $12.61billions in 2024.
1,2) KHIDI Brief Vol.239_ 한국보건산업진흥원 _ 이영찬
 ( 단위 : 만명 )
101

100
92
90

80 76

65
70
58

60

50

40

30

20

10

2
13 15 18
2 24
20 20 20
20 20
1)
[ 그림 1] 우리나라 65 세 이상 치매환자 수 추이 (2013-2024) 및 알츠하이머형 치매 현황

About 10% of elderly people (ages>=65) are estimated to be dementia patients

The social cost of dementia is \1.17billions in 2013 and is expected to be \4.32billions in 2050
1) KHIDI Brief Vol.239_ 한국보건산업진흥원 _ 이영찬
 Why Alzheimer’s Diesase? – Air pollution and AD

1)

1) 미세먼지와 인지기능 _ 노지현 , 정한용 , 이강준 _ 신경정신과협회

 Why Alzheimer’s Diesase? – Trend of policy
1)

1) 알츠하이머 진단 , 치료기술 _ 김주원 , 윤영소 _ 한국과학기술기획평가원

Definition
- Alzheimer’s disease is the most common reason for dementia

- In 1907, Alois Alzheimer reported first AD

- Symptoms: Cognitive impairment

- Most of the patients are elderly people

사진출처 : 네이버지식백과 _ 알츠하이머병 https://terms.naver.com/entry.nhn?docId=926690&cid=51007&categoryId=51007
사진출처 : 네이버지식백과 _ 알츠하이머병 https://terms.naver.com/entry.nhn?docId=926690&cid=51007&categoryId=51007
About the study
Methods : Case Control
658 subjects who screened as cognitively intact in 1996/97 (controls)
Methods : Case Control
use t-test, chi-square test,
univariate and multivariate
logistic regression models
n: 1215 subjects older than 65 ( Dwelling in Busan)
Ozone, Particulate Matter, and Newly Diagnosed Alzheimer’s
Disease: A Population-Based Cohort Study in Taiwan
-by Chau-Ren Jung, Yu-Ting Lin and Bing-Fang Hwang

Conducted a prospective cohort study

Cohorts: aged 65 or older in Jan 1, 2001

(n=97,627)

Observed period: Jan 1, 2001 ~Dec 31, 2010

Final study population: 95,690

Alzheimer occur: 1,399

Statistical methods : Cox proportional hazard model
-newly diagnosed AD was estimated as the hazard ratio (HR)

Exposure indicators:

1)Concentration of each air pollutant at baseline

-denoted by the concentration of each air pollutant in the year prior to
the baseline

2) Change in each air pollutant between the follow-up period and

baseline

Ps. To avoid collinearity problems, did not include two indicators in the
same time
Results: 1) Concentration of each air pollutant at baseline

More O3 and PM2.5 at baseline -> More AD occurs

Results: 2) Change in each air pollutant

Air pollution get worse -> Hazard Ratio increase!!

Association between air pollutants and dementia risk in the elderly
-by Yun-Chun, Wu Yuan-Chien, Lin Hwa-Lung Yub, Jen-Hau Chen,
Ta-Fu Chen, Yu Sun, Li-Li Wenf,, Ping-Keung Yip, Yi-Min Chu, Yen-Ching Chen

Conducted a case-control study

249 Alzheimer’s disease (AD) patients,

125 vascular dementia (VaD) patients,
497 controls in three hospitals in Taiwan

Exposures of 12-year PM10

and 14-year ozone were estimated

Observed period: 2007 ~ 2010

Statistical methods : Adjusted odds ratios(AORs)
by using Conditional logistic regression models

Conditions:

1) No conditions

2) APOE ε4 status- a protein involved in the metabolism of fats in the

body. It is implicated in Alzheimer's disease and cardiovascular disease.

3) Gender
Results: No condition

Air pollution level : T1<T2<T3

In unconditioned logistic regresstion, AOR increases only at level T3

PM10 seems to be more harmful than Ozon.
Results: Conditioning APOE ε4 status

Both groups seems to be effected by air pollutions only by PM10 at level T3

APOE ε4 carriers seems to be more effected by air pollutions!

But for VaD, there were no samples for APOE ε4 carriers at level T2,T3 for
PM10 and T3 for Ozone
Results: Conditioning with Gender

Both groups seems to be effected by air pollutions only by PM10 at level T3

For VaD, only men seems to be effected.

Men seems to be more effected by air pollution.

Discussion
연구가 이런 방식을 사용했는데 어떤 점이 아쉬웠다
이런 점은 좋았다
등의 장점과 단점 제시하고
이런 방식으로 연구가 이뤄졌으면 좋았을 것 같다 제시
Intersting
follow-up studies
1) 2)

Diet which helps preventing Alzheimer’s Disease

-Blueberry
-Kimchi

1) 운동과 블루베리 섭취가 알츠하이머 치매에 미치는 영향분석 _ 손원목 , 곽이섭 _ 한국스포츠학회지 _14:4,617-627

2) 김치의 산화적 스트레스 개선 및 신경세포 보호를 통한 알츠하이머 질환 예방 효과

Protective role of Kimchi from oxidative stress and amyloid β-induced Alzheimer's disease under cellular and in Vivo model_ 최지명 _ 부산대학교 대학원 _ 식품영양학과
Conclusion
결론 어쩌구저쩌구 ~~~
Thank you.