Mitigating the impact of air pollution on dementia and brain health: setting the policy agenda

Brian Castellani*, Suzanne Bartington, Jonathan Wistow, Neil Heckels, Amanda Ellison, Martie van Tongeren, Steve Arnold, Peter Barbrook-Johnson, Martha Bicket, Francis Pope, Tom Russ, Charlotte Clarke, Monica Pirani, Matthais Schwannauer, Massimo Vieno, Rachel Turnbull, Nigel Gilbert, Stefan Reis, Pete Barbrook-Johnson, Matthias Schwannauer

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

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Emerging research suggests exposure to high levels of air pollution at critical points in the life-course is detrimental to brain health, including cognitive decline and dementia. Social determinants play a significant role, including socio-economic deprivation, environmental factors and heightened health and social inequalities. Policies have been proposed more generally, but their benefits for brain health have yet to be fully explored.

Objective and methods
Over the course of two years, we worked as a consortium of 20+ academics in a participatory and consensus method to develop the first policy agenda for mitigating air pollution's impact on brain health and dementia, including an umbrella review and engaging 11 stakeholder organisations.

We identified three policy domains and 14 priority areas. Research and Funding included: (1) embracing a complexities of place approach that (2) highlights vulnerable populations; (3) details the impact of ambient PM2.5 on brain health, including current and historical high-resolution exposure models; (4) emphasises the importance of indoor air pollution; (5) catalogues the multiple pathways to disease for brain health and dementia, including those most at risk; (6) embraces a life course perspective; and (7) radically rethinks funding. Education and Awareness included: (8) making this unrecognised public health issue known; (9) developing educational products; (10) attaching air pollution and brain health to existing strategies and campaigns; and (11) providing publicly available monitoring, assessment and screening tools. Policy Evaluation included: (12) conducting complex systems evaluation; (13) engaging in co-production; and (14) evaluating air quality policies for their brain health benefits.

Given the pressing issues of brain health, dementia and air pollution, setting a policy agenda is crucial. Policy needs to be matched by scientific evidence and appropriate guidelines, including bespoke strategies to optimise impact and mitigate unintended consequences. The agenda provided here is the first step toward such a plan.
Original languageEnglish
Article number114362
JournalEnvironmental Research
Issue number2
Early online date26 Sept 2022
Publication statusPublished - Dec 2022


  • Air pollution
  • Brain health
  • Complex systems theory
  • Dementia
  • Public policy
  • Social and health inequalities

ASJC Scopus subject areas

  • Biochemistry
  • Environmental Science(all)


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