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Raising the Driving Age to 18: Persuasive Essay

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Raising the Legal Driving Age Research Paper

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Introduction

In the summer of 2005, a driving accident took the life of sixteen year old Alicia when she was out with her sixteen year old boy friend. What was most shocking was that Alicia was wearing her seatbelt, but when her boy friend lost control of the car and the car rammed into a utility pole, the sixteen year old daughter of Dr. Arturo Betancourt was killed instantly (Stafford). One cannot help but feel that perhaps there is much more to driving regulations than the abiding of speed restrictions, seatbelt obligations and traffic signals. The driver was sixteen year old as was the passenger. In the very same regard, numerous arguments have been made in the debate of whether or not the minimum driving age for teenagers should be increased from sixteen to eighteen.

Common ground

A large number of teenagers agree with the fact that the number of increasing accidents involving teenagers is largely because of the submission to adolescent influences on the part of the teenagers (The Standard Times). In a survey performed by The Standard Times that shall be referred to later on in the paper as well, teenagers tend to consider the driving license as a sign of freedom and a key to a carefree world. They begin to see speed and risk as instruments from which they can derive thrill.

Destabilization

There have been speculations that the origin of the increasing number of teenage casualties has been because of the tendency that teenagers have to accelerate to precarious speeds without using the seat belts. By violating basic rules such as speed limits and driving instructions, teenagers put themselves in positions where their decisions become threats to their own lives.

Cost and Consequence

This motion has also been seconded by the Insurance Institute of Highway Safety in the United States which has shown a considerable amount of doubt regarding whether or not 16 remains an age suitable enough to allow teenagers to drive (Dawson College). This statement was given by the institute only after extensive research had been carried out on the subject. The minimum driving age has become the subject of debate in Canada in light of recent accident trends pertaining to young drivers in the region. It is estimated that road accidents take away five thousand (5000) teenagers from their parents every year.

Problem/ Thesis

In light of the facts stated above, the thesis statement of this paper is that the minimum driving age should most certainly be raised from sixteen to eighteen years of age in Canada since it is the only remaining option to decrease the increasing number of teenage road accident casualties.

Opposition claim

However, there is criticism that the solution of the problem does not lie in increasing the minimum driving age but in improving the standards of education of driving education. Teenagers are of the opinion that by increasing the minimum driving age from what it is now, the number of problems created will be more than the number of problems solved.

Reason for opposition claim

In a survey performed by The Standard Times, it was observed that teenagers are of the opinion that having attained their driver’s license they have become free of all obligations related to their transport issues (The Standard Times). They begin to consider and rely upon the option of over speeding to carry out strenuous daily schedules.

Transition based on contrast

However, this does not change the fact that road based driving accidents have now reached a point where they are regarded as the number one killer of teenagers. The graduating license system appears to be doing its job in the regulation of deciding who gets to drive and who does not, but it appears that the system requires assistance, in the form of an increase in the minimum age of the people who are allowed to take the test.

Thesis evaluation claim

Just as was discussed in the last report, this report also chose to draw the reader’s attention to violent, rash and irrational nature that youngsters choose to adopt when they are driving unsupervised (Kelly and Nielson). The report states that in times when youngsters are unsupervised, the chances that excessive speed will be complimented by drinking and a desire to drive without seat belts begins to dominate.

Reason for thesis evaluation claim

At this point, we can draw a significant inference that there is another deeper element that causes youngsters to drive precariously. This element is the fact that youngsters choose to regard the vehicle as an object that is meant to provide them a means of entertainment rather than one that is meant to provide them a means of transport. In this perspective, the subjects choose to concentrate more on their personal selves than on the environment in which their vehicle is moving. The strengthening of this perception through peer pressure and the like causes the focus to move from driving the vehicle to using it as an instrument. However, the fact that the changing of the perception does not change the rapidly moving environment around them causes a clash of actions to take place. This clash of actions is when the accident occurs and damage is suffered by more than one party in most cases.

Supporting evidence

However, this is not the only research study that has revealed complications in the current driving license regulation of the system. Another study by Mary Kelly and Norma Nielson has revealed that merely passing the testing procedures that have been put into place for giving licenses are not enough to evaluate precisely whether or not a person can be a responsible driver when on the road. The report evaluated the driving trends of aged drivers as well as young drivers (OECD/ECMT Transport Research Centre, OECD, European Conference of Ministers of Transport, Organisation for Economic Co-operation and Development, United Nations. Economic Commission for Europe). In relation with younger drivers, the analysts found that there was an element that could not be replaced with practice in the case of teenage drivers. This element was experience . The analysts found that if there was a similarity in the driving accidents in cases of teenage drivers, it was the lack of driving experience that the young drivers had. The report showed that experience allowed drivers to exercise a better understanding of the road signs and serves to allow the drivers to exercise more practical techniques when compared to novice drivers who choose to rely on tips and techniques that they have recently learned of or have only read about before.

The report highlights that novice drivers are able to manage physical and mental tests in controlled driving conditions during driving tests and practices but the complete change in surroundings that they come across when they have to drive on actual terrain puts them into a position to which they have not been exposed to before let alone hold any experience in (Brown, Larson and Saraswati). The report stresses on the point that in times like these, a task as simple as that of changing lanes can become one that can be seriously misjudged and may lead to an otherwise avoidable accident.

Logic behind support

Even though every province in Canada has adopted varying procedural systems to implement a sound system that ensures that only fully trained people are allowed to drive, we can infer from the accident toll that there appears to be a chink in the system that is being overseen by the process that is implemented in the training of drivers.

Needless to say, the move to increase the minimum driving age comes as a revision of a previous decision to allow teenagers to drive at the age of sixteen, but it appears from the casualty counts that the decision has been one that has been taken undue advantage of and the level of sophistication that was expected was not something that can be expected from the mind of a sixteen year old of the modern day world.

Recalling of thesis statement

This brings us back to the thesis statement of the paper about the concern for the fact that the minimum driving age in Canada should be increased if the thousands of lives being lost every year are to be saved.

Should the minimum driving age be increased, it will be a measure that will allow for the purpose of saving lives to be achieved.

The increase in the minimum driving age will allow for teenagers to be kept under adult supervision for the period of their ages that they are most vulnerable to the quips of adolescence and submission to peer pressure.

Negative implications

However, if the minimum driving age is increased and the measure is implemented, we must be wary of the fact that teenagers will not comply with the altered law almost instantly but will have to be taught to do so and that violations of the altered law can be expected for which traffic regulation enforcement agencies should be trained as well.

Prelude in light of consequences

Had the minimum driving age been already increased, countless lives would have been saved. Perhaps had Alicia’s boyfriend chosen to drive the car at a low speed, Alicia’s parents would have had the opportunity to be blessed with the sight of seeing their daughter graduate.

Warrant for conclusion

Therefore, we can conclude from the discussion in the paper that the claim to increase the minimum driving age is indeed well justified and is a measure that should be taken if thousands of lives are to be prevented from being lost every year.

Works Cited

Brown, Benson Bradford, Reed Larson and T. S. Saraswati. The world’s youth: adolescence in eight regions of the globe. Cambridge University Press, 2002.

Dawson College. “Is 16 too young to be driving?; Insurance Institute wants age raised.” The Gazette (2008): E. 5.

Kelly, Mary and Norma Nielson. “Why Age Matters.” CBCA Complete (2006).

OECD/ECMT Transport Research Centre, OECD, European Conference of Ministers of Transport, Organisation for Economic Co-operation and Development, United Nations. Economic Commission for Europe. Young drivers: the road to safety. OECD Publishing, 2006.

Stafford, Rob. The perils of teen driving. 2005. Web.

The Standard Times. Teens speak out on speeding. 1999. Web.

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Knowledge Base
How to Write a Thesis Statement | 4 Steps & Examples

How to Write a Thesis Statement | 4 Steps & Examples

Published on January 11, 2019 by Shona McCombes . Revised on August 15, 2023 by Eoghan Ryan.

A thesis statement is a sentence that sums up the central point of your paper or essay . It usually comes near the end of your introduction .

Your thesis will look a bit different depending on the type of essay you’re writing. But the thesis statement should always clearly state the main idea you want to get across. Everything else in your essay should relate back to this idea.

You can write your thesis statement by following four simple steps:

Start with a question
Write your initial answer
Develop your answer
Refine your thesis statement

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What is a thesis statement, placement of the thesis statement, step 1: start with a question, step 2: write your initial answer, step 3: develop your answer, step 4: refine your thesis statement, types of thesis statements, other interesting articles, frequently asked questions about thesis statements.

A thesis statement summarizes the central points of your essay. It is a signpost telling the reader what the essay will argue and why.

The best thesis statements are:

Concise: A good thesis statement is short and sweet—don’t use more words than necessary. State your point clearly and directly in one or two sentences.
Contentious: Your thesis shouldn’t be a simple statement of fact that everyone already knows. A good thesis statement is a claim that requires further evidence or analysis to back it up.
Coherent: Everything mentioned in your thesis statement must be supported and explained in the rest of your paper.

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The thesis statement generally appears at the end of your essay introduction or research paper introduction .

The spread of the internet has had a world-changing effect, not least on the world of education. The use of the internet in academic contexts and among young people more generally is hotly debated. For many who did not grow up with this technology, its effects seem alarming and potentially harmful. This concern, while understandable, is misguided. The negatives of internet use are outweighed by its many benefits for education: the internet facilitates easier access to information, exposure to different perspectives, and a flexible learning environment for both students and teachers.

You should come up with an initial thesis, sometimes called a working thesis , early in the writing process . As soon as you’ve decided on your essay topic , you need to work out what you want to say about it—a clear thesis will give your essay direction and structure.

You might already have a question in your assignment, but if not, try to come up with your own. What would you like to find out or decide about your topic?

For example, you might ask:

After some initial research, you can formulate a tentative answer to this question. At this stage it can be simple, and it should guide the research process and writing process .

Now you need to consider why this is your answer and how you will convince your reader to agree with you. As you read more about your topic and begin writing, your answer should get more detailed.

In your essay about the internet and education, the thesis states your position and sketches out the key arguments you’ll use to support it.

The negatives of internet use are outweighed by its many benefits for education because it facilitates easier access to information.

In your essay about braille, the thesis statement summarizes the key historical development that you’ll explain.

The invention of braille in the 19th century transformed the lives of blind people, allowing them to participate more actively in public life.

A strong thesis statement should tell the reader:

Why you hold this position
What they’ll learn from your essay
The key points of your argument or narrative

The final thesis statement doesn’t just state your position, but summarizes your overall argument or the entire topic you’re going to explain. To strengthen a weak thesis statement, it can help to consider the broader context of your topic.

These examples are more specific and show that you’ll explore your topic in depth.

Your thesis statement should match the goals of your essay, which vary depending on the type of essay you’re writing:

In an argumentative essay , your thesis statement should take a strong position. Your aim in the essay is to convince your reader of this thesis based on evidence and logical reasoning.
In an expository essay , you’ll aim to explain the facts of a topic or process. Your thesis statement doesn’t have to include a strong opinion in this case, but it should clearly state the central point you want to make, and mention the key elements you’ll explain.

If you want to know more about AI tools , college essays , or fallacies make sure to check out some of our other articles with explanations and examples or go directly to our tools!

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A thesis statement is a sentence that sums up the central point of your paper or essay . Everything else you write should relate to this key idea.

The thesis statement is essential in any academic essay or research paper for two main reasons:

It gives your writing direction and focus.
It gives the reader a concise summary of your main point.

Without a clear thesis statement, an essay can end up rambling and unfocused, leaving your reader unsure of exactly what you want to say.

Follow these four steps to come up with a thesis statement :

Ask a question about your topic .
Write your initial answer.
Develop your answer by including reasons.
Refine your answer, adding more detail and nuance.

The thesis statement should be placed at the end of your essay introduction .

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Developing a Thesis Statement

Many papers you write require developing a thesis statement. In this section you’ll learn what a thesis statement is and how to write one.

Keep in mind that not all papers require thesis statements . If in doubt, please consult your instructor for assistance.

What is a thesis statement?

A thesis statement . . .

Makes an argumentative assertion about a topic; it states the conclusions that you have reached about your topic.
Makes a promise to the reader about the scope, purpose, and direction of your paper.
Is focused and specific enough to be “proven” within the boundaries of your paper.
Is generally located near the end of the introduction ; sometimes, in a long paper, the thesis will be expressed in several sentences or in an entire paragraph.
Identifies the relationships between the pieces of evidence that you are using to support your argument.

Not all papers require thesis statements! Ask your instructor if you’re in doubt whether you need one.

Identify a topic

Your topic is the subject about which you will write. Your assignment may suggest several ways of looking at a topic; or it may name a fairly general concept that you will explore or analyze in your paper.

Consider what your assignment asks you to do

Inform yourself about your topic, focus on one aspect of your topic, ask yourself whether your topic is worthy of your efforts, generate a topic from an assignment.

Below are some possible topics based on sample assignments.

Sample assignment 1

Analyze Spain’s neutrality in World War II.

Identified topic

Franco’s role in the diplomatic relationships between the Allies and the Axis

This topic avoids generalities such as “Spain” and “World War II,” addressing instead on Franco’s role (a specific aspect of “Spain”) and the diplomatic relations between the Allies and Axis (a specific aspect of World War II).

Sample assignment 2

Analyze one of Homer’s epic similes in the Iliad.

The relationship between the portrayal of warfare and the epic simile about Simoisius at 4.547-64.

This topic focuses on a single simile and relates it to a single aspect of the Iliad ( warfare being a major theme in that work).

Developing a Thesis Statement–Additional information

Your assignment may suggest several ways of looking at a topic, or it may name a fairly general concept that you will explore or analyze in your paper. You’ll want to read your assignment carefully, looking for key terms that you can use to focus your topic.

Sample assignment: Analyze Spain’s neutrality in World War II Key terms: analyze, Spain’s neutrality, World War II

After you’ve identified the key words in your topic, the next step is to read about them in several sources, or generate as much information as possible through an analysis of your topic. Obviously, the more material or knowledge you have, the more possibilities will be available for a strong argument. For the sample assignment above, you’ll want to look at books and articles on World War II in general, and Spain’s neutrality in particular.

As you consider your options, you must decide to focus on one aspect of your topic. This means that you cannot include everything you’ve learned about your topic, nor should you go off in several directions. If you end up covering too many different aspects of a topic, your paper will sprawl and be unconvincing in its argument, and it most likely will not fulfull the assignment requirements.

For the sample assignment above, both Spain’s neutrality and World War II are topics far too broad to explore in a paper. You may instead decide to focus on Franco’s role in the diplomatic relationships between the Allies and the Axis , which narrows down what aspects of Spain’s neutrality and World War II you want to discuss, as well as establishes a specific link between those two aspects.

Before you go too far, however, ask yourself whether your topic is worthy of your efforts. Try to avoid topics that already have too much written about them (i.e., “eating disorders and body image among adolescent women”) or that simply are not important (i.e. “why I like ice cream”). These topics may lead to a thesis that is either dry fact or a weird claim that cannot be supported. A good thesis falls somewhere between the two extremes. To arrive at this point, ask yourself what is new, interesting, contestable, or controversial about your topic.

As you work on your thesis, remember to keep the rest of your paper in mind at all times . Sometimes your thesis needs to evolve as you develop new insights, find new evidence, or take a different approach to your topic.

Derive a main point from topic

Once you have a topic, you will have to decide what the main point of your paper will be. This point, the “controlling idea,” becomes the core of your argument (thesis statement) and it is the unifying idea to which you will relate all your sub-theses. You can then turn this “controlling idea” into a purpose statement about what you intend to do in your paper.

Look for patterns in your evidence

Compose a purpose statement.

Consult the examples below for suggestions on how to look for patterns in your evidence and construct a purpose statement.

Franco first tried to negotiate with the Axis
Franco turned to the Allies when he couldn’t get some concessions that he wanted from the Axis

Possible conclusion:

Spain’s neutrality in WWII occurred for an entirely personal reason: Franco’s desire to preserve his own (and Spain’s) power.

Purpose statement

This paper will analyze Franco’s diplomacy during World War II to see how it contributed to Spain’s neutrality.

The simile compares Simoisius to a tree, which is a peaceful, natural image.
The tree in the simile is chopped down to make wheels for a chariot, which is an object used in warfare.

At first, the simile seems to take the reader away from the world of warfare, but we end up back in that world by the end.

This paper will analyze the way the simile about Simoisius at 4.547-64 moves in and out of the world of warfare.

Derive purpose statement from topic

To find out what your “controlling idea” is, you have to examine and evaluate your evidence . As you consider your evidence, you may notice patterns emerging, data repeated in more than one source, or facts that favor one view more than another. These patterns or data may then lead you to some conclusions about your topic and suggest that you can successfully argue for one idea better than another.

For instance, you might find out that Franco first tried to negotiate with the Axis, but when he couldn’t get some concessions that he wanted from them, he turned to the Allies. As you read more about Franco’s decisions, you may conclude that Spain’s neutrality in WWII occurred for an entirely personal reason: his desire to preserve his own (and Spain’s) power. Based on this conclusion, you can then write a trial thesis statement to help you decide what material belongs in your paper.

Sometimes you won’t be able to find a focus or identify your “spin” or specific argument immediately. Like some writers, you might begin with a purpose statement just to get yourself going. A purpose statement is one or more sentences that announce your topic and indicate the structure of the paper but do not state the conclusions you have drawn . Thus, you might begin with something like this:

This paper will look at modern language to see if it reflects male dominance or female oppression.
I plan to analyze anger and derision in offensive language to see if they represent a challenge of society’s authority.

At some point, you can turn a purpose statement into a thesis statement. As you think and write about your topic, you can restrict, clarify, and refine your argument, crafting your thesis statement to reflect your thinking.

As you work on your thesis, remember to keep the rest of your paper in mind at all times. Sometimes your thesis needs to evolve as you develop new insights, find new evidence, or take a different approach to your topic.

Compose a draft thesis statement

If you are writing a paper that will have an argumentative thesis and are having trouble getting started, the techniques in the table below may help you develop a temporary or “working” thesis statement.

Begin with a purpose statement that you will later turn into a thesis statement.

Assignment: Discuss the history of the Reform Party and explain its influence on the 1990 presidential and Congressional election.

Purpose Statement: This paper briefly sketches the history of the grassroots, conservative, Perot-led Reform Party and analyzes how it influenced the economic and social ideologies of the two mainstream parties.

Question-to-Assertion

If your assignment asks a specific question(s), turn the question(s) into an assertion and give reasons why it is true or reasons for your opinion.

Assignment : What do Aylmer and Rappaccini have to be proud of? Why aren’t they satisfied with these things? How does pride, as demonstrated in “The Birthmark” and “Rappaccini’s Daughter,” lead to unexpected problems?

Beginning thesis statement: Alymer and Rappaccinni are proud of their great knowledge; however, they are also very greedy and are driven to use their knowledge to alter some aspect of nature as a test of their ability. Evil results when they try to “play God.”

Write a sentence that summarizes the main idea of the essay you plan to write.

Main idea: The reason some toys succeed in the market is that they appeal to the consumers’ sense of the ridiculous and their basic desire to laugh at themselves.

Make a list of the ideas that you want to include; consider the ideas and try to group them.

nature = peaceful
war matériel = violent (competes with 1?)
need for time and space to mourn the dead
war is inescapable (competes with 3?)

Use a formula to arrive at a working thesis statement (you will revise this later).

although most readers of _______ have argued that _______, closer examination shows that _______.
_______ uses _______ and _____ to prove that ________.
phenomenon x is a result of the combination of __________, __________, and _________.

What to keep in mind as you draft an initial thesis statement

Beginning statements obtained through the methods illustrated above can serve as a framework for planning or drafting your paper, but remember they’re not yet the specific, argumentative thesis you want for the final version of your paper. In fact, in its first stages, a thesis statement usually is ill-formed or rough and serves only as a planning tool.

As you write, you may discover evidence that does not fit your temporary or “working” thesis. Or you may reach deeper insights about your topic as you do more research, and you will find that your thesis statement has to be more complicated to match the evidence that you want to use.

You must be willing to reject or omit some evidence in order to keep your paper cohesive and your reader focused. Or you may have to revise your thesis to match the evidence and insights that you want to discuss. Read your draft carefully, noting the conclusions you have drawn and the major ideas which support or prove those conclusions. These will be the elements of your final thesis statement.

Sometimes you will not be able to identify these elements in your early drafts, but as you consider how your argument is developing and how your evidence supports your main idea, ask yourself, “ What is the main point that I want to prove/discuss? ” and “ How will I convince the reader that this is true? ” When you can answer these questions, then you can begin to refine the thesis statement.

Refine and polish the thesis statement

To get to your final thesis, you’ll need to refine your draft thesis so that it’s specific and arguable.

Ask if your draft thesis addresses the assignment
Question each part of your draft thesis
Clarify vague phrases and assertions
Investigate alternatives to your draft thesis

Consult the example below for suggestions on how to refine your draft thesis statement.

Sample Assignment

Choose an activity and define it as a symbol of American culture. Your essay should cause the reader to think critically about the society which produces and enjoys that activity.

Ask The phenomenon of drive-in facilities is an interesting symbol of american culture, and these facilities demonstrate significant characteristics of our society.This statement does not fulfill the assignment because it does not require the reader to think critically about society.

Drive-ins are an interesting symbol of American culture because they represent Americans’ significant creativity and business ingenuity.

Among the types of drive-in facilities familiar during the twentieth century, drive-in movie theaters best represent American creativity, not merely because they were the forerunner of later drive-ins and drive-throughs, but because of their impact on our culture: they changed our relationship to the automobile, changed the way people experienced movies, and changed movie-going into a family activity.

While drive-in facilities such as those at fast-food establishments, banks, pharmacies, and dry cleaners symbolize America’s economic ingenuity, they also have affected our personal standards.

While drive-in facilities such as those at fast- food restaurants, banks, pharmacies, and dry cleaners symbolize (1) Americans’ business ingenuity, they also have contributed (2) to an increasing homogenization of our culture, (3) a willingness to depersonalize relationships with others, and (4) a tendency to sacrifice quality for convenience.

This statement is now specific and fulfills all parts of the assignment. This version, like any good thesis, is not self-evident; its points, 1-4, will have to be proven with evidence in the body of the paper. The numbers in this statement indicate the order in which the points will be presented. Depending on the length of the paper, there could be one paragraph for each numbered item or there could be blocks of paragraph for even pages for each one.

Complete the final thesis statement

The bottom line.

As you move through the process of crafting a thesis, you’ll need to remember four things:

Context matters! Think about your course materials and lectures. Try to relate your thesis to the ideas your instructor is discussing.
As you go through the process described in this section, always keep your assignment in mind . You will be more successful when your thesis (and paper) responds to the assignment than if it argues a semi-related idea.
Your thesis statement should be precise, focused, and contestable ; it should predict the sub-theses or blocks of information that you will use to prove your argument.
Make sure that you keep the rest of your paper in mind at all times. Change your thesis as your paper evolves, because you do not want your thesis to promise more than your paper actually delivers.

In the beginning, the thesis statement was a tool to help you sharpen your focus, limit material and establish the paper’s purpose. When your paper is finished, however, the thesis statement becomes a tool for your reader. It tells the reader what you have learned about your topic and what evidence led you to your conclusion. It keeps the reader on track–well able to understand and appreciate your argument.

Writing Process and Structure

This is an accordion element with a series of buttons that open and close related content panels.

Getting Started with Your Paper

Interpreting Writing Assignments from Your Courses

Generating Ideas for

Creating an Argument

Thesis vs. Purpose Statements

Architecture of Arguments

Working with Sources

Quoting and Paraphrasing Sources

Using Literary Quotations

Citing Sources in Your Paper

Drafting Your Paper

Generating Ideas for Your Paper

Introductions

Paragraphing

Developing Strategic Transitions

Conclusions

Revising Your Paper

Peer Reviews

Reverse Outlines

Revising an Argumentative Paper

Revision Strategies for Longer Projects

Finishing Your Paper

Twelve Common Errors: An Editing Checklist

How to Proofread your Paper

Writing Collaboratively

Collaborative and Group Writing

Want to create or adapt books like this? Learn more about how Pressbooks supports open publishing practices.

9.1 Developing a Strong, Clear Thesis Statement

Learning objectives.

Develop a strong, clear thesis statement with the proper elements.
Revise your thesis statement.

Have you ever known a person who was not very good at telling stories? You probably had trouble following his train of thought as he jumped around from point to point, either being too brief in places that needed further explanation or providing too many details on a meaningless element. Maybe he told the end of the story first, then moved to the beginning and later added details to the middle. His ideas were probably scattered, and the story did not flow very well. When the story was over, you probably had many questions.

Just as a personal anecdote can be a disorganized mess, an essay can fall into the same trap of being out of order and confusing. That is why writers need a thesis statement to provide a specific focus for their essay and to organize what they are about to discuss in the body.

Just like a topic sentence summarizes a single paragraph, the thesis statement summarizes an entire essay. It tells the reader the point you want to make in your essay, while the essay itself supports that point. It is like a signpost that signals the essay’s destination. You should form your thesis before you begin to organize an essay, but you may find that it needs revision as the essay develops.

Elements of a Thesis Statement

For every essay you write, you must focus on a central idea. This idea stems from a topic you have chosen or been assigned or from a question your teacher has asked. It is not enough merely to discuss a general topic or simply answer a question with a yes or no. You have to form a specific opinion, and then articulate that into a controlling idea —the main idea upon which you build your thesis.

Remember that a thesis is not the topic itself, but rather your interpretation of the question or subject. For whatever topic your professor gives you, you must ask yourself, “What do I want to say about it?” Asking and then answering this question is vital to forming a thesis that is precise, forceful and confident.

A thesis is one sentence long and appears toward the end of your introduction. It is specific and focuses on one to three points of a single idea—points that are able to be demonstrated in the body. It forecasts the content of the essay and suggests how you will organize your information. Remember that a thesis statement does not summarize an issue but rather dissects it.

A Strong Thesis Statement

A strong thesis statement contains the following qualities.

Specificity. A thesis statement must concentrate on a specific area of a general topic. As you may recall, the creation of a thesis statement begins when you choose a broad subject and then narrow down its parts until you pinpoint a specific aspect of that topic. For example, health care is a broad topic, but a proper thesis statement would focus on a specific area of that topic, such as options for individuals without health care coverage.

Precision. A strong thesis statement must be precise enough to allow for a coherent argument and to remain focused on the topic. If the specific topic is options for individuals without health care coverage, then your precise thesis statement must make an exact claim about it, such as that limited options exist for those who are uninsured by their employers. You must further pinpoint what you are going to discuss regarding these limited effects, such as whom they affect and what the cause is.

Ability to be argued. A thesis statement must present a relevant and specific argument. A factual statement often is not considered arguable. Be sure your thesis statement contains a point of view that can be supported with evidence.

Ability to be demonstrated. For any claim you make in your thesis, you must be able to provide reasons and examples for your opinion. You can rely on personal observations in order to do this, or you can consult outside sources to demonstrate that what you assert is valid. A worthy argument is backed by examples and details.

Forcefulness. A thesis statement that is forceful shows readers that you are, in fact, making an argument. The tone is assertive and takes a stance that others might oppose.

Confidence. In addition to using force in your thesis statement, you must also use confidence in your claim. Phrases such as I feel or I believe actually weaken the readers’ sense of your confidence because these phrases imply that you are the only person who feels the way you do. In other words, your stance has insufficient backing. Taking an authoritative stance on the matter persuades your readers to have faith in your argument and open their minds to what you have to say.

Even in a personal essay that allows the use of first person, your thesis should not contain phrases such as in my opinion or I believe . These statements reduce your credibility and weaken your argument. Your opinion is more convincing when you use a firm attitude.

On a separate sheet of paper, write a thesis statement for each of the following topics. Remember to make each statement specific, precise, demonstrable, forceful and confident.

Texting while driving
The legal drinking age in the United States
Steroid use among professional athletes

Examples of Appropriate Thesis Statements

Each of the following thesis statements meets several of the following requirements:

Specificity
Ability to be argued
Ability to be demonstrated
Forcefulness
The societal and personal struggles of Troy Maxon in the play Fences symbolize the challenge of black males who lived through segregation and integration in the United States.
Closing all American borders for a period of five years is one solution that will tackle illegal immigration.
Shakespeare’s use of dramatic irony in Romeo and Juliet spoils the outcome for the audience and weakens the plot.
J. D. Salinger’s character in Catcher in the Rye , Holden Caulfield, is a confused rebel who voices his disgust with phonies, yet in an effort to protect himself, he acts like a phony on many occasions.
Compared to an absolute divorce, no-fault divorce is less expensive, promotes fairer settlements, and reflects a more realistic view of the causes for marital breakdown.
Exposing children from an early age to the dangers of drug abuse is a sure method of preventing future drug addicts.
In today’s crumbling job market, a high school diploma is not significant enough education to land a stable, lucrative job.

You can find thesis statements in many places, such as in the news; in the opinions of friends, coworkers or teachers; and even in songs you hear on the radio. Become aware of thesis statements in everyday life by paying attention to people’s opinions and their reasons for those opinions. Pay attention to your own everyday thesis statements as well, as these can become material for future essays.

Now that you have read about the contents of a good thesis statement and have seen examples, take a look at the pitfalls to avoid when composing your own thesis:

A thesis is weak when it is simply a declaration of your subject or a description of what you will discuss in your essay.

Weak thesis statement: My paper will explain why imagination is more important than knowledge.

A thesis is weak when it makes an unreasonable or outrageous claim or insults the opposing side.

Weak thesis statement: Religious radicals across America are trying to legislate their Puritanical beliefs by banning required high school books.

A thesis is weak when it contains an obvious fact or something that no one can disagree with or provides a dead end.

Weak thesis statement: Advertising companies use sex to sell their products.

A thesis is weak when the statement is too broad.

Weak thesis statement: The life of Abraham Lincoln was long and challenging.

Read the following thesis statements. On a separate piece of paper, identify each as weak or strong. For those that are weak, list the reasons why. Then revise the weak statements so that they conform to the requirements of a strong thesis.

The subject of this paper is my experience with ferrets as pets.
The government must expand its funding for research on renewable energy resources in order to prepare for the impending end of oil.
Edgar Allan Poe was a poet who lived in Baltimore during the nineteenth century.
In this essay, I will give you lots of reasons why slot machines should not be legalized in Baltimore.
Despite his promises during his campaign, President Kennedy took few executive measures to support civil rights legislation.
Because many children’s toys have potential safety hazards that could lead to injury, it is clear that not all children’s toys are safe.
My experience with young children has taught me that I want to be a disciplinary parent because I believe that a child without discipline can be a parent’s worst nightmare.

Writing at Work

Often in your career, you will need to ask your boss for something through an e-mail. Just as a thesis statement organizes an essay, it can also organize your e-mail request. While your e-mail will be shorter than an essay, using a thesis statement in your first paragraph quickly lets your boss know what you are asking for, why it is necessary, and what the benefits are. In short body paragraphs, you can provide the essential information needed to expand upon your request.

Thesis Statement Revision

Your thesis will probably change as you write, so you will need to modify it to reflect exactly what you have discussed in your essay. Remember from Chapter 8 “The Writing Process: How Do I Begin?” that your thesis statement begins as a working thesis statement , an indefinite statement that you make about your topic early in the writing process for the purpose of planning and guiding your writing.

Working thesis statements often become stronger as you gather information and form new opinions and reasons for those opinions. Revision helps you strengthen your thesis so that it matches what you have expressed in the body of the paper.

The best way to revise your thesis statement is to ask questions about it and then examine the answers to those questions. By challenging your own ideas and forming definite reasons for those ideas, you grow closer to a more precise point of view, which you can then incorporate into your thesis statement.

Ways to Revise Your Thesis

You can cut down on irrelevant aspects and revise your thesis by taking the following steps:

1. Pinpoint and replace all nonspecific words, such as people , everything , society , or life , with more precise words in order to reduce any vagueness.

Working thesis: Young people have to work hard to succeed in life.

Revised thesis: Recent college graduates must have discipline and persistence in order to find and maintain a stable job in which they can use and be appreciated for their talents.

The revised thesis makes a more specific statement about success and what it means to work hard. The original includes too broad a range of people and does not define exactly what success entails. By replacing those general words like people and work hard , the writer can better focus his or her research and gain more direction in his or her writing.

2. Clarify ideas that need explanation by asking yourself questions that narrow your thesis.

Working thesis: The welfare system is a joke.

Revised thesis: The welfare system keeps a socioeconomic class from gaining employment by alluring members of that class with unearned income, instead of programs to improve their education and skill sets.

A joke means many things to many people. Readers bring all sorts of backgrounds and perspectives to the reading process and would need clarification for a word so vague. This expression may also be too informal for the selected audience. By asking questions, the writer can devise a more precise and appropriate explanation for joke . The writer should ask himself or herself questions similar to the 5WH questions. (See Chapter 8 “The Writing Process: How Do I Begin?” for more information on the 5WH questions.) By incorporating the answers to these questions into a thesis statement, the writer more accurately defines his or her stance, which will better guide the writing of the essay.

3. Replace any linking verbs with action verbs. Linking verbs are forms of the verb to be , a verb that simply states that a situation exists.

Working thesis: Kansas City schoolteachers are not paid enough.

Revised thesis: The Kansas City legislature cannot afford to pay its educators, resulting in job cuts and resignations in a district that sorely needs highly qualified and dedicated teachers.

The linking verb in this working thesis statement is the word are . Linking verbs often make thesis statements weak because they do not express action. Rather, they connect words and phrases to the second half of the sentence. Readers might wonder, “Why are they not paid enough?” But this statement does not compel them to ask many more questions. The writer should ask himself or herself questions in order to replace the linking verb with an action verb, thus forming a stronger thesis statement, one that takes a more definitive stance on the issue:

Who is not paying the teachers enough?
What is considered “enough”?
What is the problem?
What are the results

4. Omit any general claims that are hard to support.

Working thesis: Today’s teenage girls are too sexualized.

Revised thesis: Teenage girls who are captivated by the sexual images on MTV are conditioned to believe that a woman’s worth depends on her sensuality, a feeling that harms their self-esteem and behavior.

It is true that some young women in today’s society are more sexualized than in the past, but that is not true for all girls. Many girls have strict parents, dress appropriately, and do not engage in sexual activity while in middle school and high school. The writer of this thesis should ask the following questions:

Which teenage girls?
What constitutes “too” sexualized?
Why are they behaving that way?
Where does this behavior show up?
What are the repercussions?

In the first section of Chapter 8 “The Writing Process: How Do I Begin?” , you determined your purpose for writing and your audience. You then completed a freewriting exercise about an event you recently experienced and chose a general topic to write about. Using that general topic, you then narrowed it down by answering the 5WH questions. After you answered these questions, you chose one of the three methods of prewriting and gathered possible supporting points for your working thesis statement.

Now, on a separate sheet of paper, write down your working thesis statement. Identify any weaknesses in this sentence and revise the statement to reflect the elements of a strong thesis statement. Make sure it is specific, precise, arguable, demonstrable, forceful, and confident.

Collaboration

Please share with a classmate and compare your answers.

In your career you may have to write a project proposal that focuses on a particular problem in your company, such as reinforcing the tardiness policy. The proposal would aim to fix the problem; using a thesis statement would clearly state the boundaries of the problem and tell the goals of the project. After writing the proposal, you may find that the thesis needs revision to reflect exactly what is expressed in the body. Using the techniques from this chapter would apply to revising that thesis.

Key Takeaways

Proper essays require a thesis statement to provide a specific focus and suggest how the essay will be organized.
A thesis statement is your interpretation of the subject, not the topic itself.
A strong thesis is specific, precise, forceful, confident, and is able to be demonstrated.
A strong thesis challenges readers with a point of view that can be debated and can be supported with evidence.
A weak thesis is simply a declaration of your topic or contains an obvious fact that cannot be argued.
Depending on your topic, it may or may not be appropriate to use first person point of view.
Revise your thesis by ensuring all words are specific, all ideas are exact, and all verbs express action.

Home — Essay Samples — Social Issues — Driving Age — Should The Driving Age Be Raised To 18: Argumentative

Should The Driving Age Be Raised to 18: Argumentative

Categories: Driving Age

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Updated: 23 November, 2023

Words: 472 | Page: 1 | 3 min read

Works Cited

Afifi, T. O., Henriksen, C. A., Asmundson, G. J., & Sareen, J. (2012). Childhood maltreatment and substance use disorders among men and women in a nationally representative sample. Canadian Journal of Psychiatry, 57(11), 677-686.
Anda, R. F., Felitti, V. J., Bremner, J. D., Walker, J. D., Whitfield, C., Perry, B. D., . . . Giles, W. H. (2006). The enduring effects of abuse and related adverse experiences in childhood: A convergence of evidence from neurobiology and epidemiology. European Archives of Psychiatry and Clinical Neuroscience, 256(3), 174-186.
Bensley, L. S., Van Eenwyk, J., & Simmons, K. W. (2000). Self-reported childhood sexual and physical abuse and adult HIV-risk behaviors and heavy drinking. American Journal of Preventive Medicine, 18(2), 151-158.
Davis, C. G., Lehman, D. R., Wortman, C. B., Silver, R. C., & Thompson, S. C. (1995). The undoing of traumatic life events. Personality and Social Psychology Bulletin, 21(2), 109-124.
De Bellis, M. D. (2002). Developmental traumatology: The psychobiological development of maltreated children and its implications for research, treatment, and policy. Development and Psychopathology, 14(4), 747-776.
Kendler, K. S., Kuhn, J. W., & Prescott, C. A. (2004). Childhood sexual abuse, stressful life events and risk for major depression in women. Psychological Medicine, 34(8), 1475-1482.
Poulton, R., Caspi, A., Milne, B. J., Thomson, W. M., Taylor, A., Sears, M. R., & Moffitt, T. E. (2002). Association between children's experience of socioeconomic disadvantage and adult health: A life-course study. The Lancet, 360(9346), 1640-1645.
Rapsey, C. M., Scott, K. M., & Patterson, T. (2018). Long-term effects of childhood abuse on the quality of life and health of older people: Results from the Depression and Early Prevention of Suicide in General Practice Project. Journal of Elder Abuse and Neglect, 30(5), 372-386.
Silver, R. C., Boon, C., & Stones, M. H. (1985). Searching for meaning in misfortune: Making sense of incest. Journal of Social Issues, 41(1), 81-102.

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The Thesis Statement

In Gordon Harvey’s Elements of the Academic Essay , he makes a succinct attempt to define the thesis statement, stating that it is “your main insight or idea about a text or topic, and the main proposition that your essay demonstrates” (Harvey 1). He also places it foremost in his list of elements, with the implication that it is the most crucial component. The fact that Harvey uses the second person, “your main insight” and “your essay,” is significant. Rather than rehashing what has been discussed in class, a student presents her or his opinion in a hopefully simple sentence, and then devotes the following paragraphs to supporting it, defending against counters, and ideally convincing the reader.

This expected format of the academic essay, with the thesis statement, is contentious, as opined by Anne Berggren, who complains that “only in student writing is the writer expected to place at the end of the first paragraph a one-sentence of the conclusion the writer is aiming for and then, as students often put it, ‘prove’ that point” (Eisner, Caroline, ed. 54) While Berggren laces this statement with her own opinions, it is true from a personal standpoint, and it is also true that students do seek to create a single sentence meant to achieve numerous expectations, from presenting a provocative argument to conveying a general sense of the direction of the paper.

In Writing Your Thesis , Paul Oliver establishes arguably neutral expectations of a thesis statement, stipulating that it have a “structure and format which help the reader to absorb the subject matter” and an “intellectual coherence which starts with precise aims” (Oliver 13). The ambiguity of these definitions is no coincidence; throughout the book, Oliver offers similar direction such as theses’ being “original contributions to knowledge” (20). It is important to acknowledge that Oliver is clearly part of the system in that the thesis is prevalent, that it is should presented as this “single sentence,” and that it is something that any student is capable of formulating. In Avoiding Thesis and Dissertation Pitfalls , R. Murray Thomas and Dale L. Brubaker recognize this predicament by recording actual conversations between Professor and Student, with a professor allegorically explaining to a mystified student that “writing a thesis is rather like a strategy you adopt for helping someone find a place on a map. The strategy involves starting with a broad area that you are confident the person already knows, and then by gradual steps leading the person to the place you want to talk about” (Thomas and Brubaker 154). Though this reasoning is definitely clearer, thanks to lay analysis, it still is a broad concept that does little to investigate the means by which a student creates a good thesis statement.

Beyond these philosophical ideals, little natural proficiency at thesis statement composition should be expected among novice writers. In Virginia Perdue’s “Authority and the Freshman Writer: The Ideology of the Thesis Statement,” she addresses this understandable disparity and encourages that the writing instructor aim to think of different approaches to explain the purpose of thesis statement. She complicates the issue by pointing out that there are changing perceptions of academic argument that may be more apposite for first-year writing, and—taking a page from Berggren—that the format itself, in the form of a “simple” single sentence, is paradoxically complicated for students to engage in. In Writing Research Papers , James D. Lester attempts to tackle this paradox by positing an approach to the thesis statement that divides it into a two-step process: first with the preliminary thesis that allows the writer to neatly prepare arguments, and then with the final thesis that is presented to the reader. “The two differ slightly because the preliminary thesis helps you explore issues for discussion while the final thesis sentence informs your audience of the particular issue being discussed” (Lester 24). While this process may seem helpful on the surface, it in actuality further elucidates the troublesome mystique that perplexes students.

The thesis statement and expectations of it bring forth a larger problem in the academic society in general. Novice student writers feel pressured to conform to this broad notion of what a thesis statement is. Tutors should be aware about allowing their students to be able to write effective academic papers without sacrificing their originality.

Works Cited

Eisner, Caroline and Martha Vicinus, ed. Originality, Imitation, and Plagiarism: Teaching Writing in the Digital Age. U Michigan Press, 2008.

Kellogg, Ronald T and Bascom A. Raulerson III. Psychonomic Bulletin & Review, Volume 14, Number 2, April 2007, pp. 237-242.

Lester, James D. Writing Research Papers: A Complete Guide. Scott, Foresman and Company, 1986.

Oliver, Paul. Writing Your Thesis Statement. London: SAGE, 1994.

Perdue, Virgina. “Authority and the Freshman Writer: The Ideology of the Thesis Statement.” Writing Instructor, v11 n3 p135-42 Spr-Sum 1992

Thomas, R. Murray and Dale L. Brubaker. Avoiding Thesis and Dissertation Pitfalls: 61 Cases of Problems and Solutions. Bergin & Garvey, 2001.

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Published: 02 September 2024

Air pollution: a latent key driving force of dementia

Mahdiyeh Mohammadzadeh 1 , 2 ,
Amir Hossein Khoshakhlagh ORCID: orcid.org/0000-0002-2265-5054 3 &
Jordan Grafman 4

BMC Public Health volume 24 , Article number: 2370 ( 2024 ) Cite this article

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Many researchers have studied the role of air pollutants on cognitive function, changes in brain structure, and occurrence of dementia. Due to the wide range of studies and often contradictory results, the present systematic review was conducted to try and clarify the relationship between air pollutants and dementia. To identify studies for this review, a systematic search was conducted in Scopus, PubMed, and Web of Science databases (without historical restrictions) until May 22, 2023. The PECO statement was created to clarify the research question, and articles that did not meet the criteria of this statement were excluded. In this review, animal studies, laboratory studies, books, review articles, conference papers and letters to the editors were avoided. Also, studies focused on the effect of air pollutants on cellular and biochemical changes (without investigating dementia) were also excluded. A quality assessment was done according to the type of design of each article, using the checklist developed by the Joanna Briggs Institute (JBI). Finally, selected studies were reviewed and discussed in terms of Alzheimer's dementia and non-Alzheimer's dementia. We identified 14,924 articles through a systematic search in databases, and after comprehensive reviews, 53 articles were found to be eligible for inclusion in the current systematic review. The results showed that chronic exposure to higher levels of air pollutants was associated with adverse effects on cognitive abilities and the presence of dementia. Studies strongly supported the negative effects of PM 2.5 and then NO 2 on the brain and the development of neurodegenerative disorders in old age. Because the onset of brain structural changes due to dementia begins decades before the onset of disease symptoms, and that exposure to air pollution is considered a modifiable risk factor, taking preventive measures to reduce air pollution and introducing behavioral interventions to reduce people's exposure to pollutants is advisable.

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Introduction

Technological development and the rapid expansion of mechanization during the last few decades have led to an increase in life expectancy in various societies, especially in developed countries [ 1 ]. An increase in the life expectancy can lead to the growth of neurological disorders [ 2 ]. According to statistics published worldwide, neurological disorders, including Parkinson's (PD), cognitive dysfunction, Alzheimer's (AD) and dementia, are a leading cause of disability and death [ 3 , 4 ]. Cognitive function also diminishes with age [ 5 ] and therefore, elderly people are disproportionately affected by cognitive disorders and, finally, dementia [ 6 , 7 ] which imposes a significant burden on health care systems. According to statistics published by the World Health Organization (WHO), approximately 55 million people worldwide suffered from dementia in 2019, which is estimated to more than double in 2050 [ 8 ]. Dementia is the cause of 2.4 million deaths and 28.8 million disability-adjusted life years (DALYs) in 2016 and is known as the third cause of neurological DALYs [ 3 , 9 ].

Various factors are involved in dementia, including anthropometric parameters (for example, body mass index), the APOE Ɛ4 allele [ 10 ], lack of weight [ 11 ], inactivity [ 12 ], non-Mediterranean diet [ 13 ], and the lack of specific micronutrients and macronutrients [ 14 ]. In addition, many epidemiological studies have shown that exposure to air pollution can also contribute to neuropathology through oxidative stress, hyperactivation of microglia, disruption of the blood–brain barrier (BBB) and neuroinflammation [ 15 , 16 ] and cause adverse effects on the brain, accelerate cognitive aging and even increase the occurrence of AD and other forms of dementia [ 17 , 18 , 19 ]. The 2020 Lancet Commission on dementia prevention, intervention and care, considered air pollution as a new modifiable risk factor for dementia, accounting for about 2% of cases worldwide [ 20 ]. Studies conducted in the United Kingdom showed that an increase of 1 µg/m 3 PM 2.5 (particles with a diameter of 2.5 µm or less) increases the risk of dementia by 6% and the risk of AD by 10% [ 21 ]. Mortamais et al. (2021) found that an increase of 5µg/m 3 in PM 2.5 level, increases 20% the risk for all-cause dementia, 20% for AD and 33% for Vascular Dementia (VaD) in elderly people over 70 years [ 22 ]. However, the adverse effects of air pollution on cognitive function are not limited to old age. Recent epidemiological studies support the hypothesis that public exposure to air pollutants can cause structural and functional changes in children's brains [ 23 , 24 ] and by causing negative effects on neuropsychological development, make them susceptible to neurological disorders in middle and old age [ 25 , 26 ].

Therefore, prevention of exposure to air pollution is a potentially correctable risk factor in the occurrence of cognitive decline and dementia in the elderly. The present systematic review was conducted to critically examine the published scientific literature related to the impact of exposure to air pollution on dementia. Specifically, the objectives were: (1) to evaluate the type and concentration of air pollutants including PM 10 (particles with a diameter of 10 µm or less), PM 2.5 , NO 2 , O 3 , black carbon (BC), polycyclic aromatic hydrocarbons (PAHs), benzene, toluene, ethylbenzene and xylenes (BTEX), formaldehyde (FA) in geographic areas and (2) to assess the risk of dementia in adults with chronic respiratory exposure to the mentioned pollutants.

This systematic review was guided by the PRISMA statement (Preferred Reporting Items for Systematic Review and Meta-analyses) and fully complied with the protocol registered in the International Prospective Register of Systematic Reviews (PROSPERO, CRD42023413916) .

PECO statement

In this study, the PECO (population, exposure, comparator, and outcome) [ 27 ] statement was used to develop the research question, search terms, and inclusion and exclusion criteria of the systematic review. Table 1 shows the PECO statement for understanding the adverse effects of respiratory exposure to pollutants PM 10 , PM 2.5 , NO 2 , O 3 , BC, PAHs, BTEX, and FA on dementia.

Search strategy and selection of studies

According to our knowledge, this is the first systematic review that investigated the effect of respiratory exposure to pollutants i.e. PM 10 , PM 2.5 , NO 2 , O 3 , BC, PAHs, BTEX, and FA on dementia. To obtain all published studies in this field, a systematic search was conducted in Scopus, PubMed, and Web of Science databases, without a date limit until May 22, 2023. The keywords used in this study include the following (the details of the search strategy used for the systematic search in the databases are shown in Appendix A1):

Exposure to pollutants: “air pollution”, “PM 10 ”, “PM 2.5 ”, “nitrogen dioxide”, “ozone”, “black carbon”, “diesel”, “diesel exhaust”, “PAH*”, “BTEX”, “toluene”, “ethylbenzene”, “xylene”, “benzene”, “formaldehyde”, “formal”, “formalin”, “methanol”, “methylene oxide”

Outcomes of exposure: “Alzheimer's disease”, “Neuromarker”, “Neuroinflammation”, “Dementia”, “Vascular dementia”, “Frontotemporal dementia”, “Frontotemporal lobar degeneration”, “Lewy body disease”, “Lewy body dementia”

The mentioned keywords were extracted by (M.M and A.H.Kh) and systematically searched by (A.H.Kh) in Title/Abstract and Mesh (if any). After merging the studies in EndNote X20 software, all duplicates were removed and the data were independently screened and extracted by two researchers (M.M and A.H.Kh). More contradictions and ambiguities were resolved with the intervention of the third author (J.G). In addition, to obtain additional studies that meet the inclusion criteria, additional to the hand searching, the reference list of selected studies was also systematically searched in parallel.

Criteria of entering and extracting studies

In this review, we excluded studies focused on the effects of exposure to air pollutants on neurological and biochemical changes (without examining dementia) and studies that investigated exposure to air pollutants as a dependent variable. Animal studies, laboratory studies, books, review articles, conference papers, and letters to the editors were also excluded. In this systematic review, only original peer-reviewed articles in English were reviewed.

Finally, the following information was extracted from the selected articles:

Authors, the year of publication, study design, country, the number of sample people, the age range of people, gender, the type of pollutant, the mean concentration of pollutant, diagnosis tool, and the type of dementia.

Quality control

The quality of the selected studies was checked by two researchers (M.M and A.H.Kh) using the Joanna Briggs Institute (JBI) checklist for cohort studies, case–control studies and analytical cross-sectional studies, independently. This checklist evaluates the risk of bias in studies by asking 2 questions from each of the sample areas including selection criteria, exposure assessment, confounding factors and results and appropriate statistical analysis. The defined answers for each question can be one of the options (yes, no, unclear, or not applicable). According to the total selection percentage of each of the 4 mentioned answers, the quality of articles is determined in the following 3 levels:

High-quality level and low risk of bias (Q1) (Yes ≥ 50–75%).

Moderate quality level and unclear risk of bias (Q2) (unclear ≥ 50–75%).

Low-quality and high risk of bias (Q3) (No ≥ 50–75%) [ 28 ].

All the articles that were of adequate quality were included in the study.

Result synthesis

Due to heterogeneity in study design, exposure (occupational/environmental) and the age of subjects, quantitative synthesis of studies in the form of meta-analysis was not possible. Therefore, the results obtained from the selected studies, which included the type of dementia, the age of the subjects, gender, the type of air pollutants, mean concentration, the instrument for detecting pollutants, and the diagnosis of dementia, and the outcome of exposure (Appendix A2), were narratively combined. This synthesis was done in two steps. The first stage included the initial synthesis using the general grouping of studies based on Alzheimer's and non-Alzheimer's dementia; therefore, the results of articles were carefully studied, and considered which of the types of Alzheimer's dementia (AD) (Appendix A2) and non-Alzheimer's dementia (VaD, FTD and PD) (Appendix A3) have been investigated. In the second step, the relationship between the type and concentration of each pollutant in dementia was investigated.

Figure 1 shows the process of conducting the present systematic review by the members of the research team, which includes six general steps:

Visualization of the systematic review guiding process comprising eight distinct stages

Topic selection, systematic search, screening and data extraction, quality control, resolving contradictions and ambiguities, and synthesis of results.

Results and Discussion

Selection process and characteristics of articles.

In this review, 14,924 articles were obtained through a systematic search in databases, of which 4532 studies were retrieved from PubMed, 5878 from Scopus, and 4514 from Web of Science. After entering the articles into EndNote X20 software, 6546 duplicates were removed and 8378 studies were screened for title and abstract. At this stage, 8289 articles were excluded and the entry and exit criteria and quality assessment were done for 88 full texts. Finally, after conducting additional reviews, 36 studies were excluded for the following reasons:

Nine studies were review articles, two studies only investigated brain volume, in twelve articles the type of air pollutant was not specified, five studies investigated the effect of other pollutants on dementia, five studies were excluded due to the high risk of bias and access to three full texts was not possible.

In addition, hand searching and systematic search of the selected articles' reference lists were also conducted to identify additional studies eligible for inclusion, which led to the identification of two studies through reference checking. Therefore, the total number of studies included in this systematic review increased to 53 articles (Fig. 2 ).

PRISMA flow diagram of the literature search

The studies in this systematic review included 6 case–control [ 29 , 30 , 31 , 32 , 33 , 34 ], 7 cross-sectional [ 19 , 35 , 36 , 37 , 38 , 39 , 40 ], and 40 cohort studies [ 1 , 2 , 18 , 21 , 22 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , 75 ]. Specifically, selected studies have been conducted in 17 countries around the world:

19 in the United States of America, 7 in Sweden, 7 in Taiwan, 4 in Canada, 3 in France, 2 in Australia, 2 in Germany, 2 in Hong Kong, 2 in Mexico, 2 in the United Kingdom, 1 in each country of Netherlands, Spain, China, Denmark, England, Italy, and the Republic of Korea.

In total, 173,698,774 subjects were contained in the studies examined in this systematic review. The characteristics of the reviewed studies are shown in Table 2 .

Diagnostic methods in the types of dementia

When we examined the 53 selected studies, 39 diagnostic tools and methods for AD and other types of dementia had been used (Appendix A2 and A3); of these, 21 diagnostic tools were used for Alzheimer's dementia and 28 methods for non-Alzheimer's dementia. According to the investigations carried out in studies related to Alzheimer's dementia, the methods of medical records ( N = 11) and Mini-Mental Status Examination (MMSE) ( N = 8) were the most prevalent. Five studies also used medical imaging (such as MRI and CT scan) to investigate the changes made in brain structures, which indicate the onset of Alzheimer's disease. In addition, the most common diagnostic tools for non-Alzheimer's dementia were included medical reports ( N = 4), MMSE ( N = 10), Medical imaging ( N = 4), Clinical Dementia Rating Sum of Box (CDR-SB) ( N = 4), and the Montreal Cognitive Assessment (MoCA) ( N = 3).

MMSE and MoCA are among the most important reliable screening tools that are widely used for clinical and research purposes [ 76 , 77 ]. These tools have received a lot of attention due to the need for little training, ease of implementation, and the ability to differentiate dementia patients from healthy people [ 78 , 79 , 80 ]. MMSE is also widely used to describe a wide range of cognitive functions, including attention, memory, verbal ability, and visual-spatial cognitive function [ 81 ], and its total score is related to disease progression [ 82 ]. However, it has been found that the MMSE may be less reliable than the MoCA in the diagnosis of mild cognitive impairment (MCI) because this instrument had lower sensitivity among multiple study settings [ 83 , 84 , 85 , 86 , 87 ]. In addition, the MoCA can show differences in the cognitive profile of people diagnosed with MMSE in the normal range, which makes the MoCA a powerful, concise, and useful tool [ 77 , 88 , 89 ].

Although the use of questionnaire methods is a standard requirement for dementia researchers, the importance of medical imaging methods in diagnosing dementia types with high certainty should not be neglected to investigate the changes made in the brain structure and the speed of disease progression. Among the most important diagnostic imaging tools for dementia are PET imaging with 2-deoxy-positron emission tomography (PiB-PET), 2 [18F] fluoro-D-glucose tracer (FDG-PET) and Structural and Functional Magnetic Resonance Imaging (MRI) [ 90 ]. The first PET technique used to diagnose neurodegenerative disorders was 18F-fluorodeoxyglucose (18F-FDG) metabolic imaging, which is a measure of neuronal or synaptic integrity [ 91 , 92 ]. More recent advances using PET includes the detection of specific neural ligands, such as specific ligands for fibrillar Aβ [ 93 ], paired-helical filament tau [ 94 , 95 ], and synaptic vesicle protein 2A [ 96 ]. The PET technique, however, is only available in specialized centers due to its high cost.

In our systematic review, the main neuroimaging technique used was MRI. This tool can measure brain atrophy, especially in the mesial-temporal structures, and detect it even before appearing the first clinical symptoms [ 97 , 98 ]. This method is included in both the diagnostic criteria presented by Dubois [ 99 ] and NIA-AA [ 100 ] and has been used as a reliable diagnostic tool by many researchers [ 101 , 102 , 103 ]. The sensitivity of this method as an AD marker has been reported to be more than 85% [ 97 ], which is more than PiB-PET (70%) [ 104 ] and FDG-PET (80%) [ 105 , 106 ].

Atrophy in the medial temporal lobe, especially the hippocampus, and a decrease in the thickness of the cerebral cortex in vulnerable areas of AD are among the first signs detectable by MRI in the early stages of the disease [ 107 , 108 , 109 ]. This tool can show hippocampal volume reduction 2 to 3 years before the onset of dementia in asymptomatic carriers of APP mutations [ 110 ] and in elderly people up to 6 years before that [ 103 , 107 ]. In addition, entorhinal cortex volume reduction, which progresses up to four years before cognitive decline, can be detected by MRI up to 90% [ 107 ].

Alzheimer’s dementia

The characteristics and results extracted from the articles related to Alzheimer's dementia are shown in Appendix A2. Thirty-one studies investigated the effect of pollutants i.e. PM 10 , PM 2.5 , NO 2 , O 3 , BC, PAHs, BTEX, and FA on the occurrence of Alzheimer's dementia. These studies were published from 1995–2023, and most were since 2018, indicating the novelty of the subject under discussion. More than 80% of the studies investigated the incidence of Alzheimer's in people over 60 years old, but some studies included younger people, comprising Haisu Zhang (2023) [ 40 ], Lilian Calderón-Garcidueñas (2022) [ 38 , 39 ], Marta Crous-Bou (2020) [ 1 ], Anna Oudin (2019 and 2016) [ 44 , 53 ], and Ruo-Ling Li (2019) [ 51 ].

The results showed that chronic exposure to air pollutants, especially particulate matter (PMs), increases the number of hospitalizations due to the exacerbation of neurocognitive disorders caused by Alzheimer's dementia or related diseases. This finding is compatible with previous studies on the role of exposure to air pollutants on the development of this neurological disorder [ 18 , 74 , 75 ]. Results from human and animal studies have shown that air pollution is associated with atherosclerosis, increased blood inflammatory biomarkers, and oxidative stress, which may accelerate hospitalization for several neurological diseases [ 111 , 112 ]. In the United Kingdom, the results of a population-based cohort study showed that the risk of AD was associated with exposure to PM 2.5 (adjusted hazard ratio—HR 1.10, 95% CI 1.02–1.18) and NO 2 (1.23, 1.07–1.43) increases significantly so that an increase of 1 µg/m 3 PM 2.5 is associated with a 10% increase in the risk of AD. Exposure to O 3 reduced this risk [ 21 ]. Also Cerza et al. (2019) in a cohort study in Italy concluded that a positive association between exposure to O 3 and NO x and dementia hospitalizations, (O 3 : HR = 1.06; 95% CI: 1.04–1.09 per 10 μg/m 3 ; NO x : HR = 1.01; 95% CI: 1.00–1.02 per 20 μg/m 3 ) [ 52 ]. This study showed that exposure to NO x , NO 2 , PM 2.5 , and PM 10 , except for O 3 , has a significant negative relationship with AD [ 52 ].

He et al. (2022) also demonstrated in a population-based cohort study in China that exposure to PM 2.5 , PM 10 , and CO pollutants was significantly associated with an increased risk of AD, but there is no significant relationship between exposure to NO and SO 2 with the occurrence of this disorder. This study also showed an inverse relationship between O 3 exposure and AD [ 69 ]. Meanwhile, Jung et al. (2015) concluded that for an increase of 9.63 ppb in O 3 concentration, the risk of AD increases 1.06 times in the elderly ≥ 65 years (adjusted HR 1.06, 1.00–1.12) [ 43 ]. The difference between the results of these studies can be caused by different characteristics in the study population, study design, sample size, setting, and different measurements of exposure to air pollutants.

In addition, the researchers found evidence of the adverse effect of exposure to air pollutants on episodic memory. Several animal studies showed that exposure to inhaled PM 2.5 can impair neural systems that underlie episodic memory processes [ 113 , 114 , 115 ]. So far, limited longitudinal epidemiological studies have been conducted about PM 2.5 and episodic memory in humans [ 116 , 117 , 118 ]. The results of a prospective study on 998 elderly women aged 73 to 87 years old in the US showed that chronic exposure to PM 2.5 in residential environments was associated with a rapid decline in episodic memory, especially in measures of immediate recall and learning of new material [ 68 ]. A decrease in verbal episodic memory (such as the ability to remember details, with context, from daily and distant experiences) is prominent in AD and can be detected in the preclinical stage [ 119 , 120 ]. For example, impaired episodic memory is one of the main criteria for the classic diagnosis of AD by Dubois et al. (2007), which appears early in the course of the disease [ 99 ]. Studies have proven that the rapid decline of this memory is somewhat associated with an increase in the Alzheimer's disease pattern similarity (AD-PS) score [ 68 ]. AD-PS is a brain MRI-based structural biomarker that reflects high-dimensional gray matter atrophies in brain regions vulnerable to AD neuropathology [ 68 ]. In addition to exposure to environmental factors, natural aging can also lead to a decrease in episodic memory, which is related to the decrease in the volume of the hippocampus and other structures of the medial temporal lobe [ 121 ]. The medial temporal lobe and its structural components, especially the hippocampus, play an important role in encoding (learning, recalling) and retrieving (recalling) the details of events that make up episodic memories [ 121 ].

Zhao et al. (2019) showed in a human imaging study that atrophy in hippocampal subfields can impose a wide range of effects on measures of episodic memory (immediate recalls, delayed-recalls, and recognition) [ 122 ]. Although so far the relative roles of hippocampal subfields (e.g. cornu ammonis (CA, CA2-3), CA4-denate gyrus, presubiculum, subiculum) have not been determined in the processes related to encoding and retrieval, animal studies have proven the adverse effects of PMs on the morphology and functional changes in hippocampal subfields. Also, we can mention the decrease in apical dendritic spine density and dendritic branches in the CA1 and CA3 regions [ 123 ], decrease in synaptic function in CA1 neurons [ 114 , 124 ], decrease in basic protein in white matter, and increase in atrophy of neurites in the CA1 region [ 125 ]. Based on the studies, encoding is done by CA2, CA3, and dentate gyrus, while CA1 and subiculum are involved in retrieval [ 126 ]. According to the results obtained by Younan et al. (2020), it seems that the significant reduction of episodic memory processes (immediate recall/new learning) caused by exposure to PM 2.5 is more due to the adverse effects of this pollutant on hippocampal subfields associated with encoding, such as CA2, CA3, and dentate gyrus [ 68 ]. These neurotoxicological results indicate that some hippocampal subfields may be more sensitive to the adverse effects of particulate matter than other subfields.

So far, many studies have proven the existence of an inverse relationship between exposure to air pollutants and white matter volume, gray matter volume, and cerebral cortex thickness in brain areas affected by AD [ 127 , 128 , 129 , 130 ]. Wilker et al. (2015) showed in a study that with increasing PM 2.5 concentration, brain volume decreases by 0.32% [ 131 ], which was consistent with the results obtained by Chen et al. (2015) regarding the reduction of white matter volume and the volume of the whole brain due to exposure to high concentrations of this pollutant [ 128 ]. The results of the study by Crous-Bou et al. (2020) showed that chronic exposure to air pollutants, especially NO 2 and PM 10 , is associated with a decrease in the thickness of the cerebral cortex in brain areas affected by AD [ 1 ], which is consistent with the results of study done by Casanova et al. (2016) [ 127 ]. In a voxel-based morphometry study, they examined the local brain structure related to PMs in elderly women and concluded that exposure to PM 2.5 has an inverse relationship with the reduction of the frontal cortex [ 127 ]. Furthermore, Cho et al. (2023) showed that a 10 µg/m 3 increase in (β = -1.13; 95% CI, − 1.73 to − 0.53) PM 10 and a 10 ppb increase in (β = -1.09; 95% CI, − 1.40 to − 0.78) NO 2 are significantly associated with decreasing MoCA score. Also, these two pollutants were significantly associated with an increase in AD-like cortical atrophy scores and a decrease in the thickness of the cerebral cortex [ 129 ].

PET ligand studies indicate that gray matter atrophy of the brain can be caused by tau neuropathological processes, which can lead to cognitive decline in patients [ 132 , 133 , 134 ]. Several plausible biological mechanisms explain the rapid development or onset of neurological diseases caused by exposure to air pollution. After inhalation, air pollutants can pass through the BBB and enter the brain through the olfactory bulb or systemic circulation [ 135 ] causing oxidative stress and systemic inflammatory responses, disruption of the blood–brain barrier, deposition of peptides beta-amyloid (Aβ) and activation of microglia and as a result may exacerbate the disease progression of AD [ 136 , 137 ]. In addition, it has been reported that NO 2 is associated with inflammatory responses and markers such as increased serum concentration of systemic interleukin IL-6 [ 138 ]. Recent studies have shown that exposure to air pollutants can be effective in causing neurological and cognitive disorders by contributing to AD pathologies such as brain Aβ and tau burden [ 139 , 140 ]. Researchers use the levels of Aβ, total tau (t-tau) and phospho-tau (p-tau) in CSF as specific biomarkers for the clinical diagnosis of probable AD [ 99 ]. Some studies have proven that CSF Aβ, as the first marker of AD, shows abnormal levels several years before the appearance of impaired memory [ 141 , 142 ]. Diagnosis of early AD in patients with mild cognitive impairment (MCI) can be done by detecting low levels of Aβ and high levels of p-tau and t-tau in CSF [ 143 ].

Reports show that living in areas with high air pollution can lead to the accumulation of Aβ in neurons and astrocytes [ 144 ]. Also, the results obtained from the study of Fu et al. (2022) indicate that the increase in the concentration of each unit of ln-transformed Ʃ-OH PAHs in the urine of coke oven workers was associated with an increase of 9.416 units of P-Tau231 in plasma and a decrease of 0.281 in visuospatial/executive function [ 145 ]. Tau is a microtubule-associated protein that contributes to the stability of axonal microtubules in the brain [ 146 ]. The presence of hyperphosphorylated tau leads to the formation of neurofibrillary tangles, which is considered a pathological characteristic of AD [ 147 ]. Some researchers have reported changes in the concentration of phosphorylated tau as a possible sign of the progression of some neurological diseases [ 148 , 149 ]. This is consistent with the results of Nie et al.'s (2013) study, which showed that benzo[a]pyrene (B[a]P) leads to tau 231 hyperphosphorylation [ 150 ].

Non-Alzheimer’s dementia

Among the 53 selected articles, 41 studies investigated the effect of air pollutants on the incidence of non-Alzheimer's dementia (Appendix A3), which were published during the years 2014–2023. Except for the studies of Anna Oudin (2016) [ 44 ], Anna Oudin (2018) [ 49 ], Iain M Carey (2018) [ 21 ], Anna Oudin (2019) [ 53 ], Han-Wei Zhang (2019) [ 54 ], Zorana J. Andersen (2022) [ 67 ], Lilian Calderón-Garcidueñas (2022) [ 38 , 39 ], and Haisu Zhang (2023) [ 40 ], the rest of the articles included people over the age of 60 years old.

Non-Alzheimer's dementia accounts for almost half of dementia cases [ 151 ]. The most common non-Alzheimer's neurological disorders include vascular dementia (VaD) [ 152 , 153 ], Parkinson's disease (PD) [ 154 ], Fronto-Temporal Dementia (FTD) [ 155 ] and Dementia with Lewy Bodies (DLB) [ 92 ], which are characterized by the accumulation of natural proteins in the CNS, as proteinopathies [ 156 ].

Vascular Dementia

The present study showed that exposure to air pollutants may have a direct effect on the incidence and progression of VaD. In a longitudinal study, Oudin et al. (2016) concluded that the probability of VaD diagnosis, with HR = 1.43, was higher among citizens with the highest exposure to traffic-related air pollution than those with low exposure [ 44 ]. These results were consistent with the study conducted by Cerza et al. (2019) [ 52 ]. In a longitudinal study on elderly men and women in Italy, they reported that chronic exposure to NO x , NO 2 , PM 10 and PM 2.5 has a positive relationship with VaD. In addition, a direct relationship between exposure to O 3 and NO x with dementia hospitalization was also observed (O 3 : HR = 1.06 per 10 μg/m 3 ; NO x : HR = 1.01; per 20 μg/m 3 ) [ 52 ].

According to the studies, chronic exposure to air pollutants can cause vascular damage caused by large vessel atherosclerosis and small vessel arteriosclerosis and cause cortical and subcortical infarcts, sub-infarct ischemic lesions, and large and small cerebral hemorrhages [ 153 , 157 ]. Researchers identify these factors as responsible for the initiation of VaD [ 153 ]. Moreover, dysfunction and degeneration of the neurovascular unit, which consists of a network of pericytes, myocytes, astrocytes, neurons, oligodendrocytes, endothelial cells and cerebral microvessels, aggravate the pathogenesis of VaD by disrupting the BBB [ 158 ]; which require hospital care to treat and prevent further side effects.

Also, the results obtained from a case–control study in Taiwan indicate that exposure to high levels of NO 2 significantly increases the risk of developing VaD [ 31 ]. According to the studies, some researchers showed that for an increase of 5 μg/m 3 NO 2 , the risk of VaD increases by 1.62 [ 74 ]. However, some studies have reached contradictory results. A cohort study conducted in England estimated the prevalence of VaD among men and women aged 50–79 years old at 29%, but found little evidence of the effect of air pollution on this neurological disorder [ 21 ]. Differences in results could be due to differences in instruments used, study design, and sample population characteristics.

VaD is a pathological condition in the elderly characterized by progressive cognitive dysfunction and is the second most common form of dementia, after AD [ 159 ]. This disorder is manifested by the loss of rationality, judgment skills, and especially cognitive functions and memory, and patients usually survive only 5–7 years after its onset [ 160 ]. Multifactorial etiopathology, diverse clinical manifestations, and numerous clinical subgroups are among the characteristics of VaD [ 152 ]. Chronic reduction in cerebral blood flow is one of the main characteristics of this neurological disorder [ 161 ], which results in the departure of brain blood vessels from regulation. This causes functional damage to capillaries, arteries and venules and damage to myelinated axons, and by creating a lesion in the white matter, it starts the pathophysiological process of VaD [ 162 ]. Small vessel disease (leukoaraiosis and lacunar infarcts), microinfarcts, microhemorrhages, cerebral amyloid angiopathy, and mixed vascular lesions are among the most important debilitating lesions of VaD [ 163 , 164 ]. In addition, chronic cerebral hypoperfusion (CCH) has been reported as the main cause of this type of dementia [ 163 , 165 ]. The results obtained from the studies indicate that CCH is associated with both neurodegeneration and dementia [ 166 , 167 ]. Studies have shown that exposure to PMs can increase CCH-induced white matter neurotoxicity by enhancing pathophysiology [ 168 , 169 ]. In a recent epidemiological study, Chen et al. (2015) showed that exposure to PM 2.5 was associated with a decrease in regional white matter volume in the corpus callosum and frontal/temporal lobes of elderly women [ 128 ], which is consistent with the results of the study by Erickson et al. (2020) was matched [ 170 ]. In addition, experimental data obtained from animal studies showed that exposure to air pollutants, especially PMs, causes changes in myelin in the CA1 area of the hippocampus in rodents [ 171 ], which can increase the risk of developing neurological disorders and types of dementia.

Dementia due to Parkinson’s disease

The results of the studies retrieved in this systematic review showed that dementia due to PD, a dementia that begins 1 year or more after well-established Parkinson's disease [ 92 ], can be considered as one of the adverse effects of exposure to air pollutants, especially PMs. Shi et al. (2020) in a national cohort study in the USA showed that for an annual increase of 5 μg/m 3 PM 2.5 , the probability of the first hospital admission due to PD and other related dementias will increase by 1.13 times for the American Medicare population (HR = 1.13) [ 75 ]. In this regard, Yuchi et al. (2020) also obtained similar results [ 32 ]. In a population-based cohort study in Canada, they proved that exposure to air pollutants increases the risk of PD (HR for PMs = 1.09, HR for BC = 1.03, HR for NO 2 = 1.12), but no relationship was observed on the occurrence of AD [ 32 ]. These results were consistent with those obtained from the studies of Rhew et al. (2021) [ 33 ], Yitshak-Sade et al. (2021) [ 61 ] and Calderón-Garcidueñas et al. [ 39 ].

The studies have demonstrated that over 80% of individuals with Parkinson's disease develop dementia [ 172 ]. Generally, the point prevalence of dementia in patients with Parkinson's has been determined to be approximately 25%, which has a higher prevalence in men than in women [ 173 ]. Researchers have proven that the risk of dementia increased as the duration of the disease increased, so that this probability reached 50% 10 years after the diagnosis of Parkinson's [ 91 ]. Research indicates that dementia occurs in patients who survive for more than 10 years [ 93 ].

PD, containing Lewy bodies and Lewy neurites, is one of the common brain disorders associated with aging and is characterized by the accumulation of α-synuclein in intracellular inclusions [ 154 ]. The main pathological characteristic of PD is the progressive loss of nigrostriatal dopaminergic neurons in the substantia nigra pars compacta, which causes Parkinsonism in PD patients [ 174 ]. Parkinsonism is a clinical syndrome characterized by rest tremor, rigidity, bradykinesia and gait dysfunction with postural instability [ 174 ]. Neurological disorders such as progressive supranuclear palsy (PSP), corticobasal syndrome (CBS), or FTD may overlap in their symptoms with PD [ 156 ]. Reports show that a significant number of people with PD suffer from cognitive impairment and PD dementia during their disease [ 172 , 175 ]. In some cases, co-existing pathology of TDP-43 can also be detected in PD patients [ 176 ]. TDP-43 is a protein biomarker whose accumulation can diagnose and classify neurological disorders [ 177 ]. The available evidence indicates that exposure to air pollutants plays a role in the accumulation of this protein [ 178 ]. Neuropathological examination of 44 children (average age 12.89 ± 4.9 years old) and 159 young adults (average age 29.2 ± 6.8 years old) living in Mexico City showed that exposure to PM 2.5 and O 3 pollutants can cause AD and PD in 23% of people. Furthermore, it causes TDP-43 pathology in 18.7% of cases [ 179 , 180 ], which is in line with the results of the present systematic review.

Fronto-Temporal Dementia

FTD is a group of neurodegenerative disorders and although clinically and pathologically heterogeneous, they mainly affect the frontal and/or temporal lobes of the brain [ 156 , 181 ]. This type of dementia is usually characterized by predominant frontal or temporal atrophy, and atrophy in the fronto-polar region is considered a special symptom of FTD [ 182 ]. The main clinical manifestations of FTD include two types of behavioral variant (bvFTD) and primary progressive aphasia (PPA). BvFTD mainly leads to personality changes and behavioral problems; While PPA causes gradual deterioration in speech/language and has a lower prevalence than bvFTD [ 183 ]. Primary Parkinsonism is observed in more than 20% of patients with FTD, mostly in bvFTD patients, and then non-fluent variant primary progressive aphasia occurs [ 184 ]. Each of the mentioned stages can have an effective role in reducing people's lives and increasing the economic burden for health systems by creating FTD.

In the current review, only two studies investigated FTD. Parra et al. (2022) concluded in a national cohort in the UK that there was a strong association between exposure to PM 2.5 , NO 2 , and NO x with the incidence of AD and VaD but not with FTD [ 73 ]. Meanwhile, Calderón-Garcidueñas et al. (2022) obtained completely contradictory results in the study of neurological disorders caused by exposure to PM 2.5 in young adults living in the metropolis of Mexico City [ 39 ]. They showed that chronic exposure to PM 2.5 higher than the values recommended by US-EPA causes a significant reduction of gray matter in higher-order cortical areas, which is usually associated with AD, PD and FTD in educated Mexicans [ 39 ]. The discrepancy in the results of these two studies can be explained by the difference in the number of cases, the age range of the cases, and the country under study.

Strengths and limitations of the study

Although several review studies related to exposure to air pollutants and the incidence of dementia have been published in recent years [ 135 , 185 , 186 , 187 ], the present systematic review has several notable strengths that distinguish our study from other review studies. First, this study is the most up-to-date systematic review published related to the role of chronic exposure to air pollutants on dementia (Alzheimer's/Non-Alzheimer's).

Second, unlike other studies, we did not impose any restrictions on publication time [ 135 ], study design [ 185 , 186 , 187 ], and geographic scope [ 185 ] in the systematic search, which allowed us to find more studies and more comprehensive results. In addition, we tried to perform a systematic search in the largest and the most reliable databases to ensure the inclusion of all eligible studies. This resulted in the extraction of 53 related studies that met the inclusion criteria for the present review. However, our investigations showed that none of the recent review articles discussed the current number of studies [ 135 , 185 , 186 , 187 ].

Third, due to the inclusion of an acceptable number of articles in the present systematic review, the results obtained from examining a substantial population of subjects, 173,698,774 people, were presented, which indicates the comprehensiveness and generalizability of the results of the present study.

Fourth, our study included types of dementia, such as Alzheimer's and non-Alzheimer's, and related dementias. This will help researchers to understand the impact of air pollution on each type of dementia and the action mechanism of pollutants in creating structural changes in the brain.

Fifth, in this study, in addition to criterion pollutants, other common and dangerous air pollutants, including FA, BTEX, and PAHs, were also investigated; these pollutants were not investigated in any of the published reviews.

However, the lack of access to the full texts of some studies and the examination of a limited number of pollutants were among the inevitable limitations of this systematic review.

Gaps and Recommendations

An in-depth review of published studies indicates the existence of some gaps in this important health field, including the lack of sufficient studies related to the role of air pollutants on FTD. As mentioned earlier, we could find only two studies related to the effect of exposure to PM 2.5 , PM 10 , NO 2 , and NO x on FTD [ 39 , 73 ], which makes it impossible to compare the results with each other. Therefore, it is recommended that more researchers investigate the impact of exposure to different pollutants in diverse populations on FTD, to cover this important gap.

Moreover, the presence of various confounding factors can also be effective in achieving contradictory results in studies. Researchers believe that factors such as aging, early retirement, smoking, body mass index (BMI), alcohol consumption, and physical inactivity are among the confounding factors that can accelerate the process of dementia [ 66 ]. Also, studies have proven that co-morbidities, such as cardiovascular diseases, cerebrovascular disease, diabetes and mental health, environmental tobacco smoke (ETS), chronic exposure to noise, insufficient sleep, and unhealthy diet can also play an effective role in occurring or developing dementia at an older age [ 188 ]. Research has identified several potential socioeconomic factors that can influence the relationship between air pollution exposure and neurological outcomes at the individual and regional levels. Based on this, living in deprived neighborhoods and on the outskirts of cities increases the possibility of exposure to high levels of air pollution [ 189 ]. Studies have also shown that lower levels of education, and poor access to socioeconomic benefits, such as health care, are associated with an increased risk of dementia in the future [ 190 , 191 ]. Therefore, it is necessary to consider strategies to control the impact of confounding factors to achieve more accurate results.

Also, due to the limited number of studies related to occupational exposure to pollutants in dementia, it is recommended to conduct more research to investigate occupational exposure in workers of different occupations and compare and analyze their results.

Since it has been proven that prenatal exposure is effective in the occurrence of some diseases in the future; therefore, it is recommended that cohort studies be designed and implemented to investigate the role of prenatal exposure to air pollutants and dementia at older ages.

The results of this systematic review showed that chronic exposure to air pollutants, especially PM 2.5 and NO 2 , could have a potential role in the development and progression of AD and non-Alzheimer's dementia in old age. The review of selected studies indicates that the relationship between exposure to PM 2.5 and then NO 2 and O 3 and suffering from dementia has been the focus of researchers in the last 5 years. No study was found that investigated the effect of FA on dementia and met the inclusion criteria for this study. In addition, BTEX and PAHs have been neglected by researchers, which is surprising due to the widespread presence of these pollutants in the environment and industries. Therefore, conducting more studies on the impact of other air pollutants, including FA, BTEX and PAHs, on the incidence of dementia and cognitive disorders is highly recommended. We believe that the identification and prevention of modifiable risk factors, such as exposure to toxic air in conjunction with behavioral interventions, can help prevent or delay the progression of neurodegenerative disorders and significantly reduce the burden of those disorders on society.

Availability of data and materials

Data sharing is not applicable to this article as no datasets were generated or analysed during the current study.

Code availability

Not applicable.

Abbreviations

Alzheimer's dementia

Blood-brain barrier

Black carbon

Benzene, Toluene, Ethylbenzene, and Xylenes

Chronic cerebral hypoperfusion

Dementia with Lewy Bodies

Disability-adjusted life years

Formaldehyde

Parkinson Disease

Particulate Matter

Particles with a diameter of 10 µm or less

Particles with a diameter of 2.5 µm or less

Polycyclic Aromatic Hydrocarbons

The Montreal Cognitive Assessment

World Health Organization

Crous-Bou M, Gascon M, Gispert JD, Cirach M, Sánchez-Benavides G, Falcon C, et al. Impact of urban environmental exposures on cognitive performance and brain structure of healthy individuals at risk for Alzheimer’s dementia. Environ Int. 2020;138:105546.

Article PubMed CAS Google Scholar

Shi L, Wu X, Danesh Yazdi M, Braun D, Abu Awad Y, Wei Y, et al. Long-term effects of PM2·5 on neurological disorders in the American Medicare population: a longitudinal cohort study. Lancet Planet Health. 2020;4(12):e557–65.

Article PubMed PubMed Central Google Scholar

Feigin VL, Nichols E, Alam T, Bannick MS, Beghi E, Blake N, et al. Global, regional, and national burden of neurological disorders, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet Neurol. 2019;18(5):459–80.

Article Google Scholar

Maragakis NJ, Rothstein JD. Mechanisms of Disease: astrocytes in neurodegenerative disease. Nat Clin Pract Neurol. 2006;2(12):679–89.

Lipnicki DM, Crawford JD, Dutta R, Thalamuthu A, Kochan NA, Andrews G, et al. Age-related cognitive decline and associations with sex, education and apolipoprotein E genotype across ethnocultural groups and geographic regions: a collaborative cohort study. PLoS Med. 2017;14(3):e1002261.

Gao Q, Zang E, Bi J, Dubrow R, Lowe SR, Chen H, et al. Long-term ozone exposure and cognitive impairment among Chinese older adults: A cohort study. Environ Int. 2022;160:107072.

Article PubMed PubMed Central CAS Google Scholar

Jia L, Quan M, Fu Y, Zhao T, Li Y, Wei C, et al. Dementia in China: epidemiology, clinical management, and research advances. Lancet Neurol. 2020;19(1):81–92.

Article PubMed Google Scholar

WHO. Global status report on the public health response to dementia 2021 [Available from: https://www.who.int/publications/i/item/9789240033245 .

Nichols E, Szoeke CE, Vollset SE, Abbasi N, Abd-Allah F, Abdela J, et al. Global, regional, and national burden of Alzheimer’s disease and other dementias, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet Neurol. 2019;18(1):88–106.

Gachupin F, Romero MD, Ortega WJ, Jojola R, Hendrie H, Torres EP, et al. Cognition, Depressive Symptoms and Vascular Factors among Southwest Tribal Elders. Ethn Dis. 2016;26(2):235–44.

Park KM, Sung JM, Kim WJ, An SK, Namkoong K, Lee E, et al. Population-based dementia prediction model using Korean public health examination data: A cohort study. PLoS ONE. 2019;14(2):e0211957.

Ran J, Zhang Y, Han L, Sun S, Zhao S, Shen C, et al. The joint association of physical activity and fine particulate matter exposure with incident dementia in elderly Hong Kong residents. Environ Int. 2021;156.

Aridi Y S, Walker J L, Wright ORL. The Association between the Mediterranean Dietary Pattern and Cognitive Health: A Systematic Review. Nutrients [Internet]. 2017;9(7):674.

Solfrizzi V, Custodero C, Lozupone M, Imbimbo BP, Valiani V, Agosti P, et al. Relationships of Dietary Patterns, Foods, and Micro- and Macronutrients with Alzheimer’s Disease and Late-Life Cognitive Disorders: A Systematic Review. J Alzheimer’s Dis. 2017;59:815–49.

Article CAS Google Scholar

Block ML, Calderón-Garcidueñas L. Air pollution: mechanisms of neuroinflammation and CNS disease. Trends Neurosci. 2009;32(9):506–16.

Calderón-Garcidueñas L, Azzarelli B, Acuna H, Garcia R, Gambling TM, Osnaya N, et al. Air pollution and brain damage. Toxicol Pathol. 2002;30(3):373–89.

Jeremy W. Air pollution and brain health: an emerging issue. Lancet. 2017;390:1345–422.

Google Scholar

Mork D, Braun D, Zanobetti A. Time-lagged relationships between a decade of air pollution exposure and first hospitalization with Alzheimer’s disease and related dementias. Environ Int. 2023;171.

Li Z, Christensen GM, Lah JJ, Marcus M, Russell AG, Ebelt S, et al. Neighborhood characteristics as confounders and effect modifiers for the association between air pollution exposure and subjective cognitive functioning. Environ Res. 2022;212.

Livingston G, Huntley J, Sommerlad A, Ames D, Ballard C, Banerjee S, et al. Dementia prevention, intervention, and care: 2020 report of the Lancet Commission. Lancet. 2020;396(10248):413–46.

Carey IM, Anderson HR, Atkinson RW, Beevers SD, Cook DG, Strachan DP, et al. Are noise and air pollution related to the incidence of dementia? A cohort study in London, England. BMJ Open. 2018;8(9).

Mortamais M, Gutierrez L-A, de Hoogh K, Chen J, Vienneau D, Carrière I, et al. Long-term exposure to ambient air pollution and risk of dementia: Results of the prospective Three-City Study. Environ Int. 2021;148.

Guxens M, Lubczyńska MJ, Muetzel RL, Dalmau-Bueno A, Jaddoe VWV, Hoek G, et al. Air Pollution Exposure During Fetal Life, Brain Morphology, and Cognitive Function in School-Age Children. Biol Psychiatry. 2018;84(4):295–303.

Pujol J, Martínez-Vilavella G, Macià D, Fenoll R, Alvarez-Pedrerol M, Rivas I, et al. Traffic pollution exposure is associated with altered brain connectivity in school children. Neuroimage. 2016;129:175–84.

Forns J, Dadvand P, Foraster M, Alvarez-Pedrerol M, Rivas I, López-Vicente M, et al. Traffic-Related Air Pollution, Noise at School, and Behavioral Problems in Barcelona Schoolchildren: A Cross-Sectional Study. Environ Health Perspect. 2016;124(4):529–35.

Suades-González E, Gascon M, Guxens M, Sunyer J. Air Pollution and Neuropsychological Development: A Review of the Latest Evidence. Endocrinology. 2015;156(10):3473–82.

Rethlefsen ML, Kirtley S, Waffenschmidt S, Ayala AP, Moher D, Page MJ, et al. PRISMA-S: an extension to the PRISMA Statement for Reporting Literature Searches in Systematic Reviews. Syst Rev. 2021;10(1):39.

Santos WMd, Secoli SR, Püschel VAdA. The Joanna Briggs Institute approach for systematic reviews. Revista latino-americana de enfermagem. 2018;26:3074.

Kukull WA, Larson EB, Bowen JD, McCormick WC, Teri L, Pfanschmidt ML, et al. Solvent Exposure as a Risk Factor for Alzheimer’s Disease: A Case-Control Study. Am J Epidemiol. 1995;141(11):1059–71.

Wu Y-C, Lin Y-C, Yu H-L, Chen J-H, Chen T-F, Sun Y, et al. Association between air pollutants and dementia risk in the elderly. Alzheimer’s Dement. Diagn Assess Dis Monit. 2015;1(2):220–8.

Li C-Y, Li C-H, Martini S, Hou W-H. Association between air pollution and risk of vascular dementia: A multipollutant analysis in Taiwan. Environ Int. 2019;133: 105233.

Yuchi W, Sbihi H, Davies H, Tamburic L, Brauer M. Road proximity, air pollution, noise, green space and neurologic disease incidence: a population-based cohort study. Environ Health. 2020;19(1):8.

Rhew SH, Kravchenko J, Lyerly HK. Exposure to low-dose ambient fine particulate matter PM2.5 and Alzheimer’s disease, non-Alzheimer’s dementia, and Parkinson’s disease in North Carolina. PLOS ONE. 2021;16(7):e0253253.

Lin FC, Chen CY, Lin CW, Wu MT, Chen HY, Huang P. Air Pollution Is Associated with Cognitive Deterioration of Alzheimer’s Disease. Gerontology. 2021;68(1):53–61.

Tan J, Li N, Wang X, Chen G, Yan L, Wang L, et al. Associations of particulate matter with dementia and mild cognitive impairment in China: A multicenter cross-sectional study. The Innovation. 2021;2(3).

Petkus AJ, Younan D, Wang X, Beavers DP, Espeland MA, Gatz M, et al. Associations Between Air Pollution Exposure and Empirically Derived Profiles of Cognitive Performance in Older Women. J Alzheimer’s Dis. 2021;84:1691–707.

Semmens EO, Leary CS, Fitzpatrick AL, Ilango SD, Park C, Adam CE, et al. Air pollution and dementia in older adults in the Ginkgo Evaluation of Memory Study. Alzheimers Dement. 2023;19(2):549–59.

Calderón-Garcidueñas L, Chávez-Franco DA, Luévano-Castro SC, Macías-Escobedo E, Hernández-Castillo A, Carlos-Hernández E, et al. Metals, Nanoparticles, Particulate Matter, and Cognitive Decline. Front neurol. 2022;12:794071.

Calderón-Garcidueñas L, Hernández-Luna J, Mukherjee P S, Styner M, Chávez-Franco D A, Luévano-Castro S C, et al. Hemispheric Cortical, Cerebellar and Caudate Atrophy Associated to Cognitive Impairment in Metropolitan Mexico City Young Adults Exposed to Fine Particulate Matter Air Pollution. Toxics [Internet]. 2022;10(4):156.

Zhang H, Shi L, Ebelt S T, D’Souza R R, Schwartz J D, Scovronick N, et al. Short-term associations between ambient air pollution and emergency department visits for Alzheimer’s disease and related dementias. Environmental Epidemiology. 2022;7(1):e237.

Ranft U, Schikowski T, Sugiri D, Krutmann J, Krämer U. Long-term exposure to traffic-related particulate matter impairs cognitive function in the elderly. Environ Res. 2009;109(8):1004–11.

Chang K-H, Chang M-Y, Muo C-H, Wu T-N, Chen C-Y, Kao C-H. Increased Risk of Dementia in Patients Exposed to Nitrogen Dioxide and Carbon Monoxide: A Population-Based Retrospective Cohort Study. PLoS ONE. 2014;9(8): e103078.

Jung C-R, Lin Y-T, Hwang B-F. Ozone, Particulate Matter, and Newly Diagnosed Alzheimer’s Disease: A Population-Based Cohort Study in Taiwan. J Alzheimer’s Dis. 2015;44:573–84.

Oudin A, Forsberg B, Adolfsson Annelie N, Lind N, Modig L, Nordin M, et al. Traffic-Related Air Pollution and Dementia Incidence in Northern Sweden: A Longitudinal Study. Environ Health Perspect. 2016;124(3):306–12.

Chen H, Kwong JC, Copes R, Hystad P, van Donkelaar A, Tu K, et al. Exposure to ambient air pollution and the incidence of dementia: A population-based cohort study. Environ Int. 2017;108:271–7.

Culqui DR, Linares C, Ortiz C, Carmona R, Díaz J. Association between environmental factors and emergency hospital admissions due to Alzheimer’s disease in Madrid. Sci Total Environ. 2017;592:451–7.

Chen J-C, Wang X, Serre M. Particulate Air Pollutants, Brain Structure, and Neurocognitive Disorders in Older Women. Res Rep Health Eff Inst. 2017;2017(193):1–65.

PubMed Google Scholar

Andersson J, Oudin A, Sundström A, Forsberg B, Adolfsson R, Nordin M. Road traffic noise, air pollution, and risk of dementia – results from the Betula project. Environ Res. 2018;166:334–9.

Oudin A, Segersson D, Adolfsson R, Forsberg B. Association between air pollution from residential wood burning and dementia incidence in a longitudinal study in Northern Sweden. PLoS ONE. 2018;13(6):e0198283.

Lee H, Kang JM, Myung W, Choi J, Lee C, Na DL, et al. Exposure to ambient fine particles and neuropsychiatric symptoms in cognitive disorder: A repeated measure analysis from the CREDOS (Clinical Research Center for Dementia of South Korea) study. Sci Total Environ. 2019;668:411–8.

Li R-L, Ho Y-C, Luo C-W, Lee S-S, Kuan Y-H. Influence of PM2.5 Exposure Level on the Association between Alzheimer’s Disease and Allergic Rhinitis: A National Population-Based Cohort Study. Int J Environ Res Public Health [Internet]. 2019;16(18):3357.

Cerza F, Renzi M, Gariazzo C, Davoli M, Michelozzi P, Forastiere F, et al. Long-term exposure to air pollution and hospitalization for dementia in the Rome longitudinal study. Environ Health. 2019;18(1):72.

Oudin A, Andersson J, Sundström A, Nordin Adolfsson A, Oudin Åström D, Adolfsson R, et al. Traffic-related air pollution as a risk factor for dementia: no clear modifying effects of APOE ɛ4 in the Betula cohort. J Alzheimer’s Dis. 2019;71(3):733–40.

Zhang H-W, Kok VC, Chuang S-C, Tseng C-H, Lin C-T, Li T-C, et al. Long-Term Exposure to Ambient Hydrocarbons Increases Dementia Risk in People Aged 50 Years and above in Taiwan. Curr Alzheimer Res. 2019;16(14):1276–89.

Smargiassi A, Sidi EAL, Robert L-E, Plante C, Haddad M, Gamache P, et al. Exposure to ambient air pollutants and the onset of dementia in Québec. Canada Environ Res. 2020;190:109870.

Ilango SD, Chen H, Hystad P, van Donkelaar A, Kwong JC, Tu K, et al. The role of cardiovascular disease in the relationship between air pollution and incident dementia: a population-based cohort study. Int J Epidemiol. 2020;49(1):36–44.

Paul KC, Haan M, Yu Y, Inoue K, Mayeda ER, Dang K, et al. Traffic-related air pollution and incident dementia: direct and indirect pathways through metabolic dysfunction. J Alzheimer’s Dis. 2020;76(4):1477–91.

Ran J, Schooling CM, Han L, Sun S, Zhao S, Zhang X, et al. Long-term exposure to fine particulate matter and dementia incidence: A cohort study in Hong Kong. Environ Pollut. 2021;271:116303.

Shaffer Rachel M, Blanco Magali N, Li G, Adar Sara D, Carone M, Szpiro Adam A, et al. Fine Particulate Matter and Dementia Incidence in the Adult Changes in Thought Study. Environ Health Perspect. 2021;129(8):087001.

Diana Y, Xinhui W, Ramon C, Ryan B, Sarah AG, Santiago S, et al. PM<sub>2.5</sub> Associated With Gray Matter Atrophy Reflecting Increased Alzheimer Risk in Older Women. Neurology. 2021;96(8):e1190.

Yitshak-Sade M, Nethery R, Schwartz J D, Mealli F, Dominici F, Di Q, et al. PM2.5 and hospital admissions among Medicare enrollees with chronic debilitating brain disorders. Sci Total Environ. 2021;755:142524.

Shaffer RM, Li G, Adar SD, Dirk Keene C, Latimer CS, Crane PK, et al. Fine Particulate Matter and Markers of Alzheimer’s Disease Neuropathology at Autopsy in a Community-Based Cohort. J Alzheimer’s Dis. 2021;79:1761–73.

Sullivan KJ, Ran X, Wu F, Chang C-CH, Sharma R, Jacobsen E, et al. Ambient fine particulate matter exposure and incident mild cognitive impairment and dementia. J Am Geriatr Soc. 2021;69(8):2185–94.

Kriit HK, Forsberg B, Åström DO, Oudin A. Annual dementia incidence and monetary burden attributable to fine particulate matter (PM2.5) exposure in Sweden. Environmental Health. 2021;20(1):65.

Shi L, Steenland K, Li H, Liu P, Zhang Y, Lyles RH, et al. A national cohort study (2000–2018) of long-term air pollution exposure and incident dementia in older adults in the United States. Nat Commun. 2021;12(1):6754.

Wu J, Grande G, Stafoggia M, Ljungman P, Laukka EJ, Eneroth K, et al. Air pollution as a risk factor for Cognitive Impairment no Dementia (CIND) and its progression to dementia: A longitudinal study. Environ Int. 2022;160: 107067.

Andersen ZJ, Zhang J, Jørgensen JT, Samoli E, Liu S, Chen J, et al. Long-term exposure to air pollution and mortality from dementia, psychiatric disorders, and suicide in a large pooled European cohort: ELAPSE study. Environ Int. 2022;170:107581.

Younan D, Wang X, Gruenewald T, Gatz M, Serre ML, Vizuete W, et al. Racial/Ethnic Disparities in Alzheimer’s Disease Risk: Role of Exposure to Ambient Fine Particles. The Journals of Gerontology: Series A. 2022;77(5):977–85.

He F, Tang J, Zhang T, Lin J, Li F, Gu X, et al. Impact of air pollution exposure on the risk of Alzheimer’s disease in China: A community-based cohort study. Environ Res. 2022;205:112318.

Wood D, Evangelopoulos D, Beevers S, Kitwiroon N, Katsouyanni K. Exposure to Ambient Air Pollution and the Incidence of Dementia in the Elderly of England: The ELSA Cohort. Int J Environ Res Public Health [Internet]. 2022;19(23):15889.

Chen C, Whitsel EA, Espeland MA, Snetselaar L, Hayden KM, Lamichhane AP, et al. B vitamin intakes modify the association between particulate air pollutants and incidence of all-cause dementia: Findings from the Women’s Health Initiative Memory Study. Alzheimers Dement. 2022;18(11):2188–98.

Letellier N, Gutierrez L-A, Duchesne J, Chen C, Ilango S, Helmer C, et al. Air quality improvement and incident dementia: Effects of observed and hypothetical reductions in air pollutant using parametric g-computation. Alzheimers Dement. 2022;18(12):2509–17.

Parra KL, Alexander GE, Raichlen DA, Klimentidis YC, Furlong MA. Exposure to air pollution and risk of incident dementia in the UK Biobank. Environ Res. 2022;209: 112895.

Trevenen ML, Heyworth J, Almeida OP, Yeap BB, Hankey GJ, Golledge J, et al. Ambient air pollution and risk of incident dementia in older men living in a region with relatively low concentrations of pollutants: The Health in Men Study. Environ Res. 2022;215.

Shi L, Zhu Q, Wang Y, Hao H, Zhang H, Schwartz J, et al. Incident dementia and long-term exposure to constituents of fine particle air pollution: A national cohort study in the United States. Proc Natl Acad Sci. 2023;120(1).

Folstein MF, Folstein SE, McHugh PR. “Mini-mental state”: a practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res. 1975;12(3):189–98.

Nasreddine ZS, Phillips NA, Bédirian V, Charbonneau S, Whitehead V, Collin I, et al. The Montreal Cognitive Assessment, MoCA: A Brief Screening Tool For Mild Cognitive Impairment. J Am Geriatr Soc. 2005;53(4):695–9.

Damian AM, Jacobson SA, Hentz JG, Belden CM, Shill HA, Sabbagh MN, et al. The Montreal Cognitive Assessment and the Mini-Mental State Examination as Screening Instruments for Cognitive Impairment: Item Analyses and Threshold Scores. Dement Geriatr Cogn Disord. 2011;31(2):126–31.

Freitas S, Simões MR, Alves L, Santana I. Montreal cognitive assessment: validation study for mild cognitive impairment and Alzheimer disease. Alzheimer Dis Assoc Disord. 2013;27(1):37–43.

Fasnacht JS, Wueest AS, Berres M, Thomann AE, Krumm S, Gutbrod K, et al. Conversion between the Montreal Cognitive Assessment and the Mini-Mental Status Examination. J Am Geriatr Soc. 2023;71(3):869–79.

Khachiyants N, Kim k. Mini-mental status examination mapping to the corresponding brain areas in dementia. Appl technol innov. 2012;12(3):60–3.

Tombaugh TN, McIntyre NJ. The Mini-Mental State Examination: A Comprehensive Review. J Am Geriatr Soc. 1992;40(9):922–35.

Ciesielska N, Sokołowski R, Mazur E, Podhorecka M, Polak-Szabela A, Kędziora-Kornatowska K. Is the Montreal Cognitive Assessment (MoCA) test better suited than the Mini-Mental State Examination (MMSE) in mild cognitive impairment (MCI) detection among people aged over 60? Meta-analysis Psychiatr Pol. 2016;50(5):1039–52.

Dong Y, Lee WY, Basri NA, Collinson SL, Merchant RA, Venketasubramanian N, et al. The Montreal Cognitive Assessment is superior to the Mini-Mental State Examination in detecting patients at higher risk of dementia. Int Psychogeriatr. 2012;24(11):1749–55.

Larner AJ. Screening utility of the Montreal Cognitive Assessment (MoCA): in place of – or as well as – the MMSE? Int Psychogeriatr. 2012;24(3):391–6.

Breton A, Casey D, Arnaoutoglou NA. Cognitive tests for the detection of mild cognitive impairment (MCI), the prodromal stage of dementia: Meta-analysis of diagnostic accuracy studies. Int J Geriatr Psychiatry. 2019;34(2):233–42.

Pinto TC, Machado L, Bulgacov TM, Rodrigues-Júnior AL, Costa ML, Ximenes RC, et al. Is the Montreal Cognitive Assessment (MoCA) screening superior to the Mini-Mental State Examination (MMSE) in the detection of mild cognitive impairment (MCI) and Alzheimer’s Disease (AD) in the elderly? Int Psychogeriatr. 2019;31(4):491–504.

Pendlebury ST, Markwick A, de Jager CA, Zamboni G, Wilcock GK, Rothwell PM. Differences in Cognitive Profile between TIA, Stroke and Elderly Memory Research Subjects: A Comparison of the MMSE and MoCA. Cerebrovasc Dis. 2012;34(1):48–54.

Siqueira GSA, Hagemann PdMS, Coelho DdS, Santos FHD, Bertolucci PHF. Can MoCA and MMSE Be Interchangeable Cognitive Screening Tools? A Systematic Review. Gerontol. 2019;59(6):e743–63.

Lloret A, Esteve D, Lloret M-A, Cervera-Ferri A, Lopez B, Nepomuceno M, et al. When Does Alzheimer′s Disease Really Start? The Role of Biomarkers. Int J Mol Sci. 2019;20(22):5536.

Williams-Gray CH, Mason SL, Evans JR, Foltynie T, Brayne C, Robbins TW, et al. The CamPaIGN study of Parkinson’s disease: 10-year outlook in an incident population-based cohort. J Neurol Neurosurg Psychiatry. 2013;84(11):1258–64.

Walker Z, Possin KL, Boeve BF, Aarsland D. Lewy body dementias. Lancet. 2015;386(10004):1683–97.

Svenningsson P, Westman E, Ballard C, Aarsland D. Cognitive impairment in patients with Parkinson’s disease: diagnosis, biomarkers, and treatment. Lancet Neurol. 2012;11(8):697–707.

Pedersen KF, Larsen JP, Tysnes O-B, Alves G. Prognosis of Mild Cognitive Impairment in Early Parkinson Disease: The Norwegian ParkWest Study. JAMA Neurol. 2013;70(5):580–6.

Williams-Gray CH, Evans JR, Goris A, Foltynie T, Ban M, Robbins TW, et al. The distinct cognitive syndromes of Parkinson’s disease: 5 year follow-up of the CamPaIGN cohort. Brain. 2009;132(11):2958–69.

Aarsland D, Kvaløy JT, Andersen K, Larsen JP, Tang MX, Lolk A, et al. The effect of age of onset of PD on risk of dementia. J Neurol. 2007;254(1):38–45.

Ballard C, Gauthier S, Corbett A, Brayne C, Aarsland D, Jones E. Alzheimer’s disease. Lancet. 2011;377(9770):1019–31.

Bobinski M, de Leon MJ, Wegiel J, DeSanti S, Convit A, Saint Louis LA, et al. The histological validation of post mortem magnetic resonance imaging-determined hippocampal volume in Alzheimer’s disease. Neuroscience. 1999;95(3):721–5.

Dubois B, Feldman HH, Jacova C, DeKosky ST, Barberger-Gateau P, Cummings J, et al. Research criteria for the diagnosis of Alzheimer’s disease: revising the NINCDS–ADRDA criteria. Lancet Neurol. 2007;6(8):734–46.

Jack CR, Knopman DS, Jagust WJ, Shaw LM, Aisen PS, Weiner MW, et al. Hypothetical model of dynamic biomarkers of the Alzheimer’s pathological cascade. Lancet Neurol. 2010;9(1):119–28.

Scheltens P, Blennow K, Breteler MMB, de Strooper B, Frisoni GB, Salloway S, et al. Alzheimer’s disease. Lancet. 2016;388(10043):505–17.

Frisoni GB, Fox NC, Jack CR, Scheltens P, Thompson PM. The clinical use of structural MRI in Alzheimer disease. Nat Rev Neurol. 2010;6(2):67–77.

Fiandaca MS, Mapstone ME, Cheema AK, Federoff HJ. The critical need for defining preclinical biomarkers in Alzheimer’s disease. Alzheimers Dement. 2014;10(3S):S196–212.

Val JL, Bradley JK, Clifford R, Jack Jr, Matthew S, Stephen W, Maria S, et al. Comparison of 18 F-FDG and PiB PET in Cognitive Impairment. J Nucl Med. 2009;50(6):878.

Toledo JB, Xie SX, Trojanowski JQ, Shaw LM. Longitudinal change in CSF Tau and Aβ biomarkers for up to 48 months in ADNI. Acta Neuropathol. 2013;126(5):659–70.

Ewers M, Brendel M, Rizk-Jackson A, Rominger A, Bartenstein P, Schuff N, et al. Reduced FDG-PET brain metabolism and executive function predict clinical progression in elderly healthy subjects. Neuroimage Clin. 2014;4:45–52.

Martin SB, Smith CD, Collins HR, Schmitt FA, Gold BT. Evidence that volume of anterior medial temporal lobe is reduced in seniors destined for mild cognitive impairment. Neurobiol Aging. 2010;31(7):1099–106.

Dickerson BC, Stoub TR, Shah RC, Sperling RA, Killiany RJ, Albert MS, et al. Alzheimer-signature MRI biomarker predicts AD dementia in cognitively normal adults. Neurology. 2011;76(16):1395.

Bradford CD, David AW. MRI cortical thickness biomarker predicts AD-like CSF and cognitive decline in normal adults. Neurology. 2012;78(2):84.

Fox NC, Crum WR, Scahill RI, Stevens JM, Janssen JC, Rossor MN. Imaging of onset and progression of Alzheimer’s disease with voxel-compression mapping of serial magnetic resonance images. Lancet. 2001;358(9277):201–5.

Jayaraj RL, Rodriguez EA, Wang Y, Block ML. Outdoor Ambient Air Pollution and Neurodegenerative Diseases: the Neuroinflammation Hypothesis. Curr Environ Health Rep. 2017;4(2):166–79.

Araujo JA, Barajas B, Kleinman M, Wang X, Bennett BJ, Gong KW, et al. Ambient Particulate Pollutants in the Ultrafine Range Promote Early Atherosclerosis and Systemic Oxidative Stress. Circ Res. 2008;102(5):589–96.

Cheng L, Lau WKW, Fung TKH, Lau BWM, Chau BKH, Liang Y, et al. PM 2.5 Exposure Suppresses Dendritic Maturation in Subgranular Zone in Aged Rats. Neurotox Res. 2017;32(1):50–7.

Ku T, Li B, Gao R, Zhang Y, Yan W, Ji X, et al. NF-κB-regulated microRNA-574-5p underlies synaptic and cognitive impairment in response to atmospheric PM 2.5 aspiration. Part Fibre Toxicol. 2017;14(1):34.

Liu X, Qian X, Xing J, Wang J, Sun Y, Wang Qg, et al. Particulate Matter Triggers Depressive-Like Response Associated With Modulation of Inflammatory Cytokine Homeostasis and Brain-Derived Neurotrophic Factor Signaling Pathway in Mice. Toxicol Sci. 2018;164(1):278–88.

Weuve J, Puett RC, Schwartz J, Yanosky JD, Laden F, Grodstein F. Exposure to Particulate Air Pollution and Cognitive Decline in Older Women. Arch Intern Med. 2012;172(3):219–27.

Tonne C, Elbaz A, Beevers S, Singh-Manoux A. Traffic-related air pollution in relation to cognitive function in older adults. Epidemiology. 2014;25(5):674–81.

Wurth R, Kioumourtzoglou MA, Tucker KL, Griffith J, Manjourides J, Suh H. Fine Particle Sources and Cognitive Function in An Older Puerto Rican Cohort in Greater Boston. Environ Epidemiol. 2018;2(3): e022.

Gallagher M, Koh MT. Episodic memory on the path to Alzheimer’s disease. Curr Opin Neurobiol. 2011;21(6):929–34.

Aisen PS, Cummings J, Jack CR, Morris JC, Sperling R, Frölich L, et al. On the path to 2025: understanding the Alzheimer’s disease continuum. Alzheimers Res Ther. 2017;9(1):60.

Dickerson BC, Eichenbaum H. The Episodic Memory System: Neurocircuitry and Disorders. Neuropsychopharmacology. 2010;35(1):86–104.

Zhao W, W, Wang X, X, Yin C, He M, Li S, Han Y. Trajectories of the Hippocampal Subfields Atrophy in the Alzheimer’s Disease: A Structural Imaging Study. Front Neuroinform. 2019;13:13.

Fonken LK, Xu X, Weil ZM, Chen G, Sun Q, Rajagopalan S, et al. Air pollution impairs cognition, provokes depressive-like behaviors and alters hippocampal cytokine expression and morphology. Mol Psychiatry. 2011;16(10):987–95.

Davis DA, Akopian G, Walsh JP, Sioutas C, Morgan TE, Finch CE. Urban air pollutants reduce synaptic function of CA1 neurons via an NMDA/NȮ pathway in vitro. J Neurochem. 2013;127(4):509–19.

Woodward NC, Pakbin P, Saffari A, Shirmohammadi F, Haghani A, Sioutas C, et al. Traffic-related air pollution impact on mouse brain accelerates myelin and neuritic aging changes with specificity for CA1 neurons. Neurobiol Aging. 2017;53:48–58.

Zammit AR, Ezzati A, Zimmerman ME, Lipton RB, Lipton ML, Katz MJ. Roles of hippocampal subfields in verbal and visual episodic memory. Behav Brain Res. 2017;317:157–62.

Casanova R, Wang X, Reyes J, Akita Y, Serre ML, Vizuete W, et al. A Voxel-Based Morphometry Study Reveals Local Brain Structural Alterations Associated with Ambient Fine Particles in Older Women. Front Hum Neurosci. 2016;10:495.

Chen J-C, Wang X, Wellenius GA, Serre ML, Driscoll I, Casanova R, et al. Ambient air pollution and neurotoxicity on brain structure: Evidence from women’s health initiative memory study. Ann Neurol. 2015;78(3):466–76.

Cho J, Noh Y, Kim SY, Sohn J, Noh J, Kim W, et al. Long-term ambient air pollution exposures and brain imaging markers in Korean adults: the Environmental Pollution-Induced Neurological EFfects (EPINEF) study. Environ Health Perspect. 2020;128(11).

Power MC, Lamichhane AP, Liao D, Xu X, Jack CR, Gottesman RF, et al. The association of long-term exposure to particulate matter air pollution with brain MRI findings: the ARIC study. Environ Health Perspect. 2018;126(2): 027009.

Wilker EH, Preis SR, Beiser AS, Wolf PA, Au R, Kloog I, et al. Long-term exposure to fine particulate matter, residential proximity to major roads and measures of brain structure. Stroke. 2015;46(5):1161–6.

Bejanin A, Schonhaut DR, La Joie R, Kramer JH, Baker SL, Sosa N, et al. Tau pathology and neurodegeneration contribute to cognitive impairment in Alzheimer’s disease. Brain. 2017;140(12):3286–300.

Jagust W. Imaging the evolution and pathophysiology of Alzheimer disease. Nat Rev Neurosci. 2018;19(11):687–700.

Harrison TM, La Joie R, Maass A, Baker SL, Swinnerton K, Fenton L, et al. Longitudinal tau accumulation and atrophy in aging and alzheimer disease. Ann Neurol. 2019;85(2):229–40.

Power MC, Adar SD, Yanosky JD, Weuve J. Exposure to air pollution as a potential contributor to cognitive function, cognitive decline, brain imaging, and dementia: A systematic review of epidemiologic research. Neurotoxicology. 2016;56:235–53.

Schwartz M, Deczkowska A. Neurological Disease as a Failure of Brain-Immune Crosstalk: The Multiple Faces of Neuroinflammation. Trends Immunol. 2016;37(10):668–79.

Zhu X, Raina AK, Lee H-g, Casadesus G, Smith MA, Perry G. Oxidative stress signalling in Alzheimer’s disease. Brain Res. 2004;1000(1–2):32–9.

Gruzieva O, Merid SK, Gref A, Gajulapuri A, Lemonnier N, Ballereau S, et al. Exposure to traffic-related air pollution and serum inflammatory cytokines in children. Environ Health Perspect. 2017;125(6).

Alemany S, Crous-Bou M, Vilor-Tejedor N, Milà-Alomà M, Suárez-Calvet M, Salvadó G, et al. Associations between air pollution and biomarkers of Alzheimer’s disease in cognitively unimpaired individuals. Environ Int. 2021;157.

Ma Y-H, Chen H-S, Liu C, Feng Q-S, Feng L, Zhang Y-R, et al. Association of Long-term Exposure to Ambient Air Pollution With Cognitive Decline and Alzheimer’s Disease-Related Amyloidosis. Biol Psychiatry. 2023;93(9):780–9.

Jack CR, Holtzman DM. Biomarker modeling of Alzheimer’s disease. Neuron. 2013;80(6):1347–58.

Dubois B, Hampel H, Feldman HH, Scheltens P, Aisen P, Andrieu S, et al. Preclinical Alzheimer’s disease: Definition, natural history, and diagnostic criteria. Alzheimers Dement. 2016;12(3):292–323.

Buchhave P, Minthon L, Zetterberg H, Wallin ÅK, Blennow K, Hansson O. Cerebrospinal Fluid Levels ofβ-Amyloid 1–42, but Not of Tau, Are Fully Changed Already 5 to 10 Years Before the Onset of Alzheimer Dementia. Arch Gen Psychiatry. 2012;69(1):98–106.

Calderón-Garcidueñas L, Solt AC, Henríquez-Roldán C, Torres-Jardón R, Nuse B, Herritt L, et al. Long-term air pollution exposure is associated with neuroinflammation, an altered innate immune response, disruption of the blood-brain barrier, ultrafine particulate deposition, and accumulation of amyloid β-42 and α-synuclein in children and young adults. Toxicol Pathol. 2008;36(2):289–310.

Fu M, Wang H, Bai Q, Du J, Niu Q, Nie J. Urinary polycyclic aromatic hydrocarbon metabolites, plasma p-tau231 and mild cognitive impairment in coke oven workers. Chemosphere. 2022;307.

Cleveland DW, Hwo S-Y, Kirschner MW. Physical and chemical properties of purified tau factor and the role of tau in microtubule assembly. J Mol Biol. 1977;116(2):227–47.

Medeiros R, Baglietto-Vargas D, LaFerla FM. The Role of Tau in Alzheimer’s Disease and Related Disorders. CNS Neurosci Ther. 2011;17(5):514–24.

Suárez-Calvet M, Karikari TK, Ashton NJ, Lantero Rodriguez J, Milà-Alomà M, Gispert JD, et al. Novel tau biomarkers phosphorylated at T181, T217 or T231 rise in the initial stages of the preclinical Alzheimer’s continuum when only subtle changes in Aβ pathology are detected. EMBO Mol Med. 2020;12(12).

Baek MS, Lee MJ, Kim H-K, Lyoo CH. Temporal trajectory of biofluid markers in Parkinson’s disease. Sci Rep. 2021;11(1):14820.

Nie J, Duan L, Yan Z, Niu Q. Tau Hyperphosphorylation is Associated with Spatial Learning and Memory After Exposure to Benzo[a]pyrene in SD Rats. Neurotox Res. 2013;24(4):461–71.

Isaksen JL, Ghouse J, Skov MW, Olesen MS, Holst AG, Pietersen A, et al. Associations between primary care electrocardiography and non-Alzheimer dementia. Journal of Stroke and Cerebrovasc Dis. 2022;31(9).

Kuang H, Zhou ZF, Zhu YG, Wan ZK, Yang MW, Hong FF, et al. Pharmacological Treatment of Vascular Dementia: A Molecular Mechanism Perspective. Aging Dis. 2021;12(1):308–26.

O’Brien JT, Thomas A. Vascular dementia. Lancet. 2015;386(10004):1698–706.

Aarsland D, Creese B, Politis M, Chaudhuri KR, ffytche DH, Weintraub D, et al. Cognitive decline in Parkinson disease. Nat Rev Neurol. 2AD;13(4):217–31.

Bang J, Spina S, Miller BL. Frontotemporal dementia. Lancet. 2015;386(10004):1672–82.

Ashton NJ, Hye A, Rajkumar AP, Leuzy A, Snowden S, Suárez-Calvet M, et al. An update on blood-based biomarkers for non-Alzheimer neurodegenerative disorders. Nat Rev Neurol. 2020;16(5):265–84.

Künzli N, Jerrett M, Mack Wendy J, Beckerman B, LaBree L, Gilliland F, et al. Ambient Air Pollution and Atherosclerosis in Los Angeles. Environ Health Perspect. 2005;113(2):201–6.

Sweeney MD, Ayyadurai S, Zlokovic BV. Pericytes of the neurovascular unit: key functions and signaling pathways. Nat Neurosci. 2016;19(6):771–83.

Pandey T, Abubacker S. Cerebral Autosomal Dominant Arteriopathy with Subcortical Infarcts and Leukoencephalopathy: An Imaging Mimic of Multiple Sclerosis. Med Princ Pract. 2006;15(5):391–5.

Romay MC, Toro C, Iruela-Arispe ML. Emerging molecular mechanisms of vascular dementia. Curr Opin Hematol. 2019;26(3):199–206.

Wardlaw JM, Smith C, Dichgans M. Small vessel disease: mechanisms and clinical implications. Lancet Neurol. 2019;18(7):684–96.

Kalaria RN. Neuropathological diagnosis of vascular cognitive impairment and vascular dementia with implications for Alzheimer’s disease. Acta Neuropathol. 2016;131(5):659–85.

Iadecola C. The Pathobiology of Vascular Dementia. Neuron. 2013;80(4):844–66.

Kalaria RN. The pathology and pathophysiology of vascular dementia. Neuropharmacology. 2018;134:226–39.

Du S-Q, Wang X-R, Xiao L-Y, Tu J-F, Zhu W, He T, et al. Molecular Mechanisms of Vascular Dementia: What Can Be Learned from Animal Models of Chronic Cerebral Hypoperfusion? Mol Neurobiol. 2017;54(5):3670–82.

Wolters FJ, Zonneveld HI, Hofman A, Van Der Lugt A, Koudstaal PJ, Vernooij MW, et al. Cerebral perfusion and the risk of dementia: a population-based study. Circulation. 2017;136(8):719–28.

Benedictus MR, Binnewijzend MAA, Kuijer JPA, Steenwijk MD, Versteeg A, Vrenken H, et al. Brain volume and white matter hyperintensities as determinants of cerebral blood flow in Alzheimer’s disease. Neurobiol Aging. 2014;35(12):2665–70.

Babadjouni R, Patel A, Liu Q, Shkirkova K, Lamorie-Foote K, Connor M, et al. Nanoparticulate matter exposure results in neuroinflammatory changes in the corpus callosum. PLoS ONE. 2018;13(11).

Liu Q, Radwanski R, Babadjouni R, Patel A, Hodis DM, Baumbacher P, et al. Experimental chronic cerebral hypoperfusion results in decreased pericyte coverage and increased blood–brain barrier permeability in the corpus callosum. J Cereb Blood Flow Metab. 2019;39(2):240–50.

Erickson LD, L D, Gale S D, Anderson J E, Brown B L, Hedges D W. Association between Exposure to Air Pollution and Total Gray Matter and Total White Matter Volumes in Adults: A Cross-Sectional Study. Brain Sci [Internet]. 2020;10(3):164.

Woodward NC, Levine MC, Haghani A, Shirmohammadi F, Saffari A, Sioutas C, et al. Toll-like receptor 4 in glial inflammatory responses to air pollution in vitro and in vivo. J Neuroinflammation. 2017;14(1):84.

Emre M, Aarsland D, Brown R, Burn DJ, Duyckaerts C, Mizuno Y, et al. Clinical diagnostic criteria for dementia associated with Parkinson’s disease. Mov Disord. 2007;22(12):1689–707.

Aarsland D, Zaccai J, Brayne C. A systematic review of prevalence studies of dementia in Parkinson’s disease. Mov Disord. 2005;20(10):1255–63.

Postuma RB, Berg D, Stern M, Poewe W, Olanow CW, Oertel W, et al. MDS clinical diagnostic criteria for Parkinson’s disease. Mov Disord. 2015;30(12):1591–601.

Goetz CG, Emre M, Dubois B. Parkinson’s disease dementia: Definitions, guidelines, and research perspectives in diagnosis. Ann Neurol. 2008;64(S2):S81–92.

Elobeid A, Libard S, Leino M, Popova SN, Alafuzoff I. Altered Proteins in the Aging Brain. J Neuropathol Exp Neurol. 2016;75(4):316–25.

Kovacs G G. Molecular Pathological Classification of Neurodegenerative Diseases: Turning towards Precision Medicine. Int J Mol Sci [Internet]. 2016;17(2):189.

Calderón-Garcidueñas L, Ayala A. Air Pollution, Ultrafine Particles, and Your Brain: Are Combustion Nanoparticle Emissions and Engineered Nanoparticles Causing Preventable Fatal Neurodegenerative Diseases and Common Neuropsychiatric Outcomes? Environ Sci Technol. 2022;56(11):6847–56.

Calderón-Garcidueñas L, Gónzalez-Maciel A, Reynoso-Robles R, Delgado-Chávez R, Mukherjee PS, Kulesza RJ, et al. Calderón-Garcidueñas L, Gónzalez-Maciel A, Reynoso-Robles R, Delgado-Chávez R, Mukherjee PS, Kulesza RJ, et al. Hallmarks of Alzheimer disease are evolving relentlessly in Metropolitan Mexico City infants, children and young adults. APOE4 carriers have higher suicide risk and higher odds of reaching NFT stage V at ≤ 40 years of age. Environ Res. 2018;164:475–87. Environ Res. 2018;164:475–87.

Calderón-Garcidueñas L, González-Maciel A, Reynoso-Robles R, Hammond J, Kulesza R, Lachmann I, et al. Quadruple abnormal protein aggregates in brainstem pathology and exogenous metal-rich magnetic nanoparticles (and engineered Ti-rich nanorods). The substantia nigrae is a very early target in young urbanites and the gastrointestinal tract a key brainstem portal. Environ Res. 2020;191:110139.

Fiondella L, Mattioli I, Salemme S, Carbone C, Vinceti G, Tondelli M, et al. The brain correlates of behavioral disturbances in frontotemporal dementia. Alzheimers Dement. 2021;17(S6).

Rosen HJ, Gorno-Tempini ML, Goldman WP, Perry RJ, Schuff N, Weiner M, et al. Patterns of brain atrophy in frontotemporal dementia and semantic dementia. Neurology. 2002;58(2):198.

Woollacott IOC, Rohrer JD. The clinical spectrum of sporadic and familial forms of frontotemporal dementia. J Neurochem. 2016;138(S1):6–31.

Ber IL, Guedj E, Gabelle A, Verpillat P, Volteau M, Thomas-Anterion C, et al. Demographic, neurological and behavioural characteristics and brain perfusion SPECT in frontal variant of frontotemporal dementia. Brain. 2006;129(11):3051–65.

Tang J, Chen A, He F, Shipley M, Nevill A, Coe H, et al. Association of air pollution with dementia: a systematic review with meta-analysis including new cohort data from China. Environ Res. 2023;223.

Abolhasani E, Hachinski V, Ghazaleh N, Azarpazhooh MR, Mokhber N, Martin J. Air Pollution and Incidence of Dementia. Neurology. 2023;100(2):e242–54.

Peters R, Ee N, Peters J, Booth A, Mudway I, Anstey KJ. Air pollution and dementia: a systematic review. J Alzheimer’s Dis. 2019;70(s1):S145–63.

Delgado-Saborit JM, Guercio V, Gowers AM, Shaddick G, Fox NC, Love S. A critical review of the epidemiological evidence of effects of air pollution on dementia, cognitive function and cognitive decline in adult population. Sci Total Environ. 2021;757.

Xu X, Ha SU, Basnet R. Basnet R. A Review of Epidemiological Research on Adverse Neurological Effects of Exposure to Ambient Air Pollution. Front Public Health. 2016;4:157.

Stern Y. Cognitive reserve in ageing and Alzheimer’s disease. Lancet Neurol. 2012;11(11):1006–12.

Xu H, Dupre ME, Gu D, Wu B. The impact of residential status on cognitive decline among older adults in China: Results from a longitudinal study. BMC Geriatr. 2017;17(1):107.

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Mahdiyeh Mohammadzadeh

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Amir Hossein Khoshakhlagh

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Mohammadzadeh, M., Khoshakhlagh, A.H. & Grafman, J. Air pollution: a latent key driving force of dementia. BMC Public Health 24 , 2370 (2024). https://doi.org/10.1186/s12889-024-19918-4

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