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Current cigarette smoking was associated with a higher risk of Alzheimer's disease

Design
Cohort analytic study with follow up for a mean of 2 years.

Setting
Community based study in northern Manhattan, New York City, USA.

Participants
1062 elderly Medicare recipients (mean age 75 y, 69% women) without dementia at start of study.

Assessment of risk factors
A structured risk factor questionnaire was developed and used at baseline to determine exposure to putative risk factors related to dementia. 3 sets of questions dealt with smoking history. General health and function, years of formal education, and medical history were determined. A physical, neurological, and neuropsychological examination were also done. APOE genotype was determined for each participant.

Main outcome measure
Blinded diagnosis of AD using standardised clinical assessments at annual visits.

Main results
142 participants were diagnosed with AD during follow up. After adjustment for education and ethnicity and using never smoked as the reference, a previous history of smoking was not associated with AD (table). Those who were current smokers had an increased risk . . . [Full text of this article]

Rob Butler, MBBS, MRCPsych

Edgeway Community Hospital Brain Injury Unit Middlesex, UK