ArticleEnvironment & health (Washington, D.C.)2024
Associations between Metals, Serum Folate, and Cognitive Function in the Elderly: Mixture and Mediation Analyses.
Article in Environment & health (Washington, D.C.), 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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The trial behind it
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Who cites it
5 citing papers in PubMed.
- Imbalance of the Arachidonic Acid Metabolism in Neuroinflammation and Cognition Caused by Manganese Exposure: Downregulation of 15d-PGJ2 Levels and Validation of MMP9 as a Target.Environment & health (Washington, D.C.) · 2026Article
- Sex-Specific Biological Aging-Related Lipidomic Profiles Mediate the Impact of Urinary Polycyclic Aromatic Hydrocarbon Exposures on Cognitive Function in Healthy Older Adults.Environment & health (Washington, D.C.) · 2026Article
- Exogenous Metals Indirectly Affect Human Semen Quality via Immune Cells at Single-Cell Resolution.Environment & health (Washington, D.C.) · 2025Article
- Metabolome informs about the chemical exposome and links to brain health.Environment international · 2025Review
- A machine learning framework for predicting cognitive impairment in aging populations using urinary metal and demographic data.Frontiers in genetics · 2025Article
Corrections and comments
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Exposure to metals may potentially impact cognitive health in the elderly; however, the evidence remains ambiguous. The specific role of serum folate in this relationship is also unclear. We aimed to evaluate the individual and joint impact of metals on cognition in the elderly from the United States and explore the potential mediating effect of serum folate. Data from the NHANES 2011-2014 were used, with inductively coupled plasma mass spectrometry (ICP-MS) employed to measure blood metal concentrations. Cognitive function was assessed using tests for immediate, delayed, and working memory: Immediate Recall test (IRT), the Delayed Recall test (DRT), the Animal Fluency test (AFT), and the Digit Symbol Substitution test (DSST). Generalized linear regression models (GLMs), Bayesian kernel machine regression model (BKMR), and quantile g-computation (QG-C) models were used to assess associations between metals (lead, cadmium, mercury, selenium, manganese) and cognition, with mediation analyses examining serum folate's involvement in metal effects. This study included 2002 participants aged ≥60. GLMs revealed the negative association between cadmium and the z-scores of IRT (β: -0.17,95% CI: -0.30, -0.04) and DSST (β: -0.15,95% CI: -0.27, -0.04), with negative effects also observed in the BKMR and QG-C models. Selenium displayed significantly positive association with cognition across various statistical models, including GLMs, QG-C, and BKMR. Serum folate played a mediating role in the effects of cadmium and selenium exposure on DSST z-scores, with a proportion of mediation of 17% and 10%, respectively. Our study assessed the impact of metal mixtures on cognition in the elderly population, finding that high selenium level was strongly associated with better cognitive performance, while cadmium was associated with lower cognitive function scores. Serum folate might partially mediate the association between cadmium, selenium, and DSST z-scores.
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Registered trials
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