Academic Medical Center, University of Amsterdam, Department of Public Health, Amsterdam Public Health Research Institute, the Netherlands.
Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, VU University Medical Center, the Netherlands.
J Gerontol A Biol Sci Med Sci. 2018 Nov 10;73(12):1722-1728. doi: 10.1093/gerona/gly009.
This study examined whether smoking cessation in middle age and old age is associated with following a successful trajectory of functional limitations over time in Dutch older adults.
We used 16-year longitudinal data from 645 participants of the Longitudinal Aging Study Amsterdam. Three types of trajectories regarding functional limitations over time were defined: successful (high initial level of functioning and limited decline), late decline (high initial level of functioning and late onset of decline), and early decline (lower initial level of functioning and early onset of decline). Smoking cessation status was self-reported and categorized into: early quitters (stopped in middle age [35-40 years]), late quitters (already smoked in middle age and stopped in old age [≥55 years]), and continued smokers (smoked in middle age and still smoking in old age). Multinomial Logistic Regression Analyses were used to assess the association between smoking cessation and trajectory membership.
The sample (55-85 years at baseline) consisted of 20.3% early quitters, 22.9% late quitters, and 56.8% continued smokers. After adjustment for confounders, the model showed that late quitters were less likely to follow an early decline trajectory instead of a successful trajectory compared to continued smokers (odds ratio [OR] = 0.48, 95% confidence interval [CI] = 0.24-0.97). After adjustment for clinically relevant level of depressive symptoms, this association remained substantial but was no longer statistically significant (OR = 0.50, 95% CI = 0.24-1.02).
Although not statistically significant in the full model, the observed associations suggest that smoking cessation in old age may have an important impact on daily functioning in old age.
本研究旨在探讨中年和老年时期的戒烟是否与荷兰老年人随着时间推移功能障碍轨迹的成功相关。
我们使用了来自阿姆斯特丹纵向老龄化研究的 645 名参与者的 16 年纵向数据。根据功能障碍随时间的轨迹，定义了三种类型：成功型（初始功能水平较高，且下降幅度有限）、晚期下降型（初始功能水平较高，且下降发生较晚）和早期下降型（初始功能水平较低，且下降发生较早）。吸烟状况是自我报告的，并分为：早期戒烟者（中年时戒烟[35-40 岁]）、晚期戒烟者（中年时已吸烟且老年时戒烟[≥55 岁]）和持续吸烟者（中年时吸烟且老年时仍吸烟）。使用多项逻辑回归分析来评估戒烟与轨迹成员之间的关联。
样本（基线时 55-85 岁）包括 20.3%的早期戒烟者、22.9%的晚期戒烟者和 56.8%的持续吸烟者。调整混杂因素后，与持续吸烟者相比，晚期戒烟者更不可能遵循早期下降轨迹，而是遵循成功轨迹（比值比[OR] = 0.48，95%置信区间[CI] = 0.24-0.97）。调整临床相关水平的抑郁症状后，这种关联仍然显著，但不再具有统计学意义（OR = 0.50，95%CI = 0.24-1.02）。
尽管在全模型中不具有统计学意义，但观察到的关联表明，老年时戒烟可能对老年时的日常功能产生重要影响。
