Secondhand Smoke, Vascular Disease, and Dementia Incidence: Findings From the Cardiovascular Health Cognition Study
Secondhand Smoke, Vascular Disease, and Dementia Incidence: Findings From the Cardiovascular Health Cognition Study
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DOI：
10.1093/aje/kwp376
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发表时间：
2010-02-01
影响因子：
5
通讯作者：
Tager, Ira B.
中科院分区：
文献类型：
--
作者：
Barnes, Deborah E.;Haight, Thaddeus J.;Tager, Ira B.
最近的研究发现，吸烟与患痴呆症的风险增加有关，但二手烟(SHS)对痴呆症风险的影响之前还没有研究过。作者使用COX比例风险边际结构模型，在970名美国参与者中检验了自我报告的终生家庭SHS暴露与6年以上痴呆症事件风险的关系。这些参与者从未吸烟，也没有临床心血管疾病(CVD)、痴呆症和轻度认知损害。此外，由于先前的研究发现SHS与CVD风险增加相关，CVD与痴呆症风险增加相关，作者测试了SHS与临床和亚临床CVD指标之间的相互作用。中度(16-25年)和高度(>；25年)SHS暴露水平与痴呆症风险没有独立关系；然而，与没有/低(0-15年)SHS暴露和<；25%颈动脉狭窄的受试者相比，>；25年SHS暴露和>；25%颈动脉狭窄的受试者患痴呆症的风险增加了3倍(危险比=3.00，95%可信区间：1.03，9.72)。终生高SHS暴露可能会增加患有未确诊CVD的老年人患痴呆症的风险。
Recent studies have found that smoking is associated with an increased risk of dementia, but the effects of secondhand smoke (SHS) on dementia risk are not known to have previously been studied. The authors used Cox proportional hazards marginal structural models to examine the association between self-reported lifetime household SHS exposure and risk of incident dementia over 6 years among 970 US participants in the Cardiovascular Health Cognition Study (performed from 1991 to 1999) who were never smokers and were free of clinical cardiovascular disease (CVD), dementia, and mild cognitive impairment at baseline. In addition, because prior studies have found that SHS is associated with increased risk of CVD and that CVD is associated with increased risk of dementia, the authors tested for interactions between SHS and measures of clinical and subclinical CVD on dementia risk. Moderate (16-25 years) and high (> 25 years) SHS exposure levels were not independently associated with dementia risk; however, subjects with > 25 years of SHS exposure and > 25% carotid artery stenosis had a 3-fold increase (hazard ratio = 3.00, 95% confidence interval: 1.03, 9.72) in dementia risk compared with subjects with no/low (0-15 years) SHS exposure and < 25% carotid artery stenosis. High lifetime SHS exposure may increase the risk of dementia in elderly with undiagnosed CVD.