heavy smoking in midlife-->2x risk of Alzheimer's disease (AD) and other dementia
N = 21,123 who participated in survey 1978-1985, when 50-60yoa
followup was 2 decades later, average 23 years followup
DX of dementia, AD, and vascular dementia tracked
heavy = more than 2 packs per day
2+ packs/day-->over 100% incr risk
1-2 packs/day-->44% greater risk
.5-1 pack/day-->37% greater risk
folks who quit before taking survey had no greater risk than never smokers
Arch Intern Med. Published online October 25, 2010
new observational study
Archives of Internal Medicine
study led by Minna Rusanen, MD, U Eastern Finland and Kuopio U Hospital
analyzed prospective data from Kaiser Permanente Medical Care Program of Northern Ca
large and ethnically diverse population
followups: 1/1/94 (participants were an average of 71.6 years old) through 7/31/08
5367 participants (25.4%) dxd w dementia
1,136 of these dxd w/ AD, 416 w/ vascular dementia
adjusted for age, sex, education, race, marital status, hypertension, hyperlipidemia, body mass index, diabetes, heart disease, stroke, and alcohol use
hazard ratio for dementia was 2.14 (95% confidence interval [CI], 1.65 – 2.78); for AD, it was 2.57 (95% CI, 1.63 – 4.03)
for vascular dementia: 2.72 (95% CI, 1.20 – 6.18)
some early studies suggested that smokers have a reduced risk for
Parkinson's disease & cognitive impairment
probably deeply biased, mbdt survival bias