Association between environmental tobacco smoke exposure and dementia syndromes.
Association between environmental tobacco smoke exposure and dementia syndromes.
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DOI：
10.1136/oemed-2012-100785
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发表时间：
2013-01
影响因子：
4.9
通讯作者：
Copeland JR
中科院分区：
文献类型：
--
作者：
Chen R;Wilson K;Chen Y;Zhang D;Qin X;He M;Hu Z;Ma Y;Copeland JR
环境烟草烟雾(ETS)对健康有一系列不利影响，但它与痴呆症的联系尚不清楚，与痴呆症综合征的联系也不清楚。我们研究了暴露于ETS和痴呆综合征之间的剂量-反应关系。本文采用一般人群健康状况调查方法，于2007年至2009年对中国地区5个省的5921名60岁≥60岁的老年人进行了访谈，分析了他们暴露于ETS的特征。使用计算机辅助分类仪的老年自动检查诊断痴呆综合征的五个等级。在多变量调整回归模型中计算暴露于ETS的参与者中中度(1-2级)和重度(3-5级)痴呆综合征的相对危险度(RR)。重度痴呆626例(10.6%)，中度痴呆869例(14.7%)。暴露于ETS的参与者发生严重症状的风险显著增加(调整后的RR为1.29，95%CI为1.05至1.59)。这与暴露水平和持续时间呈剂量依赖关系。累积暴露剂量数据显示，0-24水平年的调整RR为0.99(95%CI 0.76~1.28)，25-49水平年的调整RR为1.15(95%CI 0.93~1.42)，59-74水平年的调整RR为1.18(95%CI 0.87~1.59)，75~99年水平年的调整RR为1.39(95%CI 1.03~1.84)，≥100年水平年的调整RR为1.95(95%CI 1.34~2.83)。在从不吸烟者和以前/现在吸烟者中发现与严重症状显著相关。ETS与中度痴呆综合征之间没有正相关关系。ETS应被认为是严重痴呆综合征的重要危险因素。避免使用ETS可能会降低全球严重痴呆症的发病率。
Environmental tobacco smoke (ETS) has a range of adverse health effects, but its association with dementia remains unclear and with dementia syndromes unknown. We examined the dose–response relationship between ETS exposure and dementia syndromes. Using a standard method of GMS, we interviewed 5921 people aged ≥60 years in five provinces in China in 2007–2009 and characterised their ETS exposure. Five levels of dementia syndrome were diagnosed using the Automated Geriatric Examination for Computer Assisted Taxonomy instrument. The relative risk (RR) of moderate (levels 1–2) and severe (levels 3–5) dementia syndromes among participants exposed to ETS was calculated in multivariate adjusted regression models. 626 participants (10.6%) had severe dementia syndromes and 869 (14.7%) moderate syndromes. Participants exposed to ETS had a significantly increased risk of severe syndromes (adjusted RR 1.29, 95% CI 1.05 to 1.59). This was dose-dependently related to exposure level and duration. The cumulative exposure dose data showed an adjusted RR of 0.99 (95% CI 0.76 to 1.28) for >0–24 level years of exposure, 1.15 (95% CI 0.93 to 1.42) for 25–49 level years, 1.18 (95% CI 0.87 to 1.59) for 59–74 level years, 1.39 (95% CI 1.03 to 1.84) for 75–99 level years and 1.95 (95% CI 1.34 to 2.83) for ≥100 level years. Significant associations with severe syndromes were found in never smokers and in former/current smokers. There were no positive associations between ETS and moderate dementia syndromes. ETS should be considered an important risk factor for severe dementia syndromes. Avoidance of ETS may reduce the rates of severe dementia syndromes worldwide.
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