Department of Epidemiology and Biostatistics, and Ministry of Education Key Laboratory of Environment and Health, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China.
Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
Age Ageing. 2019 Jan 1;48(1):101-107. doi: 10.1093/ageing/afy166.
the relations of cigarette smoking and alcohol drinking with risk of cognitive impairment remain inconsistent.
to examine the independent and joint relations of smoking and alcohol drinking with cognitive impairment, we used data from 16,948 men and women, who had been followed-up for 16-23 (mean of 20) years as participants of the Singapore Chinese Health Study, a population-based prospective cohort. Data on smoking and alcohol drinking were collected at baseline (1993-98), when participants were aged 45-74 (mean 53) years. Cognition was assessed using a 30-item Mini-Mental State Examination during follow-up three visits (2014-16), when participants were aged 61-96 (mean 73) years. Multivariable logistic regression models were used to estimate the odd ratios (ORs) and 95% confidence intervals (CIs).
cognitive impairment was present in 2,443 (14.4%) participants. Compared with non-current smokers, current smokers had 20% increased risk (OR = 1.20, 95% CI = 1.04-1.39). Compared with those who drank less than weekly, regular alcohol drinking (at least weekly) had 17% increased risk (OR = 1.17, 95% CI = 1.01-1.36). Compared with those who were neither smokers nor drinkers, those who were either current smokers or regular drinkers alone had no significantly increased risk, while the risk was highest in those who were both current smokers and regular drinkers (OR = 1.77, 95% CI = 1.39-2.26, Pinteraction = 0.003).
co-existence of smoking and regular alcohol drinking at midlife had a much stronger impact than the individual factors on risk of cognitive impairment in late life.
吸烟和饮酒与认知障碍风险的关系仍不一致。
为了研究吸烟和饮酒与认知障碍的独立和共同关系，我们使用了来自 16948 名男性和女性的数据，这些人作为新加坡华人健康研究的参与者进行了 16-23 年（平均 20 年）的随访。吸烟和饮酒的数据是在基线（1993-98 年）收集的，当时参与者的年龄为 45-74 岁（平均 53 岁）。认知功能在随访的 3 次就诊期间（2014-16 年）通过 30 项 Mini-Mental State 检查进行评估，当时参与者的年龄为 61-96 岁（平均 73 岁）。使用多变量逻辑回归模型来估计比值比（ORs）和 95%置信区间（CIs）。
认知障碍存在于 2443 名（14.4%）参与者中。与非当前吸烟者相比，当前吸烟者的风险增加了 20%（OR=1.20，95%CI=1.04-1.39）。与每周饮酒量少于一次的人相比，规律饮酒（至少每周一次）的风险增加了 17%（OR=1.17，95%CI=1.01-1.36）。与既不吸烟也不饮酒的人相比，仅为当前吸烟者或规律饮酒者的风险没有显著增加，而同时为当前吸烟者和规律饮酒者的风险最高（OR=1.77，95%CI=1.39-2.26，P 交互=0.003）。
中年时期同时存在吸烟和规律饮酒对晚年认知障碍风险的影响比单一因素要强得多。
