Xin Lu ¹ YaNan Zhou ² Qingshan Miao ² Xuexue Han ² Yi Zhou ² Gaofeng Zhao ² Hao Yu ¹ Min Chen ^1*

• ¹ School of Mental Health, Jining Medical University, Jining, Shandong, China
• ² Shandong Daizhuang Hospital, Jining, Shandong Province, China

Background: Polycyclic aromatic hydrocarbons (PAHs), as organic pollutants widely present in daily environments, have been shown by existing epidemiological studies to be significantly associated with deficits in learning and memory functions in children and adults. However, the association between exposure to PAHs and cognitive function in older adults remains unclear. Additionally, existing related studies have only assessed the association between individual PAH exposures and cognitive assessments, overlooking the risks posed by mixed exposures. This study aims to use three statistical models to investigate the individual and overall effects of mixed PAH exposures on the cognition of older adults in the United States. Methods: The study cohort was obtained from the NHANES database, which included individuals aged 60 and older from 2011 to 2014. Weighted generalized linear models (GLM), weighted quantile sum (WQS) models, and Bayesian kernel machine regression (BKMR) models were utilized to evaluate the connections between urinary PAH metabolites and the standardized Z-scores of four cognitive tests: Immediate Recall Test (IRT), Delayed Recall Test (DRT), Animal Fluency Test (AFT), and Digit Symbol Substitution Test (DSST). Results: Our analysis involved 899 individuals aged 60 and above. In the fully adjusted GLM, 2-hydroxynaphthalene (2-OHNa), 3-hydroxyfluorene (3-OHFlu), and 2-hydroxyfluorene (2-OHFlu) demonstrated negative associations with DSST Z-scores. In the WQS model, six urinary PAH metabolites were negatively linked to AFT Z-scores (β (95% confidence intervals [CI]): -0.120 (-0.208, -0.033), P = 0.007) and DSST Z-scores (β (95% CI): -0.182 (-0.262, -0.103), P < 0.001). In both assessments, 2-OHNa exerted the greatest influence among the urinary PAH metabolites. In the BKMR model, there was an overall negative correlation between urinary PAH metabolites and AFT and DSST Z-scores when the concentration was within the 25th to 75th percentile, where 2-OHNa dominated the main effect of the mixture. The WQS and BKMR models were adjusted for all covariates. Conclusion: Increased concentrations of urinary PAH metabolites are associated with cognitive decline in older adults, mainly on language ability, executive function, sustained attention, working memory, and information processing speed, with 2-OHNa playing a major effect.