Associations between disorders in activities of daily living and heavy metal concentrations in elderly people

LI Tingjun; CAI Jiansheng; LI Ruiying; XIAO Jie; YE Zeyan; CHENG Yuqian; LIU Zhe; ZHANG Zhiyong

doi:10.11836/JEOM24085

Volume 41 Issue 9

Sep. 2024

Turn off MathJax

Article Contents

Abstract

References

Journal of Environmental and Occupational Medicine > 2024 > 41(9): 995-1003. > DOI: 10.11836/JEOM24085

LI Tingjun, CAI Jiansheng, LI Ruiying, XIAO Jie, YE Zeyan, CHENG Yuqian, LIU Zhe, ZHANG Zhiyong. Associations between disorders in activities of daily living and heavy metal concentrations in elderly people[J]. Journal of Environmental and Occupational Medicine, 2024, 41(9): 995-1003. DOI: 10.11836/JEOM24085

Citation:

PDF (1596 KB)

Associations between disorders in activities of daily living and heavy metal concentrations in elderly people

a.
School of Public Health
b.
Guangxi Key Laboratory of Environmental Exposureomics and Whole Life Cycle Health Research, Guilin Medical College, Guilin, Guangxi 541199, China

Funds: This study was funded.

More Information

Corresponding author:
ZHANG Zhiyong; E-mail: rpazz@163.com
Received Date: March 05, 2024
Accepted Date: August 05, 2024

Graphical Abstract

Abstract

Abstract

Background
Heavy metals may play an important role in environmental risk factors associated disorders of activities of daily living (ADL) in older adults.
Objective
To investigate the associations between plasma levels of six heavy metals (zinc, arsenic, cadmium, lead, manganese, and copper) and ADL disorders in older adults.
Methods
A cross-sectional survey was conducted from 2018 to 2019 among 1412 rural elderly people in Gongcheng Yao Autonomous County, Guangxi Zhuang Autonomous Region. The plasma metal concentrations were detected by inductively coupled plasma mass spectrometry (ICP-MS), and subsequently classified into three groups (T1-T3) based on tertiles, with the T1 group as the reference. The samples were assessed for ADL disorders using the ADL scale. Logistic regression and restricted cubic spline model (RCS) were used to estimate the odds ratio (OR) and 95% confidence interval (CI) to assess the associations between heavy metals and the prevalence of reporting ADL disorders.
Results
The mean age of the study population was (68.52 ± 5.92) years, 825 (58.4%) female and 587 (41.6%) male. Of these, 372 (26.34%) subjects reported ADL disorders, and most of them were female (74.30%). The results of logistic regression showed that the participants in the cadmium T2 group (0.15-0.25 µg·L⁻¹) had a higher risk of ADL disorders compared to the T1 group (≤0.15 μg·L⁻¹) (OR=1.552, 95%CI: 1.086, 2.134). After stratification by sex, the relative risk of ADL disorders was lower in the plasma copper T3 group (>1019.58 µg·L⁻¹) compared to the T1 group (≤868.12 μg·L⁻¹) in men (OR=0.481, 95%CI: 0.232, 0.998). The relative risk of ADL disorders was higher in the plasma cadmium T2 group (0.15-0.25 µg·L⁻¹) compared to the T1 group (≤0.15 μg·L⁻¹) in women (OR=1.758, 95%CI: 1.182, 2.616). The RCS results showed that the risk of ADL disorders in men was nonlinearly associated with copper (P_nonlinear=0.011, P_overall<0.05).
Conclusion
High levels of cadmium are positively associated with the risk of reporting ADL disorders, while high levels of copper are negatively associated with the risk of reporting ADL disorders in men.
- activity of daily living,
- plasma,
- heavy metal,
- elderly,
- restricted cubic spline

FullText(HTML)

References (56)

References

[1]	LING Y, WANG, Z Y, HU H X, CHEN et al. Prevalence of mild cognitive impairment and its association with malnutrition in older Chinese adults in the community.[J]. Front Public Health, 2024, 12: 0.
[2]	SHAO L, SHI Y, XIE X Y, et al. Incidence and risk factors of falls among older people in nursing homes: systematic review and meta-analysis[J]. J Am Med Dir Assoc, 2023, 24(11): 1708-1717. doi: 10.1016/j.jamda.2023.06.002
[3]	CHI W C, CHANG K H, ESCORPIZO R, et al. Measuring disability and its predicting factors in a large database in Taiwan using the World Health Organization Disability Assessment Schedule 2.0[J]. Int J Environ Res Public Health, 2014, 11(12): 12148-12161. doi: 10.3390/ijerph111212148
[4]	FONG J H, FENG J. Comparing the loss of functional independence of older adults in the U. S. and China[J]. Arch Gerontol Geriatr, 2018, 74: 123-127. doi: 10.1016/j.archger.2017.10.020
[5]	OKORO C A, HOLLIS N D, CYRUS A C, et al. Prevalence of disabilities and health care access by disability status and type among adults - United States, 2016[J]. MMWR Morb Mortal Wkly Rep, 2018, 67(32): 882-887. doi: 10.15585/mmwr.mm6732a3
[6]	WANG J, SHU B, TANG D Z, et al. The prevalence of osteoporosis in China, a community based cohort study of osteoporosis[J]. Front Public Health, 2023, 11: 1084005. doi: 10.3389/fpubh.2023.1084005
[7]	HUANG J, LUO L, WANG Y, et al. The burden of chronic kidney disease associated with dietary exposure to cadmium in China, 2020[J]. Environ Pollut, 2023, 336: 122434. doi: 10.1016/j.envpol.2023.122434
[8]	DAI B Z, ZHOU L L, MEI J Y. Old age security in rural China: there is a long way to go[J]. Chin Med J (Engl), 2013, 126(22): 4348-4353. doi: 10.3760/cma.j.issn.0366-6999.20130134
[9]	HODGKIN S P, WARBURTON J, HANCOCK S. Predicting wellness among rural older Australians: a cross- sectional study[J]. Rural Remote Health, 2018, 18(3): 4547.
[10]	FU Z, XI S. The effects of heavy metals on human metabolism[J]. Toxicol Mech Methods, 2020, 30(3): 167-176. doi: 10.1080/15376516.2019.1701594
[11]	KANG P, SHIN H Y, KIM K Y. Association between dyslipidemia and mercury exposure in adults[J]. Int J Environ Res Public Health, 2021, 18(2): 775. doi: 10.3390/ijerph18020775
[12]	ZHOU Z, LU Y H, PI H F, et al. Cadmium exposure is associated with the prevalence of dyslipidemia[J]. Cell Physiol Biochem, 2016, 40(3/4): 633-643.
[13]	LUO T, CHEN S, CAI J, et al. Association between combined exposure to plasma heavy metals and dyslipidemia in a Chinese population[J]. Lipids Health Dis, 2022, 21(1): 131. doi: 10.1186/s12944-022-01743-6
[14]	CHEN Y Y, WANG C C, KAO T W, et al. The relationship between lead and cadmium levels and functional dependence among elderly participants[J]. Environ Sci Pollut Res Int, 2020, 27(6): 5932-5940. doi: 10.1007/s11356-019-07381-3
[15]	YAMASHITA R, TAKAHASHI Y, TAKASHIMA K, et al. Induction of cellular senescence as a late effect and BDNF-TrkB signaling-mediated ameliorating effect on disruption of hippocampal neurogenesis after developmental exposure to lead acetate in rats[J]. Toxicology, 2021, 456: 152782. doi: 10.1016/j.tox.2021.152782
[16]	MASOM L H, HARP J P, HAN D Y. Pb neurotoxicity: neuropsychological effects of lead toxicity[J]. Biomed Res Int, 2014, 2014: 840547.
[17]	IQBAL G, AHMED T. Co-exposure of metals and high fat diet causes aging like neuropathological changes in non-aged mice brain[J]. Brain Res Bull, 2019, 147: 148-158. doi: 10.1016/j.brainresbull.2019.02.013
[18]	GONÇALVES J F, NICOLOSO F T, DA COSTA P, et al. Behavior and brain enzymatic changes after long-term intoxication with cadmium salt or contaminated potatoes[J]. Food Chem Toxicol, 2012, 50(10): 3709-3718. doi: 10.1016/j.fct.2012.07.016
[19]	CHEN L, ZHAO Y, LIU F, et al. Biological aging mediates the associations between urinary metals and osteoarthritis among U. S. adults[J]. BMC Med, 2022, 20(1): 207. doi: 10.1186/s12916-022-02403-3
[20]	GIDIKOVA P L. Blood lead, cadmium and zinc correlations in elderly rural residents[J]. Folia Med (Plovdiv), 2019, 61(1): 113-119. doi: 10.2478/folmed-2018-0051
[21]	XIAO L, CHENG H, CAI H, et al. Associations of heavy metals with activities of daily living disability: an epigenome-wide view of DNA methylation and mediation analysis[J]. Environ Health Perspect, 2022, 130(8): 087009. doi: 10.1289/EHP10602
[22]	ROY M, PAL I, NATH A K, et al. Peroxidase activity of heme bound amyloid β peptides associated with Alzheimer's disease[J]. Chem Commun (Camb), 2020, 56(33): 4505-4518. doi: 10.1039/C9CC09758A
[23]	ALGHRABLY M, CZABAN I, JAREMKO Ł, et al. Interaction of amylin species with transition metals and membranes[J]. J Inorg Biochem, 2019, 191: 69-76. doi: 10.1016/j.jinorgbio.2018.11.004
[24]	KULICHIKHIN K Y, FEDOTOV S A, RUBEL M S, et al. Development of molecular tools for diagnosis of Alzheimer's disease that are based on detection of amyloidogenic proteins[J]. Prion, 2021, 15(1): 56-69. doi: 10.1080/19336896.2021.1917289
[25]	YEPES M. The plasminogen activating system in the pathogenesis of Alzheimer's disease[J]. Neural Regen Res, 2021, 16(10): 1973-1977. doi: 10.4103/1673-5374.308076
[26]	PANNUZZO M. Beta-amyloid pore linked to controlled calcium influx into the cell: a new paradigm for Alzheimer's Disease[J]. Alzheimers Dement, 2022, 18(1): 191-196. doi: 10.1002/alz.12373
[27]	MOCCHEGIANI E, MALAVOLTA M, LATTANZIO F, et al. Cu to Zn ratio, physical function, disability, and mortality risk in older elderly (ilSIRENTE study)[J]. Age (Dordr), 2012, 34(3): 539-552. doi: 10.1007/s11357-011-9252-2
[28]	YANG L, CHEN X, CHENG H, et al. Dietary copper intake and risk of stroke in adults: a case-control study based on national health and nutrition examination survey 2013-2018[J]. Nutrients, 2022, 14(3): 409. doi: 10.3390/nu14030409
[29]	FAGHANI S, OKHVAT A A, KARIMI N, et al. Validation of myasthenia gravis activity of daily living questionnaire: Persian version[J]. Curr J Neurol, 2022, 21(1): 35-39.
[30]	Joint Committee for Guideline Revision. 2018 Chinese guidelines for prevention and treatment of hypertension-a report of the revision committee of Chinese guidelines for prevention and treatment of hypertension[J]. J Geriatr Cardiol, 2019, 16(3): 182-241.
[31]	CHEN K, SHEN Z, GU W, et al. Prevalence of obesity and associated complications in China: a cross-sectional, real-world study in 15.8 million adults[J]. Diabetes Obes Metab, 2023, 25(11): 3390-3399. doi: 10.1111/dom.15238
[32]	ZHANG R H, ZHOU J B, CAI Y H, et al. Non-linear association of anthropometric measurements and pulmonary function[J]. Sci Rep, 2021, 11(1): 14596. doi: 10.1038/s41598-021-93985-0
[33]	HYEJIN L, BUMJO O, SUNYOUNG K, et al. ADL/ IADL dependencies and unmet healthcare needs in older persons: a nationwide survey[J]. Arch Gerontol Geriatr, 2021, 96: 104458. doi: 10.1016/j.archger.2021.104458
[34]	CHUNHABUNDIT R. Cadmium exposure and potential health risk from foods in Contaminated Area, Thailand[J]. Toxicol Res, 2016, 32(1): 65-72. doi: 10.5487/TR.2016.32.1.065
[35]	KNOELL D L, WYATT T A. The adverse impact of cadmium on immune function and lung host defense[J]. Semin Cell Dev Biol, 2021, 115: 70-76. doi: 10.1016/j.semcdb.2020.10.007
[36]	PENG Y, LI Z, YANG X, et al. Relation between cadmium body burden and cognitive function in older men: a cross-sectional study in China[J]. Chemosphere, 2020, 250: 126535. doi: 10.1016/j.chemosphere.2020.126535
[37]	GARCÍA-ESQUINAS E, NAVAS-ACIEN A, PÉREZ-GÓMEZ B, et al. Association of lead and cadmium exposure with frailty in US older adults[J]. Environ Res, 2015, 137: 424-431. doi: 10.1016/j.envres.2015.01.013
[38]	SEABRA C M, QUENTAL S, NETO A P, et al. A novel Alu-mediated microdeletion at 11p13 removes WT1 in a patient with cryptorchidism and azoospermia[J]. Reprod Biomed Online, 2014, 29(3): 388-391. doi: 10.1016/j.rbmo.2014.04.017
[39]	UMEDA S, KANDA M, MIWA T, et al. Fraser extracellular matrix complex subunit 1 promotes liver metastasis of gastric cancer[J]. Int J Cancer, 2020, 146(10): 2865-2876. doi: 10.1002/ijc.32705
[40]	YOUNESI S, PARSIAN H, HOSSEINI S R, et al. Dyshomeostasis of serum oxidant/antioxidant status and copper, zinc, and selenium levels in elderly physically disabled persons: an AHAP-based study[J]. Biol Trace Elem Res, 2015, 166(2): 136-141. doi: 10.1007/s12011-015-0261-3
[41]	GBD 2019 Dementia Forecasting Collaborators. Estimation of the global prevalence of dementia in 2019 and forecasted prevalence in 2050: an analysis for the Global Burden of Disease Study 2019[J]. Lancet Public Health, 2022, 7(2): e105-e125. doi: 10.1016/S2468-2667(21)00249-8
[42]	STELMASHOOK E V, ALEXANDROVA O P, GENRIKHS E E, et al. Effect of zinc and copper ions on cadmium-induced toxicity in rat cultured cortical neurons[J]. J Trace Elem Med Biol, 2022, 73: 127012. doi: 10.1016/j.jtemb.2022.127012
[43]	WANG Y, PENG D, ZHANG X et al. PLCβ4 driven by cadmium-exposure during gestation and lactation contributes to cognitive deficits by suppressing PIP2/PLCγ1/CREB/BDNF signaling pathway in male offspring.[J]. J Hazard Mater, 2024, 474: 134756. doi: 10.1016/j.jhazmat.2024.134756
[44]	GAIER E D, KLEPPINGER A, RALLE M, et al. High serum Cu and Cu/Zn ratios correlate with impairments in bone density, physical performance and overall health in a population of elderly men with frailty characteristics[J]. Exp Gerontol, 2012, 47(7): 491-496. doi: 10.1016/j.exger.2012.03.014
[45]	VEIGA N, ALVAREZ N, CASTELLANO E E, et al. Comparative study of antioxidant and pro-oxidant properties of homoleptic and heteroleptic copper complexes with amino acids, dipeptides and 1, 10-phenanthroline: the quest for antitumor compounds[J]. Molecules, 2021, 26(21): 6520. doi: 10.3390/molecules26216520
[46]	WANG J, WANG X, HE Y, et al. Antioxidant and pro-oxidant activities of melatonin in the presence of copper and polyphenols in vitro and in vivo[J]. Cells, 2019, 8(8): 903. doi: 10.3390/cells8080903
[47]	WANG D, TIAN Z, ZHANG P, et al. The molecular mechanisms of cuproptosis and its relevance to cardiovascular disease[J]. Biomed Pharmacother, 2023, 163: 114830. doi: 10.1016/j.biopha.2023.114830
[48]	LI S, SUN W, ZHANG D. Association of zinc, iron, copper, and selenium intakes with low cognitive performance in older adults: a cross-sectional study from national health and nutrition examination survey (NHANES)[J]. J Alzheimers Dis, 2019, 72(4): 1145-1157. doi: 10.3233/JAD-190263
[49]	GONG Z, SONG W, GU M. Serum copper and zinc concentrations and cognitive impairment in older adults aged 60 years and older[J]. Biol Trace Elem Res, 2022, 200(4): 1495-1501. doi: 10.1007/s12011-021-02765-4
[50]	AL-KHATEEB E, AL-ZAYADNEH E, AL-DALAHMAH O, et al. Relation between copper, lipid profile, and cognition in elderly Jordanians[J]. J Alzheimers Dis, 2014, 41(1): 203-211. doi: 10.3233/JAD-132180
[51]	CHANG C S, CHOI J B, KIM H J, et al. Correlation between serum testosterone level and concentrations of copper and zinc in hair tissue[J]. Biol Trace Elem Res, 2011, 144(1/3): 264-271.
[52]	JAIN R B. Thyroid function and serum copper, selenium, and zinc in general U. S. population[J]. Biol Trace Elem Res, 2014, 159(1/3): 87-98.
[53]	HUGHES M F, BECK B D, CHEN Y, et al. Arsenic exposure and toxicology: a historical perspective[J]. Toxicol Sci, 2011, 123(2): 305-332. doi: 10.1093/toxsci/kfr184
[54]	OBENG-GYASI E. Sources of lead exposure in various countries[J]. Rev Environ Health, 2019, 34(1): 25-34. doi: 10.1515/reveh-2018-0037
[55]	GAU J T, CHAVAN B, LI Y, et al. Association between serum zinc levels and basic physical functioning: secondary data analysis of NHANES 2011-14[J]. BMC Nutr, 2021, 7(1): 57. doi: 10.1186/s40795-021-00461-z
[56]	WANG J, UM P, DICKERMAN B A, et al. Zinc, magnesium, selenium and depression: a review of the evidence, potential mechanisms and implications[J]. Nutrients, 2018, 10(5): 584. doi: 10.3390/nu10050584

[1]	CHEN Xiuqin, LI Zhiyuan, LIU Penghao, GAO Junling, WU Yiling, HUANG Limei. Prevalence and influencing factors of mild cognitive impairment in the elderly in Songjiang District, Shanghai[J]. Journal of Environmental and Occupational Medicine, 2024, 41(3): 318-322, 329. DOI: 10.11836/JEOM23335
[2]	LIU Qiumei, YU Guoqi, ZHANG Zhiyong, NONG Chuntao, CAI Jiansheng, XU Min, ZHANG Junling, XU Xia, LIU Shuzhen, WEI Chunmei, QIN Jian. Associations between cadmium exposure and cognition-related gene methylation of workers in a Guangxi metal smelter[J]. Journal of Environmental and Occupational Medicine, 2021, 38(10): 1077-1082. DOI: 10.13213/j.cnki.jeom.2021.21200
[3]	LI Chengcheng, LYU Yuebin, CHEN Chen, ZHOU Jinhui, GU Heng, WEI Yuan, ZHAO Feng, LU Feng, LIU Yingchun, CAO Zhaojin, SHI Xiaoming. Association of urinary cadmium with high sensitive C-reactive protein among the elderly aged 65 years and older in nine longevity areas of China[J]. Journal of Environmental and Occupational Medicine, 2021, 38(10): 1063-1068. DOI: 10.13213/j.cnki.jeom.2021.21241
[4]	CHEN Tianyi, CHEN Fei'er, WANG Kan, MA Xuedong, WEI Xinping, SONG Caixia, ZHANG Hua, CAI Yunfei, XIA Zhaolin, ZHAO Zhuohui. Individual exposure assessment of fine particulate matters and influencing factors in the elderly in urban area of Shanghai[J]. Journal of Environmental and Occupational Medicine, 2021, 38(1): 1-9. DOI: 10.13213/j.cnki.jeom.2021.20375
[5]	OUYANG Yi-fei, WANG Hui-jun, WANG Zhi-hong, SONG Yi-qi, ZHANG Bing. Physical activity among elderly residents in 15 provinces of China in 2015[J]. Journal of Environmental and Occupational Medicine, 2019, 36(12): 1094-1099. DOI: 10.13213/j.cnki.jeom.2019.19414
[6]	OUYANG Yi-fei, ZHANG Bing. Improve healthy lifestyle, promote elderly health[J]. Journal of Environmental and Occupational Medicine, 2019, 36(12): 1091-1093. DOI: 10.13213/j.cnki.jeom.2019.19687
[7]	KONG Ling-yan, CHAO Jian-qian, HU Jie, CAI Rui-xue, WANG Ying-peng. Effects of malnutrition and weight loss risk on quality of life of elderly group in Nanjing communites[J]. Journal of Environmental and Occupational Medicine, 2019, 36(9): 841-846. DOI: 10.13213/j.cnki.jeom.2019.19117
[8]	ZHOU De-ding, XU Nai-ting, GAO Ning, SHI Yan, PENG Juan-juan, YU Yan. A structural equation model of fall-related risk factors among the elderly in urban areas of Shanghai[J]. Journal of Environmental and Occupational Medicine, 2019, 36(8): 703-709. DOI: 10.13213/j.cnki.jeom.2019.19223
[9]	XIAO Meng-ying, WANG Zhao-yang, FAN Hong-min, CHE Chong-liang, GAO Xue-juan, LU Yao, CONG Long-xue, LIU Ya-jing, YANG Yun-ying, WANG Li-hua, HU Bo, CHEN Yin-ping, LI Yun, YUAN Ju-xiang. Relationship Between Occupational High Temperature Exposure Years and Prevalence of Hypertension: Based on Restricted Cubic Spline Model[J]. Journal of Environmental and Occupational Medicine, 2016, 33(11): 1031-1036. DOI: 10.13213/j.cnki.jeom.2016.16204
[10]	LIU Ya-jing, WANG Chao-yang, FAN Hong-min, HU Bo, YANG Yun-ying, WANG Li-hua, XIAO Meng-ying, CHE Chong-liang, YUAN Ju-xiang, CHEN Yin-ping, LI Yun. Relationship Between Shift Work Years and Hypertension in Male Steel Workers:Based on Restricted Cubic Spline Model[J]. Journal of Environmental and Occupational Medicine, 2016, 33(9): 839-844. DOI: 10.13213/j.cnki.jeom.2016.16141