PT  - JOURNAL ARTICLE
AU  - Valentina Gallo
AU  - Giovanni Leonardi
AU  - Carol Brayne
AU  - Ben Armstrong
AU  - Tony Fletcher
TI  - Serum perfluoroalkyl acids concentrations and memory impairment in a large cross-sectional study
AID  - 10.1136/bmjopen-2012-002414
DP  - 2013 Jun 01
TA  - BMJ Open
PG  - e002414
VI  - 3
IP  - 6
4099  - http://bmjopen.bmj.com/content/3/6/e002414.short
4100  - http://bmjopen.bmj.com/content/3/6/e002414.full
SO  - BMJ Open2013 Jun 01; 3
AB  - Objectives To examine the cross-sectional association between serum perfluorooctanate (PFOA), perfuorooctane sulfonate (PFOS), perfluorononanoic acid (PFNA) and perfluorohexane sulfonate (PFHxS) concentrations with self-reported memory impairment in adults and the interaction of these associations with diabetes status. Design Cross-sectional study. Setting Population-based in Mid-Ohio Valley, West Virginia following contamination by a chemical plant. Participants The C8 Health Project collected data and measured the serum level of perfluoroalkyl acids (PFAAs) of 21 024 adults aged 50+ years. Primary outcome measure Self-reported memory impairment as defined by the question ‘have experienced short-term memory loss?’ Results A total of 4057 participants self-reported short-term memory impairment. Inverse associations between PFOS and PFOA and memory impairment were highly statistically significant with fully adjusted OR=0.93 (95% CI 0.90 to 0.96) for doubling PFOS and OR=0.96 (95% CI 0.94 to 0.98) for doubling PFOA concentrations. Comparable inverse associations with PFNA and PFHxS were of borderline statistical significance. Inverse associations of PFAAs with memory impairment were weaker or non-existent in patients with diabetes than overall in patients without diabetes. Conclusions An inverse association between PFAA serum levels and self-reported memory impairment has been observed in this large population-based, cross-sectional study that is stronger and more statistically significant for PFOA and PFOS. The associations can be potentially explained by a preventive anti-inflammatory effect exerted by a peroxisome proliferator-activated receptor agonist effect of these PFAAs, but confounding or even reverse causation cannot be excluded as an alternative explanation.