Association between cooking fuels and mild cognitive impairment among older adults from six low- and middle-income countries

Lee Smith, Damiano Pizzol, Guillermo F. López Sánchez, Karel Kostev, Hans Oh, Louis Jacob, Nicola Veronese, Benjamin R. Underwood, Laurie Butler, Yvonne Barnett, Mark A. Tully, Ai Koyanagi

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There is a small body of evidence suggesting that unclean cooking fuel use may be associated with cognitive decline. However, to date, no study has investigated the association between unclean cooking fuel and mild cognitive impairment (MCI). Thus, we investigated the association between cooking fuel type or ventilation type and MCI among adults aged ≥ 65 years using nationally representative datasets from six low- and middle-income countries. Cross-sectional, community-based data from the World Health Organization (WHO) Study on global Ageing and adult health (SAGE) were analyzed. MCI was defined using the National Institute on Aging-Alzheimer's Association criteria. Unclean cooking fuel referred to kerosene/paraffin, coal/charcoal, wood, agriculture/crop, animal dung, and shrubs/grass. Multivariable logistic regression analysis was conducted to assess associations. Data on 13,623 individuals were analyzed [mean (SD) age 72.8 (11.0) years; 45.5% males]. Unclean cooking fuel (vs. clean cooking fuel) was associated with a significant 1.48 (95% CI = 1.08–2.03) times higher odds for MCI. Having no chimney or hood for cooking ventilation was also associated with significantly higher odds for MCI (OR = 1.88; 95% CI = 1.25–2.84). Unclean cooking fuel use and lack of chimney or hood for cooking ventilation were associated with higher odds for MCI. Findings support the implementation of the United Nations Sustainable Goal 7, which advocates affordable, reliable, sustainable, and modern energy for all, as this may also help reduce MCI and ultimately dementia.
Original languageEnglish
Article number14055
Number of pages8
JournalScientific Reports
Issue number1
Early online date18 Aug 2022
Publication statusPublished online - 18 Aug 2022

Bibliographical note

Funding Information:
This paper uses data from WHO’s Study on Global Ageing and Adult Health (SAGE). SAGE is supported by the U.S. National Institute on Aging through Interagency Agreements OGHA 04034785, YA1323–08-CN-0020, Y1-AG-1005–01 and through research grants R01-AG034479 and R21-AG034263. All methods were carried out in accordance with relevant guidelines and regulations.

Funding Information:
Dr. Guillermo F. López Sánchez is funded by the European Union – Next Generation EU.

Publisher Copyright:
© 2022, The Author(s).


  • Cooking fuel
  • Mild cognitive impairment
  • Low- and middle-income countries
  • Older adults


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