The Royal College of Physicians of Edinburgh (RCPE) welcomes the publication of Cognitive decline, dementia and air pollution. A report by the Committee on the Medical Effects of Air Pollutants.

This important report concludes that “epidemiological evidence is suggestive of an association between exposure to ambient air pollutants and both the risk of developing dementia and acceleration of cognitive decline” and that there “is evidence that air pollution, particularly particulate air pollution, increases the risk of cardiovascular, including cerebrovascular, disease. These diseases are known to have adverse effects on cognitive function.”

The rising number of people with dementia is a major concern for the RCPE - with charities such as Age Scotland highlighting that the number of people in Scotland living with dementia is expected to increase by 50% to over 120,000 within the next 20 years as the population continues to age. A growing number of people with dementia requires additional resources within health and social care services, and places obvious strains on individuals and families.

The report’s findings suggest that taking action to reduce air pollution may help prevent some cases of dementia and may also slow down rates of cognitive decline. This builds on previous research indicating dementia can be preventable and the importance of lifestyle factors. The RCPE considers that the Scottish Government should assess how it can support appropriate measures across portfolios that may aid the prevention of dementia.

On air pollution, it is generally accepted that Scotland has some of the strongest targets in Europe for emissions and air quality and these are supported by the RCPE. However, there are concerns about the ability to meet these targets and to do so on a consistent basis. In light of this new report, the RCPE is calling on the Scottish Government to take all action necessary, including the consideration of additional measures, to ensure that emissions and air quality targets are enforced as a matter of urgency. This could lead to tangible public health benefits.

In addition, the RCPE is continuing to undertake a number of other pieces of work in relation to air pollution and its impact on health, including its Short Life Working Group investigating the impact of air pollution on children.

Commenting, Prof Andy Elder, President of the Royal College of Physicians of Edinburgh, said:

 People living with dementia and their families understand what a debilitating condition it can be. We now appreciate that its seeds can be sown much earlier in life and as such that prevention and attention to brain health over the life course are of huge importance. The College therefore welcomes this significant report which highlights the substantial evidence of the links between air pollution and cognitive decline and opens a potential avenue for prevention.

The rising prevalence of cognitive impairment and dementia presents a growing challenge for our health and social care services, as well as so many individuals and their families. This report should act as an urgent wake-up call to government to ensure that the air quality and emissions targets currently enshrined in legislation are actually enforced and met. This has the potential to reduce the number of people developing dementia and to slow down the rate at which cognitive impairment worsens and must therefore be considered a priority.

Commenting, Prof Jill Belch of the University of Dundee, said:

Air Pollution is one of the truly reversible causes of dementia. The Scottish Government has some of the toughest emission regulations in Europe. Fellows and Members of the RCPE have provided much evidence to support this legislation, but there is still work to be done.

The RCPE asks the Scottish Government to enforce its emissions level legislation though local authorities, and work on other enforcement, for example the idling law, which appears to be universally ignored. The consequences of air pollution on human health, from womb to tomb, are now well documented.

Prof Craig Ritchie of the University of Edinburgh, said:

The link between pollution and poor brain health has been known for some time both at a biological and epidemiological level.

What this report does is bring that scientific knowledge to the public and politicians awareness. The Brain can’t be healthy unless the planet is.

Anna Borthwick, Executive Lead of Brain Health Scotland at Alzheimer Scotland, said:

It is now increasingly clear that air pollution impacts brain health and increases risk of dementia. Our research shows that in Scotland, 1 in 2 people feel they are exposed to air pollution every week, and those in areas of multiple deprivation feel they encounter air pollution on a daily basis.

Taking personal steps to reduce pollution and seek clean air is critically important, but of all the steps we can take to protect our brain health, this is the one that most requires collective action. This must be tackled at a national level by those who can lead societal change.