Environmental lead exposure and cognitive function in community-dwelling older adults

R. A. Shih, T. A. Glass, K. Bandeen-Roche, M. C. Carlson, K. I. Bolla, A. C. Todd, B. S. Schwartz

Research output: Contribution to journalArticlepeer-review

110 Scopus citations


OBJECTIVE: To determine if long-term exposure to high levels of lead in the environment is associated with decrements in cognitive ability in older Americans. METHODS: We completed a cross-sectional analysis using multiple linear regression to evaluate associations of recent (in blood) and cumulative (in tibia) lead dose with cognitive function in 991 sociodemographically diverse, community-dwelling adults, aged 50 to 70 years, randomly selected from 65 contiguous neighborhoods in Baltimore, MD. Tibia lead was measured with Cd induced K-shell X-ray fluorescence. Seven summary measures of cognitive function were created based on standard tests in these domains: language, processing speed, eye-hand coordination, executive functioning, verbal memory and learning, visual memory, and visuoconstruction. RESULTS: The mean (SD) blood lead level was 3.5 (2.2) μg/dL and tibia lead level was 18.7 (11.2) μg/g. Higher tibia lead levels were consistently associated with worse cognitive function in all seven domains after adjusting for age, sex, APOE-ϵ4, and testing technician (six domains p ≤ 0.01, one domain p ≤ 0.05). Blood lead was not associated with any cognitive domain. Associations with tibia lead were attenuated after adjustment for years of education, wealth, and race/ethnicity. CONCLUSIONS: Independent of recent lead dose, retained cumulative dose resulting from previous environmental exposures may have persistent effects on cognitive function. A portion of age-related decrements in cognitive function in this population may be associated with earlier lead exposure.

Original languageEnglish
Pages (from-to)1556-1562
Number of pages7
Issue number9
StatePublished - Nov 2006


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