Integrating noise as a risk factor in studies of Alzheimer's disease and dementia: Guidance for epidemiologic research.

Matthew Bozigar, Jennifer Weuve, Sierra N Clark, Stephanie T Grady, Manuella Lech Cantuaria, Yutong Samuel Cai, Charlotte Roscoe, Martin Röösli, Junenette L Peters, Edmund Seto, Danielle Vienneau, Mette Sørensen, Richard L Neitzel, Aaron L Hastings, Thomas J Luben, Zorana Jovanovic Andersen, Charlotte Clark, Anna L Hansell, Perry Hystad, Michael Brauer, Sara D Adar

Journal: Alzheimer's & dementia : the journal of the Alzheimer's Association 2026;22(5):e71513

PMID: 42174391

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Abstract

Noise exposure is increasingly recognized as a modifiable environmental risk factor for Alzheimer's disease and related dementias (ADRD), yet its integration into epidemiologic research remains limited. We reviewed international noise mapping resources, exposure metrics, and analytic approaches relevant to ADRD studies. Mechanistic pathways and methodological challenges were synthesized from recent studies via expert knowledge. We present a stepwise framework for integrating noise into ADRD research, detailing metric selection, spatiotemporal assignment, and analytic guardrails. Our review recommends the application of 24-hour average, nighttime, and event-based metrics, and stresses that health effects may occur at low noise levels. We further underscore the importance of accounting for indoor, occupational, and life course exposures. Rigorous noise exposure assessment and transparent reporting will improve comparability and causal inference in ADRD studies. Future research should harmonize exposure metrics, integrate co-exposures (e.g., air pollution), and clarify etiologically relevant windows to strengthen prevention strategies.

Address: School of Nutrition and Public Health, College of Health, Oregon State University, Corvallis, Oregon, USA.; Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts, USA.; Department of Population Health & Policy, School of Health and Medical Sciences, City St George's, University of London, London, UK.; Department of Environmental Health, Boston University School of Public Health, Boston, Massachusetts, USA.; Work, Environment and Cancer, Danish Cancer Institute, Copenhagen, Denmark.; Research Unit for ORL-Head & Neck Surgery and Audiology, University of Southern Denmark, Odense, Denmark.; Department of Collective Health, Faculty of Medical Sciences, State University of Campinas, Campinas, Brazil.; Centre for Environmental Health and Sustainability, University of Leicester, Leicester, UK.; NIHR Health Protection Research Unit in Chemical Threats and Hazards, University of Leicester, Leicester, UK.; NIHR Leicester Biomedical Research Centre (BRC), Leicester, UK.; Environmental Systems and Human Health, Oregon Health & Science University-Portland State University (OHSU-PSU) School of Public Health, Portland, Oregon, USA.; Swiss Tropical and Public Health Institute, Allschwil, Switzerland.; University of Basel, Basel, Switzerland.; Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, Washington, USA.; Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands.; Work, Environment and Cancer, Danish Cancer Institute, Copenhagen, Denmark.; Department of Natural Science and Environment, Roskilde University, Roskilde, Denmark.; School of Public Health, University of Michigan, Ann Arbor, Michigan, USA.; Volpe National Transportation Systems Center, U.S. Department of Transportation, Cambridge, Massachusetts, USA.; Department of Public Health, University of Copenhagen, Copenhagen, Denmark.; Centre for Environmental Health and Sustainability, University of Leicester, Leicester, UK.; NIHR Health Protection Research Unit in Chemical Threats and Hazards, University of Leicester, Leicester, UK.; NIHR Leicester Biomedical Research Centre (BRC), Leicester, UK.; Leicester British Heart Foundation Centre of Research Excellence, Leicester, UK.; School of Population and Public Health, The University of British Columbia, Vancouver, British Columbia, Canada.; Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA.

DOI: 10.1002/alz.71513

MeSH Terms: Humans, Alzheimer Disease, Risk Factors, Noise, Dementia, Environmental Exposure