Galanis D J, Petrovitch H, Launer L J, Harris T B, Foley D J, White L R
University of Hawaii Cancer Research Center, Honolulu 96813, USA.
Am J Epidemiol. 1997 Mar 15;145(6):507-15. doi: 10.1093/oxfordjournals.aje.a009138.
The associations between cigarette smoking history and later cognitive performance were examined among 3,429 Japanese-American participants of the Honolulu Heart Program (HHP) and its extension, the Honolulu-Asia Aging Study (HAAS). Cognitive performance was measured by the Cognitive Abilities Screening Instrument (CASI), administered as part of HAAS (mean age at HAAS exam (standard deviation (SD)): 77.7 (4.6) years). Information on smoking history was collected during the first and third HHP exams (mean age (SD) at Exam III: 58.6 (4.7) years). Compared with never-smokers, those who had smoked continuously between Exams I-III and those who had quit smoking during that period had significantly lower CASI scores, after adjustment for age, education, Japanese acculturation, and Exam III alcohol intake. In multiple logistic regression controlling for the above covariates, a significantly higher risk of cognitive impairment (CASI score < 82) was associated with continuous smoking (odds ratio (OR) = 1.36, 95% confidence interval (CI) 1.10-1.69) and quitting between Exams I-III (OR = 1.36, 95% CI 1.03-1.80) compared with never smoking. This excess risk of cognitive impairment among continuous smokers and Exam I-III quitters was slightly diminished by further adjustment for body mass index and several vascular covariates. Additional analyses suggested a reduced risk of cognitive impairment among the longer-term quitters. This study suggests a positive association between smoking during middle age and later risk of cognitive impairment.
在火奴鲁鲁心脏项目（HHP）及其扩展项目火奴鲁鲁-亚洲老龄化研究（HAAS）的3429名日裔美国参与者中，研究了吸烟史与后期认知表现之间的关联。认知表现通过认知能力筛查工具（CASI）进行测量，该工具作为HAAS的一部分进行施测（HAAS检查时的平均年龄（标准差（SD））：77.7（4.6）岁）。吸烟史信息在HHP的第一次和第三次检查期间收集（第三次检查时的平均年龄（SD）：58.6（4.7）岁）。在对年龄、教育程度、日本文化适应程度和第三次检查时的酒精摄入量进行调整后，与从不吸烟者相比，在第一次至第三次检查期间持续吸烟的人和在此期间戒烟的人CASI得分显著更低。在控制上述协变量的多因素逻辑回归分析中，与从不吸烟相比，持续吸烟（优势比（OR）=1.36，95%置信区间（CI）1.10 - 1.69）和在第一次至第三次检查期间戒烟（OR = 1.36，95%CI 1.03 - 1.80）与认知障碍（CASI得分<82）的风险显著更高相关。通过进一步调整体重指数和几个血管协变量，持续吸烟者和第一次至第三次检查期间戒烟者中这种认知障碍的额外风险略有降低。额外分析表明长期戒烟者认知障碍风险降低。这项研究表明中年吸烟与后期认知障碍风险之间存在正相关。
