Occupational and domestic exposure associations with cerebral small vessel disease and vascular dementia: A systematic review and meta-analysis

Alzheimers Dement. 2024 Apr;20(4):3021-3033. doi: 10.1002/alz.13647. Epub 2024 Jan 25.

Abstract

Introduction: The prevalence of cerebral smallvessel disease (SVD) and vascular dementia according to workplace or domestic exposure to hazardous substances is unclear.

Methods: We included studies assessing occupational and domestic hazards/at-risk occupations and SVD features. We pooled prevalence estimates using random-effects models where possible, or presented a narrative synthesis.

Results: We included 85 studies (n = 47,743, mean age = 44·5 years). 52/85 reported poolable estimates. SVD prevalence in populations exposed to carbon monoxide was 81%(95% CI = 60-93%; n = 1373; results unchanged in meta-regression), carbon disulfide73% (95% CI = 54-87%; n = 131), 1,2-dichloroethane 88% (95% CI = 4-100%, n = 40), toluene 82% (95% CI = 3-100%, n = 64), high altitude 49% (95% CI = 38-60%; n = 164),and diving 24% (95% CI = 5-67%, n = 172). We narratively reviewed vascular dementia studies and contact sport, lead, military, pesticide, and solvent exposures as estimates were too few/varied to pool.

Discussion: SVD and vascular dementia may be associated with occupational/domestic exposure to hazardous substances. CRD42021297800.

Keywords: cerebral small vessel disease; dementia; occupations; public health; stroke; white matter hyperintensities; workplace.

Publication types

  • Systematic Review
  • Meta-Analysis
  • Review

MeSH terms

  • Cerebral Small Vessel Diseases* / epidemiology
  • Dementia, Vascular* / epidemiology
  • Environmental Exposure / adverse effects
  • Environmental Exposure / statistics & numerical data
  • Hazardous Substances / adverse effects
  • Humans
  • Occupational Exposure* / adverse effects
  • Prevalence

Substances

  • Hazardous Substances