Heavy smoking in midlife and long-term risk of Alzheimer disease and vascular dementia

Minna Rusanen, Miia Kivipelto, Charles P. Quesenberry, Jufen Zhou, Rachel Whitmer

Research output: Contribution to journalArticle

150 Citations (Scopus)

Abstract

Background: Smoking is a risk factor for several life-threatening diseases, but its long-term association with dementia is controversial and somewhat understudied. Our objective was to investigate 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. Methods: We analyzed prospective data from a multi-ethnic population-based cohort of 21 123 members of a health care system who participated in a survey between 1978 and 1985. Diagnoses of dementia, AD, and VaD made in internal medicine, neurology, and neuropsychology were collected from January 1, 1994, to July 31, 2008. Multivariate Cox proportional hazards models were used to investigate the association between midlife smoking and risk of dementia, AD, and VaD. Results: 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.

Original languageEnglish (US)
Pages (from-to)333-339
Number of pages7
JournalArchives of Internal Medicine
Volume171
Issue number4
DOIs
StatePublished - Feb 28 2011
Externally publishedYes

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Vascular Dementia
Alzheimer Disease
Smoking
Dementia
Neuropsychology
Sex Education
Marital Status
Neurology
Internal Medicine
Hyperlipidemias
Proportional Hazards Models
Population
Heart Diseases
Body Mass Index
Stroke
Alcohols
Hypertension
Delivery of Health Care

ASJC Scopus subject areas

  • Internal Medicine

Cite this

Heavy smoking in midlife and long-term risk of Alzheimer disease and vascular dementia. / Rusanen, Minna; Kivipelto, Miia; Quesenberry, Charles P.; Zhou, Jufen; Whitmer, Rachel.

In: Archives of Internal Medicine, Vol. 171, No. 4, 28.02.2011, p. 333-339.

Research output: Contribution to journalArticle

Rusanen, Minna ; Kivipelto, Miia ; Quesenberry, Charles P. ; Zhou, Jufen ; Whitmer, Rachel. / Heavy smoking in midlife and long-term risk of Alzheimer disease and vascular dementia. In: Archives of Internal Medicine. 2011 ; Vol. 171, No. 4. pp. 333-339.
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