Articles and Data on Climate, Air Pollution and Brain Health
Stroke
Alexeeff SE, et al. Long‐term PM2.5 exposure and risks of ischemic heart disease and stroke events: review and meta‐analysis. J Am Heart Assoc. 2021 Meta-analyses of 14 studies, for long exposure to air pollution: Each 10 µg/m3 increase in average PM2.5 exposure, associated with an ischemic stroke risk of 13% (equivalent rise in AQI 25-59)
Toubasi A, et al. Short-term Exposure to Air Pollution and Ischemic Stroke: A Systematic Review and Meta-Analysis. Neurology 2023 Recent meta-analysis (110 studies) with short exposure to air pollution: Robust association between <5day exposure to multiple outdoor air pollutants and risk/ mortality of ischemic stroke onset
Liu J, et al. Heat exposure and cardiovascular health outcomes: a systematic review and meta-analysis. Lancet Planetary Health 2022 Meta-analysis of 201 studies in China: pooled estimates showed that every 1°C increase in temperature was significantly associated with a 3.8% increase in stroke related mortality
Qu C, et al. Burden of Stroke Attributable to Nonoptimal Temperature in 204 Countries and Territories, A Population-Based Study, 1990-2019 Neurology April 2024 Continuously increasing age adjusted stroke mortality and disability attributable to high temperature since 1990 globally
Ranta A, Kang J, Saad A, et al. Climate Change and Stroke. Stroke March 2024 A review of the evidence associating climate change with stroke
Alahmad B, et al. Multi-Country Multi-City (MCC) Network. Extreme Temperatures and Stroke Mortality: Evidence From a Multi-Country Analysis. Stroke 2024 3.5 million ischemic and 2.5 million hemorrhagic strokes from 25 countries found 0.7-11 excess deaths per 1000 people attributable to both high and low temperature extremes
Ambient Temperature and Stroke Risk Among Adults Aged 18-64 Years: A Case-Crossover Study. Journal of American College of Cardiology 10/2024 doi:10.1016/j.jacc.2024.08.058
Extreme Temperatures and Stroke Mortality: Evidence From a Multi-Country Analysis. Stroke 7/2024 https://doi.org/10.1161/STROKEAHA.123.045751
Joint Exposure to Ambient Air Pollutants, Genetic Risk, and Ischemic Stroke: A Prospective Analysis in UK Biobank. Stroke 02/2024 https://doi.org/10.1161/STROKEAHA.123.044935
Impact of rapid temperature fluctuations on acute stroke risk: a nationwide case-crossover study from 2001 to 2020 [Lancet, 4/2025 ] DOI:10.1016/j.lanwpc.2025.101546
Dementia
Abolhasani E, et al. Air Pollution and Incidence of Dementia. Neurology 2023 This meta-analysis of 20 cohort studies: Showed a 3% increase in dementia risk for every 1 µg/m3 increment in PM2.5 (equivalent to an increment in AQI of 25 to 29)
Li C, et al. Relationships of Residential Distance to Major Traffic Roads and Dementia Incidence and Brain Structural Measures. Health Data Science 2023 For a cohort in the United Kingdom, those living less than 1000 m from a major traffic road had a 13% higher risk of dementia vs greater than 1000 m
Johnson GM, et al. Association of PM2.5 Exposure and Alzheimer Disease Pathology in Brain Bank Donors—Effect Modification by APOE Genotype. Neurology 2024 Study links CERAD Alzheimer’s pathology score with increased 1 and 3 year PM2.5 exposure
Gao Y, et al. Heat Exposure and Dementia Related Mortality in China. JAMA Netw Open 2024 Dementia related deaths increased during excessively hot days/nights
Elser H, et al. Wildfire Exposure and Incident Dementia. JAMA Neurology 2024 Over 65yo Kaiser patients with 3yr smoke exposure had an 18% increased risk of dementia for every 1 μg/m3
Wildfire Exposure and Incident Dementia. JAMA Neurology 11/2024 https://doi.org/10.1001/jamaneurol.2024.4058
Long-Term Intake of Red Meat in Relation to Dementia Risk and Cognitive Function in US Adults. [Neurology, 1/15/25] doi: 10.1212/WNL.0000000000210286.
Extreme Heat and Hospitalization Among Older Persons With Alzheimer Disease and Related Dementias [JAMA Netw, 2/3/25] doi:10.1001/jamainternmed.2024.7719
Parkinson’s
Kryzanowski B, et al. Fine Particulate Matter and Parkinson’s Disease. Neurology 2023 For a large US Medicare cohort, the relative risk of PD was 56% greater for those exposed to a median level of PM2.5 compared with those with the lowest level of PM2.5
Neuro-infectious Disease
Thomson MC, Stanberry LR. Climate change and vector borne disease. NEJM 2022 Climate change associates with diseases with potential for encephalopathy
World Health Organization World malaria report 2023 Chapter 10 spotlights the growing threat of malaria with a chapter on climate change
Review Articles
Sisodiya SM, et al. Climate change and disorders of the nervous system. Lancet Neurology 2024
Extreme Heat
See references 3 to 5 above under stroke
Balester, Heat related Mortality in Europe. Nature Medicine 2022 More than 60,000 excess deaths from the European heatwave in summer of 2022
Minor K, et al. Rising temperatures erode human sleep globally. One Earth 2022
Gao Y, et al. Heat Exposure and Dementia-Related Mortality in China. JAMA Netw Open. 2024
Extreme Heat and Hospitalization Among Older Persons With Alzheimer Disease and Related Dementias [JAMA Netw, 2/3/25] doi:10.1001/jamainternmed.2024.7719
Impact of rapid temperature fluctuations on acute stroke risk: a nationwide case-crossover study from 2001 to 2020 [Lancet, 4/2025 ] DOI:10.1016/j.lanwpc.2025.101546
Disparities and Climate Equity
Multiple Sclerosis
There are only a small number of studies addressing this association.
Elser H, et al. Anomalously warm weather and acute care visits in patients with multiple sclerosis. PLoS Medicine. 2021 A database Review of 106,225 MS patients nationwide found an increased risk of ER visits of 4.3% and increased risk of inpatient visits of 3.2% with elevated monthly temperature averages of greater or equal to 1.5°C.
Climate Communication
Kotcher J, et al. How to communicate about climate change with patients. BMJ 2024 Includes recommendations on how to counsel patients on mitigation of risk from climate hazards like extreme heat and wildfires
Air Pollution Data
American Lung Association State of the Air Report 2025 PDF and Key Findings PDF,
World Health Organization Air Pollution Data
IQAir Real time and annual air quality rankings
Literature Review on the Impacts of Residential Combustion, American Lung Association, July 2022
Position Statements
World Stroke Organization Policy Statement on Climate Change and Stroke, 05/2024
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