{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T05:29:53Z","timestamp":1789622993178,"version":"build-2803163510"},"reference-count":53,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2021,1,4]],"date-time":"2021-01-04T00:00:00Z","timestamp":1609718400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Kaohsiung Medical University Research Center","award":["KMU-TC108A01"],"award-info":[{"award-number":["KMU-TC108A01"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>The issue of air pollution is gaining increasing attention worldwide, and mounting evidence has shown an association between air pollution and cognitive decline. The aim of this study was to investigate the relationships between air pollutants and cognitive impairment using the Mini-Mental State Exam (MMSE) and its sub-domains. In this study, we used data from the Taiwan Biobank combined with detailed daily data on air pollution. Cognitive function was assessed using the MMSE and its five subgroups of cognitive functioning. After multivariable linear regression analysis, a high level of particulate matter with an aerodynamic diameter of \u22642.5 \u03bcm (PM2.5), low ozone (O3), high carbon monoxide (CO), high sulfur dioxide (SO2), high nitric oxide (NO), high nitrogen dioxide (NO2), and high nitrogen oxide (NOx) were significantly associated with low total MMSE scores. Further, high SO2 and low O3 were significantly associated with low MMSE G1 scores. Low O3, high CO, high SO2, high NO2, and high NOx were significantly associated with low MMSE G4 scores, and high PM2.5, high particulate matter with an aerodynamic diameter of \u226410 \u03bcm (PM10), high SO2, high NO2, and high NOx were significantly associated with low MMSE G5 scores. Our results showed that exposure to different air pollutants may lead to general cognitive decline and impairment of specific domains of cognitive functioning, and O3 may be a protective factor. These findings may be helpful in the development of policies regarding the regulation of air pollution.<\/jats:p>","DOI":"10.3390\/ijerph18010316","type":"journal-article","created":{"date-parts":[[2021,1,4]],"date-time":"2021-01-04T08:35:19Z","timestamp":1609749319000},"page":"316","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":29,"title":["Air Pollution Is Associated with Poor Cognitive Function in Taiwanese Adults"],"prefix":"10.3390","volume":"18","author":[{"given":"Meng-Chieh","family":"Chen","sequence":"first","affiliation":[{"name":"Department of General Medicine, Kaohsiung Medical University Hospital, Kaohsiung 807, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chen-Feng","family":"Wang","sequence":"additional","affiliation":[{"name":"Institute of Electronics, National Chiao Tung University, Hsinchu 300, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bo-Cheng","family":"Lai","sequence":"additional","affiliation":[{"name":"Institute of Electronics, National Chiao Tung University, Hsinchu 300, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3952-7718","authenticated-orcid":false,"given":"Sun-Wung","family":"Hsieh","sequence":"additional","affiliation":[{"name":"Department of Neurology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan"},{"name":"Department of Neurology, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, Kaohsiung 812, Taiwan"},{"name":"Neuroscience Research Center, Kaohsiung Medical University, Kaohsiung 807, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1610-4184","authenticated-orcid":false,"given":"Szu-Chia","family":"Chen","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan"},{"name":"Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, Shan-Ming Rd., Hsiao-Kang Dist., Kaohsiung 812, Taiwan"},{"name":"Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan"},{"name":"Research Center for Environmental Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chih-Hsing","family":"Hung","sequence":"additional","affiliation":[{"name":"Research Center for Environmental Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan"},{"name":"Department of Pediatrics, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan"},{"name":"Department of Pediatrics, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, Kaohsiung 812, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chao-Hung","family":"Kuo","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, Shan-Ming Rd., Hsiao-Kang Dist., Kaohsiung 812, Taiwan"},{"name":"Division of Gastroenterology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,1,4]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"484","DOI":"10.1111\/resp.13531","article-title":"Air pollution in the Asia-Pacific Region: A Joint Asian Pacific Society of Respirology\/American Thoracic Society perspective (Republication)","volume":"24","author":"North","year":"2019","journal-title":"Respirology"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"417","DOI":"10.1016\/j.chest.2018.10.041","article-title":"Air Pollution and Noncommunicable Diseases: A Review by the Forum of International Respiratory Societies\u2019 Environmental Committee, Part 2: Air Pollution and Organ Systems","volume":"155","author":"Schraufnagel","year":"2019","journal-title":"Chest"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"235","DOI":"10.1016\/j.neuro.2016.06.004","article-title":"Exposure to air pollution as a potential contributor to cognitive function, cognitive decline, brain imaging, and dementia: A systematic review of epidemiologic research","volume":"56","author":"Power","year":"2016","journal-title":"Neurotoxicology"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"189","DOI":"10.1016\/0022-3956(75)90026-6","article-title":"\u201cMini-mental state\u201d. 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