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Relation between smoking and risk of dementia and Alzheimer disease: the Rotterdam Study.
Neurology 2007; 69(10):998-1005Neur

Abstract

BACKGROUND AND OBJECTIVE

Previous studies relating smoking with the risk of dementia have been inconsistent and limited in their validity by short follow-up times, large intervals between baseline and follow-up assessments, and unspecific determination of dementia diagnosis. We re-assessed after longer follow-up time in the large population-based cohort of the Rotterdam Study whether smoking habits and pack-years of smoking are associated with the risk of dementia, Alzheimer disease (AD), and vascular dementia (VaD).

METHODS

Prospective population-based cohort study in 6,868 participants, 55 years or older and free of dementia at baseline. First, Cox proportional hazard models were used to relate smoking status at baseline with the risks of incident dementia, VaD, and AD, using never smokers as the reference category in all analyses. Then Cox proportional hazard models were used to relate pack-years of smoking with the risks of incident dementia, VaD, and AD. To explore the impact of the APOEepsilon4 allele, sex, and age on the association between smoking status and dementia, we repeated all analyses stratifying, in separate models, by APOEepsilon4 genotype, sex, and median of age.

RESULTS

After a mean follow-up time of 7.1 years, current smoking at baseline was associated with an increased risk of dementia (HR 1.47, 95% CI 1.18 to 1.86) and AD (HR 1.56, 95% CI 1.21 to 2.02). This increase in disease risk was restricted to persons without the APOEepsilon4 allele. There was no association between current smoking and risk of VaD, and there was no association between past smoking and risk of dementia, AD, or VaD.

CONCLUSION

Current smoking increases the risk of dementia. This effect is more pronounced in persons without the APOEepsilon4 allele than APOEepsilon4 carriers.

Authors+Show Affiliations

Department of Epidemiology & Biostatistics, Erasmus Medical Center, Rotterdam, The Netherlands.

Pub Type(s)

Comparative Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

17785668

Citation

Reitz, C, et al. "Relation Between Smoking and Risk of Dementia and Alzheimer Disease: the Rotterdam Study." Neurology, vol. 69, no. 10, 2007, pp. 998-1005.
Reitz C, den Heijer T, van Duijn C, et al. Relation between smoking and risk of dementia and Alzheimer disease: the Rotterdam Study. Neurology. 2007;69(10):998-1005.
Reitz, C., den Heijer, T., van Duijn, C., Hofman, A., & Breteler, M. M. (2007). Relation between smoking and risk of dementia and Alzheimer disease: the Rotterdam Study. Neurology, 69(10), pp. 998-1005.
Reitz C, et al. Relation Between Smoking and Risk of Dementia and Alzheimer Disease: the Rotterdam Study. Neurology. 2007 Sep 4;69(10):998-1005. PubMed PMID: 17785668.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Relation between smoking and risk of dementia and Alzheimer disease: the Rotterdam Study. AU - Reitz,C, AU - den Heijer,T, AU - van Duijn,C, AU - Hofman,A, AU - Breteler,M M B, PY - 2007/9/6/pubmed PY - 2007/9/29/medline PY - 2007/9/6/entrez SP - 998 EP - 1005 JF - Neurology JO - Neurology VL - 69 IS - 10 N2 - BACKGROUND AND OBJECTIVE: Previous studies relating smoking with the risk of dementia have been inconsistent and limited in their validity by short follow-up times, large intervals between baseline and follow-up assessments, and unspecific determination of dementia diagnosis. We re-assessed after longer follow-up time in the large population-based cohort of the Rotterdam Study whether smoking habits and pack-years of smoking are associated with the risk of dementia, Alzheimer disease (AD), and vascular dementia (VaD). METHODS: Prospective population-based cohort study in 6,868 participants, 55 years or older and free of dementia at baseline. First, Cox proportional hazard models were used to relate smoking status at baseline with the risks of incident dementia, VaD, and AD, using never smokers as the reference category in all analyses. Then Cox proportional hazard models were used to relate pack-years of smoking with the risks of incident dementia, VaD, and AD. To explore the impact of the APOEepsilon4 allele, sex, and age on the association between smoking status and dementia, we repeated all analyses stratifying, in separate models, by APOEepsilon4 genotype, sex, and median of age. RESULTS: After a mean follow-up time of 7.1 years, current smoking at baseline was associated with an increased risk of dementia (HR 1.47, 95% CI 1.18 to 1.86) and AD (HR 1.56, 95% CI 1.21 to 2.02). This increase in disease risk was restricted to persons without the APOEepsilon4 allele. There was no association between current smoking and risk of VaD, and there was no association between past smoking and risk of dementia, AD, or VaD. CONCLUSION: Current smoking increases the risk of dementia. This effect is more pronounced in persons without the APOEepsilon4 allele than APOEepsilon4 carriers. SN - 1526-632X UR - https://www.unboundmedicine.com/medline/citation/17785668/Relation_between_smoking_and_risk_of_dementia_and_Alzheimer_disease:_the_Rotterdam_Study_ L2 - http://www.neurology.org/cgi/pmidlookup?view=long&pmid=17785668 DB - PRIME DP - Unbound Medicine ER -