Letenneur L, Dartigues J F, Commenges D, Barberger-Gateau P, Tessier J F, Orgogozo J M
Unité INSERM 330, Université de Bordeaux II, France.
Ann Epidemiol. 1994 Nov;4(6):449-54. doi: 10.1016/1047-2797(94)90004-3.
We examined the relationship between tobacco consumption and Alzheimer's disease (AD), cognitive deficit, and memory performances in elderly community residents of southwestern France. Subjects were considered to have a cognitive deficit if they scored under 24 on the French version of the Mini-Mental State Examination, and poor memory performances if they scored under 8 on the Benton Visual Retention Test. Among the 3770 subjects who gave information about their smoking habits, only 356 (9.5%) were current smokers, 998 (26.5%) were past smokers, and 2416 (64%) were never smokers. Current smokers (odds ratio (OR) = 0.52, P < 0.001) and past smokers (OR = 0.54, P < 0.001) had a lower risk of cognitive deficit than did never smokers. However, this significant relationship disappeared after adjustment for potential confounding factors such as occupational category (OR = 0.91 (not significant) for current smokers and OR = 0.87 (not significant) for past smokers). Similar results were obtained for the risk of AD and of poor memory performances. The apparent protective effect of smoking habits on cognitive abilities could be due to a confounding effect of occupational category.
我们研究了法国西南部老年社区居民的烟草消费与阿尔茨海默病（AD）、认知缺陷及记忆表现之间的关系。如果受试者在法语版简易精神状态检查表上得分低于24分，则被认为存在认知缺陷；如果在本顿视觉保持测验中得分低于8分，则被认为记忆表现较差。在提供吸烟习惯信息的3770名受试者中，只有356人（9.5%）为当前吸烟者，998人（26.5%）为既往吸烟者，2416人（64%）从不吸烟。当前吸烟者（优势比（OR）=0.52，P<0.001）和既往吸烟者（OR=0.54，P<0.001）出现认知缺陷的风险低于从不吸烟者。然而，在对职业类别等潜在混杂因素进行调整后，这种显著关系消失了（当前吸烟者的OR=0.91（不显著），既往吸烟者的OR=0.87（不显著））。AD风险及记忆表现较差方面也得到了类似结果。吸烟习惯对认知能力的明显保护作用可能归因于职业类别的混杂效应。
