Smoking, drinking, and incident cognitive impairment: a cohort community based study included in the Gospel Oak project

摘要

OBJECTIVES—Recentlongitudinal studies have reported that smoking increases risk forcognitive impairment and that moderate alcohol intake could bepreventive.The association between both cigarette smoking and alcoholdrinking and incident cognitive impairment was studied in arepresentative population.
METHODS—This is a 1 year prospective population based cohort sudy of all residents aged 65 or over in the electoral ward of Gospel Oak in London, UK (n=889).Cognitive impairment was assessed at baseline and 1 year later usingthe organic brain syndrome (OBS) cognitive impairment scale from theshort CARE structured assessment. Subjects who were cognitivelyimpaired at baseline were excluded from this analysis.
RESULTS—The prevalenceof OBS cognitive impairment was 10.4% at index assessment and the 1 year cumulative incidence of cognitive impairment was 5.7%. Cognitiveimpairment was not associated with use of alcohol, although there was anon-significant association in the direction of a protective effectagainst onset of cognitive impairment for moderate drinkers comparedwith non-drinkers and heavy drinkers. Current smoking status predictedcognitive impairment (risk ratio (RR) 3.7; (95% confidence interval(95% CI)=1.1-12.3) independently from sex, age, alcohol, occupationalclass, education, handicap, depression, and baseline cognitive function.
CONCLUSIONS—Smokingseems to be a prospective risk factor for incident cognitiveimpairment; thus encouragement of older people to stop smoking could beconsidered as part of a strategy to reduce the incidence of cognitive impairment.