Smoking History in Middle Age and Subsequent Cognitive Performance in Elderly Japanese-American Men: The Honolulu-Asia Aging Study

Abstract

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.

A longitudinal study of drinking and cognitive performance in elderly Japanese American men: the Honolulu-Asia Aging Study

“…Similarly, a recent analysis among this cohort indicated that smoking history was less reliably reported by low CASI scorers than by other HAAS participants. 23 Additional strengths of this study include the size of the cohort and the high rates of participation during the follow-up examinations.…”

“…Terms were entered to describe the smoking history of participants up to Exam III, as this was recently found to be significantly related to cognitive performance in this cohort. 23 …”

Relationship Between ApoE, MRI Findings, and Cognitive Function in the Cardiovascular Health Study

“…In the Honolulu-Asia study, 92% of the dementia cases diagnosed by DSM IIIR criteria scored Ͻ82 on the CASI. 65 Isolated memory loss was recently documented in the Seattle Dementia Study to be a strong predictor of subsequent clinical dementia; 10 of 21 individuals (48%) with isolated memory loss became clinically demented during a 48-month follow-up period. 66 Verbal memory loss is also an early sign of dementia.…”

Associations of cigarette smoking with viral immune and cognitive function in human immunodeficiency virus–seropositive women

“…Once infected, HIV-seropositive smokers presented a higher serum β2-microglobulin level and an increased CD4 cell count, which lasted approximately 2 years (Royce and Winkelstein, 1990;Burns et al, 1991). Studies performed in the post-HAART era, during which the incidence of opportunistic infections has decreased markedly, have found that smoking is associated with a decreased quality of life and an increased mortality (Page-Shafer et al, 1996;Turner et al, 2001; Crothers et al, smoking presents a higher risk of late-life cognitive impairment (Galanis et al, 1997;Richards et al, 2003). Nonetheless, clinical studies involving nicotine administration in healthy smokers and nonsmokers have shown an enhancement of cognitive function, mostly involving attention and psychomotor speed domains (Sacco et al, 2004).…”