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Relationship of Cigarette Smoking and Time of Quitting with Incident Dementia and Cognitive Decline.

TitleRelationship of Cigarette Smoking and Time of Quitting with Incident Dementia and Cognitive Decline.
Publication TypeJournal Article
Year of Publication2020
AuthorsDeal JA, Power MC, Palta P, Alonso A, Schneider ALC, Perryman K, Bandeen-Roche K
Secondary AuthorsSharrett ARichey
JournalJ Am Geriatr Soc
Volume68
Issue2
Pagination337-345
Date Published2020 02
ISSN1532-5415
KeywordsAged, Case-Control Studies, Causality, Cigarette Smoking, Cognitive Dysfunction, Dementia, Ex-Smokers, Female, Humans, Male, Middle Aged, Non-Smokers, Prospective Studies, Smoking Cessation, Time Factors
Abstract

OBJECTIVES: Understanding how dementia risk is impacted by timing of smoking cessation has public health implications for prevention efforts. We investigated the relationship of cigarette smoking and cessation with dementia risk and cognitive decline in the Atherosclerosis Risk in Communities (ARIC) study.

DESIGN: Ongoing prospective cohort study.

SETTING: Begun in 1987-1989, ARIC was conducted in four US communities.

PARTICIPANTS: A total of 13 002 men and women (25% African American) aged 52 to 75 years.

MEASUREMENTS: All-cause dementia was defined using standardized algorithms incorporating longitudinal cognitive data, proxy report, and hospital and death certificate dementia codes. Cognitive decline was measured using a composite cognitive score created from three tests measured at two time points (1996-1998 and 2011-2013). Smoking and cessation status were defined by self-report using data from 1987-1989 (visit 1) and 1996-1998 (visit 4). Incident dementia risk and differences in cognitive change by smoking status were estimated with Cox proportional hazards and linear regression models, respectively. To address smoking-related attrition, cognitive scores were imputed for living participants with incomplete cognitive testing.

RESULTS: The proportion of never, former, and current smokers was 44%, 41%, and 14%; 79% of former smokers quit 9 years or more before baseline. A total of 1347 participants developed dementia. After adjustment, compared with never smoking, the hazard ratio for all-cause dementia for current smoking was 1.33 (95% confidence interval [CI] = 1.12-1.59) and for recent quitting (

CONCLUSION: Although quitting at any time suggested benefit, dementia risk depended on time since smoking cessation. Our study highlights the importance of early midlife cessation to decrease dementia risk. J Am Geriatr Soc 68:337-345, 2020.

DOI10.1111/jgs.16228
Alternate JournalJ Am Geriatr Soc
PubMed ID31675113
PubMed Central IDPMC7002272
Grant ListR01 HL070825 / HL / NHLBI NIH HHS / United States
U01 HL096917 / HL / NHLBI NIH HHS / United States
U01 HL096902 / HL / NHLBI NIH HHS / United States
R25 NS065729 / NS / NINDS NIH HHS / United States
HHSN268201700001I / HL / NHLBI NIH HHS / United States
HHSN268201700004I / HL / NHLBI NIH HHS / United States
U01 HL096899 / HL / NHLBI NIH HHS / United States
R00 AG052830 / AG / NIA NIH HHS / United States
HHSN268201700003I / HL / NHLBI NIH HHS / United States
K99 AG052830 / AG / NIA NIH HHS / United States
P30 AG066507 / AG / NIA NIH HHS / United States
U01 HL096812 / HL / NHLBI NIH HHS / United States
U01 HL096814 / HL / NHLBI NIH HHS / United States
K01 AG054693 / AG / NIA NIH HHS / United States
HHSN268201700002I / HL / NHLBI NIH HHS / United States
HHSN268201700005I / HL / NHLBI NIH HHS / United States