[S01.005] Effects of Second-Hand Smoke and Cardiovascular Disease on Incident Dementia in Participants from the Cardiovascular Health Study

Thaddeus J. Haight, Deborah Barnes, Kala Mehta, Kristine Yaffe, San Francisco, CA, Michelle C. Carlson, Baltimore, MD, Lewis Kuller, Pittsburgh, PA, Ira B. Tager, Berkeley, CA

OBJECTIVE: To determine whether cumulative lifetime second-hand-smoke (SHS) exposure poses a risk for onset dementia in elders with and without cardiovascular disease (CVD). BACKGROUND: The risk of SHS exposure for dementia in elderly never-smokers is not well known. Cumulative exposure to SHS may act independently or interact with clinical or subclinical CVD to increase the risk of dementia. DESIGN/METHODS: 3602 elders were evaluated for dementia in the Cardiovascular Health Study. Of these, 985 (728 women, ages 66-92) had no previous clinical CVD (MI, angioplasty, angina pectoris, by-pass, claudication, stroke/TIA), no prior diagnosis of dementia, and were never smokers. 495 elders reported SHS (years) with mean (range) 27.9 (1-80). Marginal structural Cox proportional hazards models were used to evaluate the causal relative hazard (RH) of clinical CVD with respect to dementia over 6 years. Effects were examined within strata of age, age-adjusted SHS, and separately for cerebral vascular disease (infarct<3mm, infarct >3mm, or white grade matter disease) and carotid artery disease (>25% stenosis, or >80 percentile common or internal wall thickness). RESULTS: The causal relative hazard (RH) of clinical CVD on dementia was 1.94 (95% CI 1.27,2.96) within age and SHS strata. The RH estimates associated with lower levels (equivalent of >0-30 years) and higher levels of lifetime SHS exposure (>30-80 years) compared with no exposure were 1.02 (0.72, 1.45) and 1.31 (0.95, 1.82), respectively. RH estimates were higher for both levels of SHS (low, high) in elders with carotid artery disease 1.30 (0.64, 2.63) and 2.38 (1.23, 4.63), respectively, compared with elders with no SHS exposure and no disease. CONCLUSIONS/RELEVANCE: These results suggest that higher levels of lifetime SHS exposure are associated with greater risk of incident dementia in the elderly, and pose a significant risk in those with underlying carotid artery disease. Supported by: Grant from Flight Attendant Medical Research Institute, University of California, San Francisco.
Category - Aging and Dementia
SubCategory - Epidemiology

Tuesday, May 1, 2007 3:00 PM

Scientific Sessions: Aging and Dementia: Epidemiology I (2:00 PM-3:30 PM)

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