University of California, San Francisco, 4150 Clement Street, 151R, San Francisco, CA 94121, USA.
Am J Epidemiol. 2010 Feb 1;171(3):292-302. doi: 10.1093/aje/kwp376. Epub 2010 Jan 5.
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 < or =25% carotid artery stenosis. High lifetime SHS exposure may increase the risk of dementia in elderly with undiagnosed CVD.
最近的研究发现，吸烟与痴呆风险增加有关，但二手烟（SHS）对痴呆风险的影响以前尚未研究过。作者使用 Cox 比例风险边际结构模型，在 970 名美国心血管健康认知研究（1991 年至 1999 年进行）的参与者中，检查了自我报告的终生家庭 SHS 暴露与 6 年内发生痴呆的风险之间的关联，这些参与者从不吸烟，并且在基线时没有临床心血管疾病（CVD）、痴呆和轻度认知障碍。此外，由于先前的研究发现 SHS 与 CVD 风险增加有关，而 CVD 与痴呆风险增加有关，因此作者测试了 SHS 与临床和亚临床 CVD 测量值之间对痴呆风险的相互作用。中度（16-25 年）和高度（>25 年）SHS 暴露水平与痴呆风险无独立相关性；然而，与无/低（0-15 年）SHS 暴露和<或=25%颈动脉狭窄相比，暴露于 SHS>25 年且颈动脉狭窄>25%的受试者痴呆风险增加了 3 倍（风险比=3.00，95%置信区间：1.03，9.72）。高终生 SHS 暴露可能会增加患有未确诊 CVD 的老年痴呆症的风险。
