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Mitigating the impact of air pollution on dementia and brain health: Setting the policy agenda

Castellani, Brian; Bartington, Suzanne; Wistow, Jonathan; Heckels, Neil; Ellison, Amanda; Van Tongeren, Martie; Arnold, Steve R.; Barbrook-Johnson, Pete; Bicket, Martha; Pope, Francis D.; Russ, Tom C.; Clarke, Charlotte L.; Pirani, Monica; Schwannauer, Matthias; Vieno, Massimo; Turnbull, Rachel; Gilbert, Nigel; Reis, Stefan

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Suzanne Bartington

Jonathan Wistow

Neil Heckels

Martie Van Tongeren

Steve R. Arnold

Pete Barbrook-Johnson

Martha Bicket

Francis D. Pope

Tom C. Russ

Charlotte L. Clarke

Monica Pirani

Matthias Schwannauer

Massimo Vieno

Rachel Turnbull

Nigel Gilbert

Stefan Reis


Background Emerging research suggests exposure to high levels of air pollution at critical points in the life-course is detrimental to brain health, including cognitive decline and dementia. Social determinants play a significant role, including socio-economic deprivation, environmental factors and heightened health and social inequalities. Policies have been proposed more generally, but their benefits for brain health have yet to be fully explored. Objective and methods Over the course of two years, we worked as a consortium of 20+ academics in a participatory and consensus method to develop the first policy agenda for mitigating air pollution's impact on brain health and dementia, including an umbrella review and engaging 11 stakeholder organisations. Results We identified three policy domains and 14 priority areas. Research and Funding included: (1) embracing a complexities of place approach that (2) highlights vulnerable populations; (3) details the impact of ambient PM2.5 on brain health, including current and historical high-resolution exposure models; (4) emphasises the importance of indoor air pollution; (5) catalogues the multiple pathways to disease for brain health and dementia, including those most at risk; (6) embraces a life course perspective; and (7) radically rethinks funding. Education and Awareness included: (8) making this unrecognised public health issue known; (9) developing educational products; (10) attaching air pollution and brain health to existing strategies and campaigns; and (11) providing publicly available monitoring, assessment and screening tools. Policy Evaluation included: (12) conducting complex systems evaluation; (13) engaging in co-production; and (14) evaluating air quality policies for their brain health benefits. Conclusion Given the pressing issues of brain health, dementia and air pollution, setting a policy agenda is crucial. Policy needs to be matched by scientific evidence and appropriate guidelines, including bespoke strategies to optimise impact and mitigate unintended consequences. The agenda provided here is the first step toward such a plan.


Castellani, B., Bartington, S., Wistow, J., Heckels, N., Ellison, A., Van Tongeren, M., …Reis, S. (2022). Mitigating the impact of air pollution on dementia and brain health: Setting the policy agenda. Environmental Research, 215(2), Article 114362.

Journal Article Type Article
Acceptance Date Sep 14, 2022
Publication Date 2022-12
Deposit Date Sep 29, 2022
Publicly Available Date Oct 7, 2022
Journal Environmental Research
Print ISSN 0013-9351
Publisher Elsevier
Peer Reviewed Peer Reviewed
Volume 215
Issue 2
Article Number 114362


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