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Women’s health - No.683 Imprimer

Heavy Smoking in Midlife and Long-term Risk of Alzheimer Disease and Vascular Dementia

Minna Rusanen et al, (Arch Intern Med. Published online October 25, 2010. doi:10.1001/archinternmed.2010.393 ) investigated the long-term association of amount of smoking in middle age on the risk of dementia, Alzheimer disease (AD), and vascular dementia (VaD) several decades later in a large, diverse population. They used prospective data from a multiethnic population-based cohort of 21 123 members of a health care system who participated in a survey between 1978 and 1985. A total of 5367 people (25.4%) were diagnosed as having dementia (including 1136 cases of AD and 416 cases of VaD) during a mean follow-up period of 23 years. Results were adjusted for age, sex, education, race, marital status, hypertension, hyperlipidemia, body mass index, diabetes, heart disease, stroke, and alcohol use. Compared with nonsmokers, those smoking more than 2 packs a day had an elevated risk of dementia (adjusted hazard ratio [HR], 2.14; 95% CI, 1.65-2.78), AD (adjusted HR, 2.57; 95% CI, 1.63-4.03), and VaD (adjusted HR, 2.72; 95% CI, 1.20-6.18).

Conclusions

In this large cohort, heavy smoking in midlife was associated with a greater than 100% increase in risk of dementia, AD, and VaD more than 2 decades later. These results suggest that the brain is not immune to long-term consequences of heavy smoking.

 
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