Abstract
OBJECTIVE--To study the association between Alzheimer's disease and nicotine intake through smoking. DESIGN--Population based case-control study. SETTING--City of Rotterdam and four northern provinces of The Netherlands. SUBJECTS--198 patients with early onset Alzheimer's disease, 198 controls matched for age and sex, and families of 17 patients in whom Alzheimer's disease was apparently inherited as an autosomal dominant disorder. MAIN OUTCOME MEASURES--Age of onset of dementia, relative risk of Alzheimer's disease. RESULTS--89 of 193 patients with Alzheimer's disease had a history of smoking compared with 102 of 195 controls. Among the patients and controls with a family history of dementia, smoking was significantly less common in those with dementia (40/95 with dementia v 55/96 controls; relative risk 0.35; 95% confidence interval 0.16 to 0.78). The risk of Alzheimer's disease decreased with increasing daily number of cigarettes smoked before onset of disease (relative risk 0.3 in those smoking greater than 21/day v 1 in non-smokers). In six families in which the disease was apparently inherited as an autosomal dominant disorder, the mean age of onset was 4.17 years later in smoking patients than in non-smoking patients from the same family (p = 0.03). CONCLUSIONS--These findings suggest an inverse association between smoking and Alzheimer's disease, although smoking cannot be advocated for other health reasons. We speculate that nicotine may have a role in the aetiology of both Alzheimer's disease and Parkinson's disease.
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- Amaducci L. A., Fratiglioni L., Rocca W. A., Fieschi C., Livrea P., Pedone D., Bracco L., Lippi A., Gandolfo C., Bino G. Risk factors for clinically diagnosed Alzheimer's disease: a case-control study of an Italian population. Neurology. 1986 Jul;36(7):922–931. doi: 10.1212/wnl.36.7.922. [DOI] [PubMed] [Google Scholar]
- Benwell M. E., Balfour D. J., Anderson J. M. Evidence that tobacco smoking increases the density of (-)-[3H]nicotine binding sites in human brain. J Neurochem. 1988 Apr;50(4):1243–1247. doi: 10.1111/j.1471-4159.1988.tb10600.x. [DOI] [PubMed] [Google Scholar]
- Broe G. A., Henderson A. S., Creasey H., McCusker E., Korten A. E., Jorm A. F., Longley W., Anthony J. C. A case-control study of Alzheimer's disease in Australia. Neurology. 1990 Nov;40(11):1698–1707. doi: 10.1212/wnl.40.11.1698. [DOI] [PubMed] [Google Scholar]
- Calne D. B., Eisen A., McGeer E., Spencer P. Alzheimer's disease, Parkinson's disease, and motoneurone disease: abiotrophic interaction between ageing and environment? Lancet. 1986 Nov 8;2(8515):1067–1070. doi: 10.1016/s0140-6736(86)90469-1. [DOI] [PubMed] [Google Scholar]
- Chandra V., Philipose V., Bell P. A., Lazaroff A., Schoenberg B. S. Case-control study of late onset "probable Alzheimer's disease". Neurology. 1987 Aug;37(8):1295–1300. doi: 10.1212/wnl.37.8.1295. [DOI] [PubMed] [Google Scholar]
- Ditter S. M., Mirra S. S. Neuropathologic and clinical features of Parkinson's disease in Alzheimer's disease patients. Neurology. 1987 May;37(5):754–760. doi: 10.1212/wnl.37.5.754. [DOI] [PubMed] [Google Scholar]
- Farrer L. A., Myers R. H., Cupples L. A., St George-Hyslop P. H., Bird T. D., Rossor M. N., Mullan M. J., Polinsky R., Nee L., Heston L. Transmission and age-at-onset patterns in familial Alzheimer's disease: evidence for heterogeneity. Neurology. 1990 Mar;40(3 Pt 1):395–403. doi: 10.1212/wnl.40.3_part_1.395. [DOI] [PubMed] [Google Scholar]
- Ferini-Strambi L., Smirne S., Garancini P., Pinto P., Franceschi M. Clinical and epidemiological aspects of Alzheimer's disease with presenile onset: a case control study. Neuroepidemiology. 1990;9(1):39–49. doi: 10.1159/000110750. [DOI] [PubMed] [Google Scholar]
- French L. R., Schuman L. M., Mortimer J. A., Hutton J. T., Boatman R. A., Christians B. A case-control study of dementia of the Alzheimer type. Am J Epidemiol. 1985 Mar;121(3):414–421. doi: 10.1093/oxfordjournals.aje.a114013. [DOI] [PubMed] [Google Scholar]
- Hachinski V. C., Iliff L. D., Zilhka E., Du Boulay G. H., McAllister V. L., Marshall J., Russell R. W., Symon L. Cerebral blood flow in dementia. Arch Neurol. 1975 Sep;32(9):632–637. doi: 10.1001/archneur.1975.00490510088009. [DOI] [PubMed] [Google Scholar]
- Hofman A., Collette H. J., Bartelds A. I. Incidence and risk factors of Parkinson's disease in The Netherlands. Neuroepidemiology. 1989;8(6):296–299. doi: 10.1159/000110197. [DOI] [PubMed] [Google Scholar]
- Hofman A., Schulte W., Tanja T. A., van Duijn C. M., Haaxma R., Lameris A. J., Otten V. M., Saan R. J. History of dementia and Parkinson's disease in 1st-degree relatives of patients with Alzheimer's disease. Neurology. 1989 Dec;39(12):1589–1592. doi: 10.1212/wnl.39.12.1589. [DOI] [PubMed] [Google Scholar]
- Hughes C. P., Berg L., Danziger W. L., Coben L. A., Martin R. L. A new clinical scale for the staging of dementia. Br J Psychiatry. 1982 Jun;140:566–572. doi: 10.1192/bjp.140.6.566. [DOI] [PubMed] [Google Scholar]
- Jones G. M., Reith M., Philpot M. P., Sahakian B. J. Smoking and dementia of Alzheimer type. J Neurol Neurosurg Psychiatry. 1987 Oct;50(10):1383–1383. doi: 10.1136/jnnp.50.10.1383. [DOI] [PMC free article] [PubMed] [Google Scholar]
- London E. D., Ball M. J., Waller S. B. Nicotinic binding sites in cerebral cortex and hippocampus in Alzheimer's dementia. Neurochem Res. 1989 Aug;14(8):745–750. doi: 10.1007/BF00964952. [DOI] [PubMed] [Google Scholar]
- McKhann G., Drachman D., Folstein M., Katzman R., Price D., Stadlan E. M. Clinical diagnosis of Alzheimer's disease: report of the NINCDS-ADRDA Work Group under the auspices of Department of Health and Human Services Task Force on Alzheimer's Disease. Neurology. 1984 Jul;34(7):939–944. doi: 10.1212/wnl.34.7.939. [DOI] [PubMed] [Google Scholar]
- Sahakian B., Jones G., Levy R., Gray J., Warburton D. The effects of nicotine on attention, information processing, and short-term memory in patients with dementia of the Alzheimer type. Br J Psychiatry. 1989 Jun;154:797–800. doi: 10.1192/bjp.154.6.797. [DOI] [PubMed] [Google Scholar]
- Shalat S. L., Seltzer B., Pidcock C., Baker E. L., Jr Risk factors for Alzheimer's disease: a case-control study. Neurology. 1987 Oct;37(10):1630–1633. doi: 10.1212/wnl.37.10.1630. [DOI] [PubMed] [Google Scholar]