Rajczyk Jenna I, Ferketich Amy, Wing Jeffrey J
Division of Epidemiology, College of Public Health, The Ohio State University, Columbus, OH, USA.
J Alzheimers Dis. 2023;91(1):215-223. doi: 10.3233/JAD-220501.
Smoking status may influence subjective cognitive decline (SCD); however, few studies have evaluated this association.
To assess whether smoking status is associated with SCD among middle age and older adults, and to determine if this association is modified by sex at birth.
A cross-sectional analysis was conducted using data from the 2019 Behavioral Risk Factor Surveillance System (BRFSS) survey to analyze the relationship between SCD and smoking status (current, recent former, and remote former). Eligible respondents included participants 45 years of age or older who responded to the SCD and tobacco questions of interest. Survey-weighted Poisson regression models were employed to estimate the crude and adjusted prevalence ratios (cPR/aPR) and corresponding 95% confidence intervals (CI) of the association between smoking status and SCD. A Wald test was computed to determine the significance of the interaction term between smoking status and sex (α= 0.05).
There were 136,018 eligible respondents, of which approximately 10% had SCD. There was a graded association between smoking and SCD, with the greatest prevalence of SCD among current smokers (aPR = 1.87; CI: 1.54, 2.28), followed by recent former smokers (aPR = 1.47; 95% CI: 1.02, 2.12), and remote former smokers (aPR = 1.11; 95% CI: 0.93, 1.33) each compared to never smokers. There was no evidence of effect modification by sex (p interaction = 0.73).
The consistency of smoking as a risk factor for objective and subjective cognitive decline supports the need for future studies to further the evidence on whether changes to smoking status impacts cognition in middle age.
吸烟状况可能会影响主观认知能力下降（SCD）；然而，很少有研究评估这种关联。
评估吸烟状况与中老年人群中的SCD是否相关，并确定这种关联是否因出生时的性别而有所不同。
使用2019年行为危险因素监测系统（BRFSS）调查的数据进行横断面分析，以分析SCD与吸烟状况（当前吸烟者、近期戒烟者和长期戒烟者）之间的关系。符合条件的受访者包括45岁及以上且回答了感兴趣的SCD和烟草问题的参与者。采用调查加权泊松回归模型来估计吸烟状况与SCD之间关联的粗患病率比和调整患病率比（cPR/aPR）以及相应的95%置信区间（CI）。计算Wald检验以确定吸烟状况与性别之间交互项的显著性（α = 0.05）。
共有136,018名符合条件的受访者，其中约10%有SCD。吸烟与SCD之间存在分级关联，当前吸烟者中SCD的患病率最高（aPR = 1.87；CI：1.54，2.28），其次是近期戒烟者（aPR = 1.47；95%CI：1.02，2.12），长期戒烟者（aPR = 1.11；95%CI：0.93，1.33），与从不吸烟者相比。没有证据表明性别会产生效应修正作用（p交互作用 = 0.73）。
吸烟作为客观和主观认知能力下降的危险因素具有一致性，这支持未来研究进一步提供证据，以探讨吸烟状况的改变是否会影响中年人的认知。
