School of Medicine, Niigata University, Niigata, Japan.
Division of Preventive Medicine, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.
Maturitas. 2023 Oct;176:107788. doi: 10.1016/j.maturitas.2023.107788. Epub 2023 Jun 14.
Alcohol drinking and tobacco smoking have impacts on lifestyle-related diseases, but their association with dementia remains a debated topic. This study aimed to examine longitudinal associations between alcohol consumption, smoking, and dementia risk in middle-aged and older Japanese people.
This study used a cohort design with an 8-year follow-up. Participants were community-dwelling Japanese people (N = 13,802) aged 40-74 years. The baseline survey, including a self-administered questionnaire, was conducted in 2011-2013. Predictors were alcohol consumption and tobacco smoking. The outcome was incident dementia obtained from a long-term care insurance database. Covariates were demographics, lifestyle factors, body mass index, general health status, and history of stroke, diabetes, and depression.
Participant mean age was 59.0 years. The 1-149, 150-299, and 300-449 g ethanol/week groups had significantly lower adjusted hazard ratios (HRs) (0.62, 0.59, and 0.47, respectively) compared with the reference group, with no significant linear association. HRs increased toward 1 when past-drinkers and those with poor health status and a disease history were excluded (0.80, 0.66, and 0.82, respectively). Higher smoking levels were dose-dependently associated with a higher HR (adjusted P for trend = 0.0105), with the ≥20 cigarettes/day group having a significantly higher adjusted HR (1.80). Heavy drinkers (≥449 g ethanol/week) with smoking habits, but not those without smoking habits, had higher dementia risk (P for interaction = 0.0046).
Light-to-moderate alcohol consumption is associated with decreased dementia risk, and smoking is dose-dependently associated with increased dementia risk, with an interaction between high alcohol consumption and smoking on dementia risk.
饮酒和吸烟会对与生活方式相关的疾病产生影响，但它们与痴呆症的关系仍然存在争议。本研究旨在探讨中年和老年日本人群中饮酒、吸烟与痴呆风险的纵向关联。
本研究采用队列设计，随访 8 年。参与者为社区居住的日本成年人（N=13802），年龄在 40-74 岁之间。基线调查包括一份自我管理问卷，于 2011-2013 年进行。预测因子为饮酒和吸烟。结果为长期护理保险数据库中获得的新发痴呆病例。协变量为人口统计学因素、生活方式因素、体重指数、总体健康状况以及中风、糖尿病和抑郁症病史。
参与者的平均年龄为 59.0 岁。与参考组相比，1-149、150-299 和 300-449 g 乙醇/周组的调整后的危险比（HR）分别显著降低（0.62、0.59 和 0.47），但没有显著的线性关联。当排除过去饮酒者和健康状况不佳以及有疾病史的人时，HR 向 1 增加（分别为 0.80、0.66 和 0.82）。较高的吸烟水平与更高的 HR 呈剂量依赖性相关（调整后的趋势 P 值=0.0105），每天吸烟≥20 支的组具有显著更高的调整后 HR（1.80）。有吸烟习惯的重度饮酒者（≥449 g 乙醇/周）痴呆风险较高，但无吸烟习惯的重度饮酒者痴呆风险无显著差异（交互作用 P 值=0.0046）。
轻至中度饮酒与痴呆风险降低相关，吸烟与痴呆风险增加呈剂量依赖性相关，而高饮酒量与吸烟之间存在痴呆风险的交互作用。
