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Modern Geomatics Technologies and Applications

Determining the most polluted districts of Tehran to avoid residing people at risk of
cognitive impairment and Alzheimer disease

2*
1
Naghmeh Jafarpournaser , Mahmoud Reza Delavar , Maryam Noroozian 3

1 GIS Department, School of Surveying and Geospatial Eng., College of Engineering, University of Tehran,
North Kargar Ave., Jalal Al Ahmad Crossing Tehran, Iran,
2 Center of Excellence in Geomatic Eng. in Disaster Management, School of Surveying and Geospatial Eng.,
College of Engineering, University of Tehran, North Kargar Ave., Jalal Al Ahmad Crossing Tehran, Iran,
3 Cognitive Neurology and Neuropsychiatry Division, Department of Psychiatry, Tehran University of Medical
Sciences (TUMS) and Roozbeh Hospital, South Kargar Avenue, Tehran, Iran
* mdelavar@ut.ac.ir

Abstract: Previous research has verified that some genes carriers can control the disease to some extent if they avoid
prolonged exposure to air pollutants. Annually, a significant number of people lives in Tehran lose their lives due to
diseases related to air pollution. According to the measurements of Tehran Air Quality Control Company, particulate
matters with a diameter of less than 2.5 (PM2.5) and 10 microns (PM10) are the most significant air pollutants. These two
group of particulate matters are the most important environmental factors affecting cognitive impairment. As
recommended by experts, staying away from areas with high levels of these pollutants helps to control the disease process,
especially in patients or people at risk. Living in cleaner parts of cities where there have less rates of these pollutants is
one of the solutions to prevent cognitive impairment and Alzheimer disease (AD) fast progress. This paper has studied the
concentration of these pollutants in Tehran. The best and worst districts polluted areas of Tehran with respect to PM 2.5
and PM10 which are correlated with cognitive impairment and AD patients are determined.

1. Introduction
Dementia and age-related cognitive disorders, such as Alzheimer Disease (AD) which are the most common form of
dementia, are progressive neurodegenerative disorders that affect a significant population of elderly. The number of patients with
dementia in Iran is projected to reach 1.02 million by 2030 [1,2]. In addition to the financial costs of dementia and AD to patients
and caregivers, it is associated with irreparable mental and physical damages such as mental distress, depression, anxiety, damage
to the navigational parts of the brain, severe physical impacts and even death [3]. Therefore, it is necessary to pay attention to
this disease in order to take the necessary actions to diagnose, prevent and control the cognitive impairment and AD.
Aging, cardiovascular disease, family history and genetic factors such as apolipoprotein E ɛ4 (APOE ɛ4) [4] are among
the most important risk factors for AD and cognitive impairment [5-7]. In [8], some environmental factors have also been
identified as risk factors. Epidemiological studies on the identification of some modifiable risk factors [9] show that about one
third of cases are affected by the modifiable factors [10].
Given that the progression of the disease has begun years before the onset of symptoms, thus identifying modifiable risk
factors and developing some strategies to prevent the disease or progression of the disease are very important among vulnerable
people due to aging, cardiovascular disease and family history. Dementia and AD begin with the preclinical stage. Strategies to
prevent the disease or progression of the disease in susceptible individuals should be implemented at this stage [3].
People living in mega cities are often more exposed to air pollution, noise and lack of green space [8]. Prolonged exposure
to air pollution [11,12], noise [13] and being away from green space [14], which are known to be modifiable risk factors for
cognitive decline and AD, are directly associated with premature death [15] and adverse health effects, such as mental health
effects [16-18].
In this regard, the study of the interaction between environmental risk factors with APOE ɛ4 and other genetic factors is
very important [19]. Recent research show that, the industrialization and mechanization of human life in metropolitan areas and
their consequences, such as air pollution with destructive neurological effects, reduce cognitive abilities and increase the risk of
dementia and AD [20-30]. According to the studies by the Lancet Prevention Commission, air pollution is also a potential risk
factor for dementia and AD [31]. Unfortunately, in recent years, high levels of air pollutants has been reported respired by
humans more than WHO’s air quality guidelines [32,33]. The correlation between air pollution and AD was first reported in
2015 in a study among 95,690 people over the age of 65 [34]. Some studies have reported a correlation between long-term
exposure to the ambient air pollutants including ozone, PM 10 [35], PM2.5 [36,37] as well as nitrogen dioxide (NO2) [38] and AD.
In United States, carriers of the APOE ɛ4 gene whom are exposed to air pollution are more likely to develop AD than others
[37].

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