Smoking as a Risk Factor for Dementia and Cognitive Decline: A Meta-Analysis of Prospective Studies
2007/06/14 by K. J. Anstey, Kaarin J. Anstey, Chwee von Sanden +5 · 915 citations
Medicine · #Alzheimer's disease #Cognitive decline #Confidence interval #Dementia #Dementia and Cognitive Impairment Research #Disease #Gerontology #Internal medicine #Medicine #Meta-analysis #Nutritional Studies and Diet #Prospective cohort study #Relative risk #Risk factor #Vascular dementia
paper · doi:10.1093/aje/kwm116
published in American Journal of Epidemiology 166(4), 367-378 (Oxford University Press)
openalex publication_date 2007/06/14 · openalex created_date 2025/10/10 · openalex updated_date 2026/08/05
Abstract
The authors assessed the association of smoking with dementia and cognitive decline in a meta-analysis of 19 prospective studies with at least 12 months of follow-up. Studies included a total of 26,374 participants followed for dementia for 2-30 years and 17,023 participants followed up for 2-7 years to assess cognitive decline. Mean study age was 74 years. Current smokers at baseline, relative to never smokers, had risks of 1.79 (95% confidence interval (CI): 1.43, 2.23) for incident Alzheimer's disease, 1.78 (95% CI: 1.28, 2.47) for incident vascular dementia, and 1.27 (95% CI: 1.02, 1.60) for any dementia. Compared with those who never smoked, current smokers at baseline also showed greater yearly declines in Mini-Mental State Examination scores over the follow-up period (effect size (beta)=-0.13, 95% CI: -0.18, -0.08). Compared with former smokers, current smokers at baseline showed an increased risk of Alzheimer's disease (relative risk=1.70, 95% CI: 1.25, 2.31) and an increased decline in cognitive abilities (effect size (beta)=-0.07, 95% CI: -0.11, -0.03), but the groups were not different regarding risk of vascular dementia or any dementia. The authors concluded that elderly smokers have increased risks of dementia and cognitive decline.
Cited by
- Modifiable risk factors for stroke, dementia and late-life depression: a systematic review and DALY-weighted risk factors for a composite outcome
- Vascular Contributions to Cognitive Impairment and Dementia
- Estimation of the global prevalence of dementia in 2019 and forecasted prevalence in 2050: an analysis for the Global Burden of Disease Study 2019
- Association of cognitive impairment and peripheral artery disease (PAD): A systematic review
- Dementia and Cognitive Impairment
- Cardiopulmonary Impact of Electronic Cigarettes and Vaping Products: A Scientific Statement From the American Heart Association
- Accounting for Bias Due to Selective Attrition
- Distinct medical and substance use histories associate with cognitive decline in Alzheimer’s Disease
- Atrial Fibrillation and Cognitive Function
- Ageing and Skills
- Is exposure to secondhand smoke associated with cognitive parameters of children and adolescents?-a systematic literature review
- Association of Passive Smoking With Cognitive Impairment in Nonsmoking Older Adults
- Long Working Hours and Cognitive Function: The Whitehall II Study
- Cigarette Smoking is a Risk Factor for Alzheimer's Disease: An Analysis Controlling for Tobacco Industry Affiliation
- Cognitive Dysfunction, Affective States, and Vulnerability to Nicotine Addiction: A Multifactorial Perspective
- Smoking, dementia and cognitive decline in the elderly, a systematic review. [europepmc]
- Integrative data analysis through coordination of measurement and analysis protocol across independent longitudinal studies. [europepmc]
- Epidemiology of Alzheimer's disease: occurrence, determinants, and strategies toward intervention. [europepmc]
- Cigarette smoking is a risk factor for Alzheimer's Disease: an analysis controlling for tobacco industry affiliation. [europepmc]
- Meta-analysis of the acute effects of nicotine and smoking on human performance. [europepmc]
- The projected effect of risk factor reduction on Alzheimer's disease prevalence. [europepmc]
- Vascular contributions to cognitive impairment and dementia: a statement for healthcare professionals from the american heart association/american stroke association. [europepmc]
- Accounting for bias due to selective attrition: the example of smoking and cognitive decline. [europepmc]
- Impact of smoking on cognitive decline in early old age: the Whitehall II cohort study. [europepmc]
- Smoking and increased Alzheimer's disease risk: a review of potential mechanisms. [europepmc]
- Dementia and cognitive impairment: epidemiology, diagnosis, and treatment. [europepmc]
- Cardiovascular risk factors and future risk of Alzheimer's disease. [europepmc]
- Periodontal disease associates with higher brain amyloid load in normal elderly. [europepmc]
- Age-Related Sensory Impairments and Risk of Cognitive Impairment. [europepmc]
- Defining Optimal Brain Health in Adults: A Presidential Advisory From the American Heart Association/American Stroke Association. [europepmc]
- Cognitive function trajectories and their determinants in older people: 8 years of follow-up in the English Longitudinal Study of Ageing. [europepmc]
- Mild cognitive impairment and progression to dementia in people with diabetes, prediabetes and metabolic syndrome: a systematic review and meta-analysis. [europepmc]
- Social Isolation and Cognitive Function in Later Life: A Systematic Review and Meta-Analysis. [europepmc]
- Global, regional, and national burden of Alzheimer's disease and other dementias, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016. [europepmc]
- Anticholinergic Drug Exposure and the Risk of Dementia: A Nested Case-Control Study. [europepmc]
- Modifiable Risk Factors for Alzheimer's Disease. [europepmc]
- Associations Between Cardiovascular Risk, Structural Brain Changes, and Cognitive Decline. [europepmc]
- Estimation of the global prevalence of dementia in 2019 and forecasted prevalence in 2050: an analysis for the Global Burden of Disease Study 2019. [europepmc]
- Pathophysiology of blood brain barrier dysfunction during chronic cerebral hypoperfusion in vascular cognitive impairment. [europepmc]
- Alzheimer's disease: insights into pathology, molecular mechanisms, and therapy. [europepmc]
Related