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Few studies of air pollution and depression have been conducted in the United States where this mental health disorder is prevalent among adults. We investigated associations between ambient air pollutants (O<jats:sub>3<\/jats:sub>, PM<jats:sub>2.5<\/jats:sub> and NO<jats:sub>2<\/jats:sub>) and depression symptoms in middle-aged and older adults (<jats:italic>n<\/jats:italic>\u2009=\u20091496) without cardiovascular disease or cognitive impairment in Los Angeles, California.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>Air pollution exposures were assigned to residential addresses using a geographic information system with air quality monitoring data. The Center for Epidemiological Studies-Depression scale (CES-D) assessed depression symptoms at study entry. Carotid artery intima-media thickness (CIMT) was obtained as a measure of subclinical atherosclerosis. Linear and Poisson regression models estimated cross-sectional associations between air pollutants and total CES-D score and suspected clinical depression (CES-D score\u2009\u2265\u200916) adjusting for potential confounders and examined effect modification by CIMT.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>Higher exposure to O<jats:sub>3<\/jats:sub>, PM<jats:sub>2.5<\/jats:sub> and NO<jats:sub>2<\/jats:sub> overall were not cross-sectionally associated with higher CES-D total scores or CES-D score\u2009\u2265\u200916. However, the interaction between CIMT and PM<jats:sub>2.5<\/jats:sub> was statistically significant (\u03b2-interaction term\u2009=\u20091.01, 95% CI\u2009=\u20090.05, 1.97; <jats:italic>p<\/jats:italic>-value\u2009=\u20090.03). Adults with CIMT levels\u2009\u2265\u20090.77\u00a0mm had higher depression symptom prevalence as PM<jats:sub>2.5<\/jats:sub> increased (\u03b2\u2009=\u20090.04 per 10\u00a0\u00b5g\/m<jats:sup>3<\/jats:sup>, 95% CI = \u22120.22, 0.30) while those with CIMT\u2009&lt;\u20090.77\u00a0mm had lower prevalence (\u03b2 = -0.18, 95% CI = \u22120.41, 0.05).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p>Higher O<jats:sub>3<\/jats:sub>, PM<jats:sub>2.5<\/jats:sub> and NO<jats:sub>2<\/jats:sub> exposures were generally unassociated with depressive symptoms. Additional studies are needed to investigate whether persons with higher subclinical atherosclerosis are more susceptible to possible PM<jats:sub>2.5<\/jats:sub> effects on mental health.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1007\/s00420-025-02165-4","type":"journal-article","created":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T08:20:15Z","timestamp":1756282815000},"page":"731-741","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Air pollution and depression symptoms in middle-aged and older adults in Los Angeles County"],"prefix":"10.1007","volume":"98","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7873-8310","authenticated-orcid":false,"given":"Nicole M.","family":"Gatto","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marian","family":"Ramzy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cecilia","family":"Rocha","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Howard N.","family":"Hodis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fred","family":"Lurmann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victor W.","family":"Henderson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wendy J.","family":"Mack","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,8,27]]},"reference":[{"issue":"1","key":"2165_CR1","doi-asserted-by":"publisher","first-page":"38","DOI":"10.1183\/09031936.00130014","volume":"45","author":"M Adam","year":"2015","unstructured":"Adam M et al (2015) Adult lung function and long-term air pollution exposure. 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