{"doi":"10.1093/exposome/osaf002","title":"Exposome-wide association study of cognition among older adults in the National Health and Nutrition Examination Survey","abstract":"Abstract Cognitive impairment among older adults is a growing public health challenge and environmental chemicals may be modifiable risk factors. A wide array of chemicals has not yet been tested for association with cognition in an environment-wide association framework. In the US National Health and Nutrition Examination Survey (NHANES) 1999-2000 and 2011-2014 cross-sectional cycles, cognition was assessed using the Digit Symbol Substitution Test (DSST, scores 0-117) among participants aged 60 years and older. Concentrations of environmental chemicals measured in blood or urine were log2 transformed and standardized. Chemicals with at least 50% of measures above the lower limit of detection were included (nchemicals = 147, nclasses=14). We tested for associations between chemical concentrations and cognition using parallel survey-weighted multivariable linear regression models adjusted for age, sex, race/ethnicity, education, smoking status, fish consumption, cycle year, urinary creatinine, and cotinine. Participants with at least one chemical measurement (n = 4982) were mean age 69.8 years, 55.0% female, 78.2% non-Hispanic White, and 77.0% at least high school educated. The mean DSST score was 50.4 (standard deviation (SD)=17.4). In adjusted analyses, 5 of 147 exposures were associated with DSST at P-value <.01. Notably, a SD increase in log2-scaled cotinine concentration was associated with 2.71 points lower DSST score (95% CI −3.69, −1.73). A SD increase in log2-scaled urinary tungsten concentration was associated with 1.34 points lower DSST score (95% CI −2.11, −0.56). Exposure to environmental chemicals, particularly metals and tobacco smoke, may be modifiable factors for cognition among older adults.","journal":"Exposome","year":2025,"id":516050,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":10,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.8558,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2025-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1381406,"name":"Erika Walker","orcid":null,"position":1,"is_corresponding":false},{"id":1381407,"name":"Scarlet Cockell","orcid":null,"position":2,"is_corresponding":false},{"id":374328,"name":"John Dou","orcid":"0000-0003-4577-8660","position":3,"is_corresponding":false},{"id":316819,"name":"Vy Kim Nguyen","orcid":"0000-0002-6128-0523","position":4,"is_corresponding":false},{"id":1213054,"name":"Mitchell Schrank","orcid":null,"position":5,"is_corresponding":false},{"id":833,"name":"Chirag J. Patel","orcid":"0000-0002-8756-8525","position":6,"is_corresponding":false},{"id":278643,"name":"Erin B. Ware","orcid":"0000-0003-4731-8158","position":7,"is_corresponding":false},{"id":324124,"name":"Justin A. Colacino","orcid":"0000-0002-5882-4569","position":8,"is_corresponding":false},{"id":230377,"name":"Sung Kyun Park","orcid":"0000-0001-9981-6250","position":9,"is_corresponding":false},{"id":232636,"name":"Kelly M. Bakulski","orcid":"0000-0002-9605-6337","position":10,"is_corresponding":false},{"id":471727,"name":"Lauren Y. M. Middleton","orcid":"0000-0001-9422-2912","position":0,"is_corresponding":true}],"reference_count":56,"raw_metadata":null,"created_at":"2026-07-19T02:48:44.647022Z","pmid":"39926246","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}