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Serum perfluoroalkyl acids concentrations and memory impairment in a large cross-sectional study
  1. Valentina Gallo1,2,
  2. Giovanni Leonardi1,
  3. Carol Brayne3,
  4. Ben Armstrong1,
  5. Tony Fletcher1
  1. 1Department of Social and Environmental Health Research, London School of Hygiene and Tropical Medicine, London, UK
  2. 2Centre for Primary Care and Public Health, Blizard Institute, Queen Mary, University of London, London, UK
  3. 3Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
  1. Correspondence to Dr Valentina Gallo; v.gallo{at}qmul.ac.uk

Abstract

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.

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