Magazine article Clinical Psychiatry News

For Some, Midlife Smoking May Raise AD Risk

Magazine article Clinical Psychiatry News

For Some, Midlife Smoking May Raise AD Risk

Article excerpt

CHICAGO -- Smoking in midlife might increase the chance of Alzheimer's in later life among those who already carry an increased genetic risk.

A population-based Finnish study with more than 20 years of follow-up concluded that carriers of the apolipoprotein E4 allele who smoked in midlife were seven times more likely to develop Alzheimer's than were carriers who didn't smoke. Alcohol consumption seemed to exacerbate the smoking-associated risk; carriers who drank frequently and smoked at midlife were more than 11 times as likely to develop the disorder as were carriers who never indulged in either behavior, Dr. Minna Rusanen said at the International Conference on Alzheimer's Disease.

The news is actually good for apo E4 carriers, who are considered almost certain to develop the disorder at a relatively young age, she said in an interview. "Recent knowledge about the environmental risk factors of the disease is giving hope to genetically susceptible people," said Dr. Rusanen of the Kuopio (Finland) University Hospital. "The risk of developing Alzheimer's may be lowered by adopting an overall healthy lifestyle early in life. Promoting smoking cessation should be one of the major issues in the public education; it could help to prevent, or at least delay, the onset of Alzheimer's, and thus help one to live a cognitively healthy life also through old age."

The association between smoking and dementia has never been conclusively proved, Dr. Rusanen noted. "Several case-control studies in the 1980s and 1990s suggested an inverse relationship between smoking and dementia, but this was probably due to a survival bias." Some studies found a positive association only among apo E4 noncarriers, but one concluded that apo E status didn't modify dementia risk among smokers. The connection between smoking and Alzheimer's risk, however, is biologically plausible. "Smoking is known to have negative vascular effects, and predispose to cerebrovascular disease by accelerating atherosclerosis and inducing oxidative stress and inflammation--mechanisms which are also thought to have relevance in the development of Alzheimer's."

To further investigate this question, Dr. …

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