Massachusetts General Hospital, Department of Neurology, Charlestown, MA, 02129, USA; Harvard Medical School, USA.
Parkinsonism Relat Disord. 2024 Nov;128:107133. doi: 10.1016/j.parkreldis.2024.107133. Epub 2024 Sep 3.
Cigarette smoking is associated with a reduced risk of Parkinson's disease (PD). As dementia with Lewy bodies (DLB) and PD share core neuropathologic features, we set out to examine the relationship between smoking and DLB.
Diagnosis at baseline visit and smoking history of participants ≥50 years old in the National Alzheimer's Coordinating Center (NACC) cohort were evaluated in this cross-sectional study. Odds of diagnosis of cognitive impairment due to DLB, PD, vascular dementia (VD), or Alzheimer's disease (AD) compared to normal cognition based on smoking status and duration were determined using logistic regression.
37,478 participants were included (mean age 72 years (SD 9), 57 % female). The odds of DLB were reduced in all smoking status groups compared to never smokers (OR (95 % CI)): ever smokers 0.850 (0.745-0.971), former smokers 0.871 (0.761-0.997), current smokers 0.640 (0.419-0.947)) and in all smoking duration groups. As expected, the odds of PD were reduced in all smoking groups and fell with longer smoking duration. The odds of VD were increased in the current smoking group and rose with greater smoking duration. The odds of AD were unchanged in current smokers, decreased in ever and former smokers, and increased with longer cumulative smoking duration.
Cigarette smoking is associated with lower odds of diagnosis of DLB at baseline visit in the NACC cohort. In the context of the well-established reduced risk of PD among smokers, this preliminary evidence of a potential protective effect of smoking on DLB warrants further study.
吸烟与帕金森病（PD）的风险降低有关。由于路易体痴呆（DLB）和 PD 具有共同的神经病理学特征，我们着手研究吸烟与 DLB 之间的关系。
在这项横断面研究中，评估了国家阿尔茨海默病协调中心（NACC）队列中≥50 岁的参与者在基线就诊时的诊断和吸烟史。根据吸烟状况和持续时间，使用逻辑回归确定了认知障碍归因于 DLB、PD、血管性痴呆（VD）或阿尔茨海默病（AD）的诊断几率与正常认知的比较。
共纳入 37478 名参与者（平均年龄 72 岁（SD 9），57%为女性）。与从不吸烟者相比，所有吸烟状况组的 DLB 几率均降低（OR（95%CI））：现吸烟者 0.850（0.745-0.971），前吸烟者 0.871（0.761-0.997），当前吸烟者 0.640（0.419-0.947）），且在所有吸烟持续时间组中也是如此。正如预期的那样，所有吸烟组的 PD 几率均降低，且随着吸烟持续时间的延长而降低。当前吸烟者的 VD 几率增加，且随着吸烟持续时间的增加而增加。当前吸烟者的 AD 几率不变，曾经和现在的吸烟者的几率降低，且随着累积吸烟持续时间的增加而增加。
在 NACC 队列中，吸烟与基线就诊时 DLB 诊断几率降低有关。在吸烟者 PD 风险降低这一既定事实的背景下，吸烟对 DLB 具有潜在保护作用的初步证据值得进一步研究。
