{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T17:04:57Z","timestamp":1777395897758,"version":"3.51.4"},"reference-count":53,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2019,10,21]],"date-time":"2019-10-21T00:00:00Z","timestamp":1571616000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Alzheimer\u2019s Disease"],"published-print":{"date-parts":[[2019,11,26]]},"abstract":"<jats:p>\u00a0Cognitive health is an emerging public health concern for the aging American population. Mercury (Hg) is a toxic element that can cause nervous system damage. This hypothesis-testing study evaluated the relationship between blood ethyl-Hg levels and cognitive decline in an older adult and elderly American population. A total of 1,821,663 weighted-persons between 60\u201380 years old with detectable blood ethyl-Hg levels within the 2011\u20132012 National Health and Nutritional Examination Survey were examined. Those persons with blood ethyl-Hg levels greater than the median were deemed the higher ethyl-Hg exposure group and those with ethyl-Hg levels less than the median were deemed the lower ethyl-Hg exposure group. Three tests were utilized to measure cognitive function: 1) Consortium to Establish a Registry for Alzheimer\u2019s Disease \u2013 Word List Learning (CERAD W-L) delayed recall test, 2) animal fluency test, and 3) Digit Symbol Substitution Test. Each cognitive test score was categorized as higher for those with scores greater than the median and lower for those with scores less than the median. Survey logistic regression modeling with covariates was used to analyze the data for the relationship between blood ethyl-Hg levels and cognitive function scores. Significantly increased risks for lower animal fluency test (odds ratio (OR)\u200a=\u200a13.652, p\u200a=\u200a0.0029) and CERAD W-L delayed recall test (OR\u200a=\u200a6.401, p\u200a=\u200a0.0433) scores were observed among the higher ethyl-Hg exposure group as compared to the lower ethyl-Hg exposure group. This study supports the hypothesis that increased ethyl-Hg exposure is associated with significant cognitive decline in older adult and elderly Americans.<\/jats:p>","DOI":"10.3233\/jad-190894","type":"journal-article","created":{"date-parts":[[2019,10,23]],"date-time":"2019-10-23T11:59:11Z","timestamp":1571831951000},"page":"901-910","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":8,"title":["A Cross-Sectional Study of Blood Ethylmercury Levels and Cognitive Decline Among Older Adults and the Elderly in the United States"],"prefix":"10.1177","volume":"72","author":[{"given":"David A.","family":"Geier","sequence":"first","affiliation":[{"name":"Institute of Chronic Illnesses, Inc., Silver Spring, MD, USA"},{"name":"CoMeD, Inc., Silver Spring, MD, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Janet K.","family":"Kern","sequence":"additional","affiliation":[{"name":"Institute of Chronic Illnesses, Inc., Silver Spring, MD, USA"},{"name":"CoMeD, Inc., Silver Spring, MD, USA"},{"name":"CONEM US Autism Research Group, Allen, TX, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kristin G.","family":"Homme","sequence":"additional","affiliation":[{"name":"International Academy of Oral Medicine and Toxicology, ChampionsGate, FL, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mark R.","family":"Geier","sequence":"additional","affiliation":[{"name":"Institute of Chronic Illnesses, Inc., Silver Spring, MD, USA"},{"name":"CoMeD, Inc., Silver Spring, MD, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2019,10,21]]},"reference":[{"key":"ref001","volume-title":"The Healthy Brain Initiative: The Public Health Road Map for State and National Partnerships, 2013\u20132018.","author":"Alzheimer\u2019s Association and Centers for Disease Control and Prevention","year":"2013"},{"key":"ref002","unstructured":"Centers for Disease Control and Prevention (2015)\n                      The Healthy Brain Initiative: The Public Health Road Map for State and National Partnerships, 2013\u20132018, Interim Progress Report.\n                      CDC, Atlanta, GA. Available from: https:\/\/www.cdc.gov\/aging\/pdf\/2013-healthy-brain-initiative-interim-report.pdf. Accessed 27 May 2018."},{"key":"ref003","doi-asserted-by":"publisher","DOI":"10.1016\/j.jalz.2007.01.018"},{"key":"ref004","unstructured":"U.S. Department of Health and Human Services, Centers for Disease Control and Prevention.\n                      Cognitive impairment: A Call for Action, Now\n                      ! https:\/\/www.cdc.gov\/aging\/pdf\/cognitive_impairment\/cogimp_poilicy_final.pdf. Posted February 2011. Accessed on 15 April 2018."},{"key":"ref005","doi-asserted-by":"publisher","DOI":"10.1001\/archneur.60.8.1119"},{"key":"ref006","volume-title":"Medicare and Medicaid costs for people with Alzheimer\u2019s disease","author":"Alzheimer\u2019s Association","year":"2001"},{"key":"ref007","first-page":"370","volume":"1","author":"Kurland LT","year":"1960","journal-title":"World Neurol"},{"key":"ref008","doi-asserted-by":"publisher","DOI":"10.1126\/science.181.4096.230"},{"key":"ref009","first-page":"303","volume":"18","author":"Jalili MA","year":"1961","journal-title":"Br J Ind Med"},{"key":"ref010","doi-asserted-by":"publisher","DOI":"10.1002\/ajim.4700050308"},{"key":"ref011","doi-asserted-by":"publisher","DOI":"10.1289\/ehp.02110s111"},{"key":"ref012","first-page":"32","volume":"11","author":"Masley SC","year":"2012","journal-title":"Integr Med"},{"key":"ref013","doi-asserted-by":"publisher","DOI":"10.1001\/jama.296.15.1885"},{"key":"ref014","volume-title":"Mercury in health care; policy paper","author":"WHO","year":"2005"},{"key":"ref015","doi-asserted-by":"publisher","DOI":"10.1021\/ac501352d"},{"key":"ref016","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.39.9.1159"},{"key":"ref017","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwt158"},{"key":"ref018","doi-asserted-by":"publisher","DOI":"10.1016\/j.cca.2015.02.030"},{"key":"ref019","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.39.9.1159"},{"key":"ref020","doi-asserted-by":"publisher","DOI":"10.1016\/j.jalz.2007.08.005"},{"key":"ref021","doi-asserted-by":"publisher","DOI":"10.1111\/j.1532-5415.2009.02267.x"},{"key":"ref022","doi-asserted-by":"publisher","DOI":"10.1017\/S1355617704101094"},{"key":"ref023","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(03)12772-9"},{"key":"ref024","volume-title":"A Compendium of Neuropsychological Tests: Administration, Norms and Commentary","author":"Strauss E","year":"2006","edition":"3"},{"key":"ref025","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuropsychologia.2004.02.001"},{"key":"ref026","doi-asserted-by":"publisher","DOI":"10.1177\/1533317509345154"},{"key":"ref027","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.62.4.556"},{"key":"ref028","doi-asserted-by":"publisher","DOI":"10.1001\/archneur.61.1.59"},{"key":"ref029","volume-title":"WAIS Manual \u2013 Third Edition","author":"Wechsler D","year":"1997"},{"key":"ref030","doi-asserted-by":"publisher","DOI":"10.3233\/JAD-2003-5501"},{"key":"ref031","doi-asserted-by":"publisher","DOI":"10.1159\/000109998"},{"key":"ref032","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwk017"},{"key":"ref033","doi-asserted-by":"publisher","DOI":"10.1590\/S0100-879X2007000300019"},{"key":"ref034","doi-asserted-by":"publisher","DOI":"10.1590\/S1980-57642009DN20200003"},{"key":"ref035","doi-asserted-by":"publisher","DOI":"10.1016\/j.envint.2013.01.005"},{"key":"ref036","doi-asserted-by":"publisher","DOI":"10.1136\/oem.52.12.813"},{"key":"ref037","first-page":"782","volume":"49","author":"Ngim CH","year":"1992","journal-title":"Br J Ind Med"},{"key":"ref038","unstructured":"MohsRC.\n                      How Human Memory Works\n                      . https:\/\/science.howstuffworks.com\/life\/inside-the-mind\/human-brain\/human-memory.htm. Posted 2018. Accessed 25 May 2018."},{"key":"ref039","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/122.10.1839"},{"key":"ref040","doi-asserted-by":"publisher","DOI":"10.55782\/ane-2012-1887"},{"key":"ref041","doi-asserted-by":"publisher","DOI":"10.1177\/1559325817690849"},{"key":"ref042","doi-asserted-by":"publisher","DOI":"10.1523\/JNEUROSCI.4558-12.2013"},{"key":"ref043","doi-asserted-by":"publisher","DOI":"10.1038\/nn.3555"},{"key":"ref044","doi-asserted-by":"publisher","DOI":"10.1016\/S0378-5173(00)00514-7"},{"key":"ref045","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2006-3363"},{"key":"ref046","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuro.2013.05.015"},{"key":"ref047","doi-asserted-by":"publisher","DOI":"10.1136\/adc.52.12.962"},{"key":"ref048","doi-asserted-by":"publisher","DOI":"10.1289\/ehp.7712"},{"key":"ref049","doi-asserted-by":"publisher","DOI":"10.1001\/jama.293.15.1875"},{"key":"ref050","first-page":"243","volume":"28","author":"Gao YX","year":"2015","journal-title":"Biomed Environ Sci"},{"key":"ref051","doi-asserted-by":"publisher","DOI":"10.1093\/oxfordjournals.aje.a116479"},{"key":"ref052","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa025028"},{"key":"ref053","doi-asserted-by":"publisher","DOI":"10.1186\/s12877-016-0342-y"}],"container-title":["Journal of Alzheimer\u2019s Disease"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.3233\/JAD-190894","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.3233\/JAD-190894","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.3233\/JAD-190894","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T10:07:04Z","timestamp":1777370824000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.3233\/JAD-190894"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,10,21]]},"references-count":53,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2019,11,26]]}},"alternative-id":["10.3233\/JAD-190894"],"URL":"https:\/\/doi.org\/10.3233\/jad-190894","relation":{},"ISSN":["1387-2877","1875-8908"],"issn-type":[{"value":"1387-2877","type":"print"},{"value":"1875-8908","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,10,21]]}}}