Ylenmääräinen tupakointi altistaa muistisairauksille

[Psykopatologia]

http://www.hs.fi/ulkomaat/artikkeli/Tut ... 5261167929

Tutkimus: Runsas tupakointi altistaa muistisairauksille
26.10.2010 1:28 |STT–REUTERS

CHICAGO. Tupakoivat viisikymppiset sairastuvat laajan seurantatutkimuksen mukaan muita todennäköisemmin muistisairauksiin. Yli kaksi askia päivässä polttavilla dementian riski oli kaksinkertainen verrattuna tupakoimattomiin.

Kansainvälinen tutkimusryhmä seurasi yli 21 000 yhdysvaltalaisen terveydentilan kehitystä. Koehenkilöt olivat tutkimuksen alkuhetkellä 50–60-vuotiaita.

Lähes neljäsosalla todettiin 20 vuotta myöhemmin jonkinasteinen dementia. Alzheimerin tauti havaittiin reilulla 5 prosentilla.

Tutkimus on ensimmäinen, jossa tupakoinnin ja muistisairauksien yhteyttä selvitettiin näin pitkällä aikajänteellä. Tupakoinnin vaikutusta aivojen toimintaan on vaikea tutkia, koska tupakoitsijat kuolevat usein ennen kuin dementia puhkeaa.

Tuloksista kerrottiin Archives of Internal Medicine -julkaisussa.

(Koko artikkeli)

[Psykopatologia]

Heavy Smoking in Midlife and Long-term Risk of Alzheimer Disease and Vascular Dementia
Minna Rusanen, MD; Miia Kivipelto, MD, PhD; Charles P. Quesenberry Jr, PhD; Jufen Zhou, MS; Rachel A. Whitmer, PhD
Arch Intern Med. Published online October 25, 2010. doi:10.1001/archinternmed.2010.393

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 multiethnic 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.


Author Affiliations:
Departments of Neurology, University of Eastern Finland (Drs Rusanen and Kivipelto) and Kuopio University Hospital (Dr Rusanen), Kuopio, Finland; Karolinksa Aging Research Center, Stockholm, Sweden (Dr Kivipelto); and Kaiser Permanente Division of Research, Oakland, California (Drs Quesenberry and Whitmer and Ms Zhou).