Association between cumulative smoking exposure and cognitive decline in non-demented older adults: NEDICES study

Abstract Whether cumulative smoking exposure is associated with cognitive decline among older adults remains unresolved. To address this question, we used data from the Neurological Disorders in Central Spain (NEDICES) cohort study, in which 2624 older adults were evaluated at two-time points separa...

Full description

Bibliographic Details
Main Authors: Julián Benito-León, Ritwik Ghosh, José Lapeña-Motilva, Cristina Martín-Arriscado, Félix Bermejo-Pareja
Format: Article
Language:English
Published: Nature Portfolio 2023-04-01
Series:Scientific Reports
Online Access:https://doi.org/10.1038/s41598-023-32663-9
_version_ 1797850048781877248
author Julián Benito-León
Ritwik Ghosh
José Lapeña-Motilva
Cristina Martín-Arriscado
Félix Bermejo-Pareja
author_facet Julián Benito-León
Ritwik Ghosh
José Lapeña-Motilva
Cristina Martín-Arriscado
Félix Bermejo-Pareja
author_sort Julián Benito-León
collection DOAJ
description Abstract Whether cumulative smoking exposure is associated with cognitive decline among older adults remains unresolved. To address this question, we used data from the Neurological Disorders in Central Spain (NEDICES) cohort study, in which 2624 older adults were evaluated at two-time points separated by three years. A 37-item version of the Mini-Mental State Examination (MMSE-37) was administered at two visits to assess cognitive change. Regarding smoking exposure, we calculated an individual baseline score based on pack-years (i.e., packs of cigarettes smoked per day multiplied by years of smoking) in current and former smokers. Thus, smoking exposure was categorized into tertiles (low: < 19.0, medium: 19.0–47.0, and high: > 47.0). We used multivariable generalized estimating equation models to assess associations between pack-years and smoking status with 37-MMSE total score change from baseline to follow-up. The MMSE-37 total score had a decline of 1.05 points (confidence interval [CI] 95% 0.62 to 1.48) in the lower tertile of pack-years, 1.16 (CI 95% 0.70 to 1.62) in the middle tertile and 1.17 (CI 95% 0.70 to 1.65) in the higher tertile compared to never smokers, after adjusting for several demographic and clinical variables. The same occurred with smoking status, i.e., a decline of 1.33 (CI 95% 0.87 to 1.79) in current smokers and 1.01 (CI 95% 0.63 to 1.40) in former smokers. Our study provides evidence of the cumulative effect of smoking on cognition in older adults. Using a prospective population-based design, we demonstrated that cumulative smoking exposure was associated with cognitive decline in non-demented older adults. More population-based evidence is required to elucidate this association in older adults without dementia.
first_indexed 2024-04-09T18:54:05Z
format Article
id doaj.art-a3af52a0966643b18bffdadeeb1fb958
institution Directory Open Access Journal
issn 2045-2322
language English
last_indexed 2024-04-09T18:54:05Z
publishDate 2023-04-01
publisher Nature Portfolio
record_format Article
series Scientific Reports
spelling doaj.art-a3af52a0966643b18bffdadeeb1fb9582023-04-09T11:16:47ZengNature PortfolioScientific Reports2045-23222023-04-011311710.1038/s41598-023-32663-9Association between cumulative smoking exposure and cognitive decline in non-demented older adults: NEDICES studyJulián Benito-León0Ritwik Ghosh1José Lapeña-Motilva2Cristina Martín-Arriscado3Félix Bermejo-Pareja4Department of Neurology, University Hospital “12 de Octubre”Department of General Medicine, Burdwan Medical CollegeDepartment of Neurology, University Hospital “12 de Octubre”Research Institute (imas12), University Hospital “12 de Octubre”Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED)Abstract Whether cumulative smoking exposure is associated with cognitive decline among older adults remains unresolved. To address this question, we used data from the Neurological Disorders in Central Spain (NEDICES) cohort study, in which 2624 older adults were evaluated at two-time points separated by three years. A 37-item version of the Mini-Mental State Examination (MMSE-37) was administered at two visits to assess cognitive change. Regarding smoking exposure, we calculated an individual baseline score based on pack-years (i.e., packs of cigarettes smoked per day multiplied by years of smoking) in current and former smokers. Thus, smoking exposure was categorized into tertiles (low: < 19.0, medium: 19.0–47.0, and high: > 47.0). We used multivariable generalized estimating equation models to assess associations between pack-years and smoking status with 37-MMSE total score change from baseline to follow-up. The MMSE-37 total score had a decline of 1.05 points (confidence interval [CI] 95% 0.62 to 1.48) in the lower tertile of pack-years, 1.16 (CI 95% 0.70 to 1.62) in the middle tertile and 1.17 (CI 95% 0.70 to 1.65) in the higher tertile compared to never smokers, after adjusting for several demographic and clinical variables. The same occurred with smoking status, i.e., a decline of 1.33 (CI 95% 0.87 to 1.79) in current smokers and 1.01 (CI 95% 0.63 to 1.40) in former smokers. Our study provides evidence of the cumulative effect of smoking on cognition in older adults. Using a prospective population-based design, we demonstrated that cumulative smoking exposure was associated with cognitive decline in non-demented older adults. More population-based evidence is required to elucidate this association in older adults without dementia.https://doi.org/10.1038/s41598-023-32663-9
spellingShingle Julián Benito-León
Ritwik Ghosh
José Lapeña-Motilva
Cristina Martín-Arriscado
Félix Bermejo-Pareja
Association between cumulative smoking exposure and cognitive decline in non-demented older adults: NEDICES study
Scientific Reports
title Association between cumulative smoking exposure and cognitive decline in non-demented older adults: NEDICES study
title_full Association between cumulative smoking exposure and cognitive decline in non-demented older adults: NEDICES study
title_fullStr Association between cumulative smoking exposure and cognitive decline in non-demented older adults: NEDICES study
title_full_unstemmed Association between cumulative smoking exposure and cognitive decline in non-demented older adults: NEDICES study
title_short Association between cumulative smoking exposure and cognitive decline in non-demented older adults: NEDICES study
title_sort association between cumulative smoking exposure and cognitive decline in non demented older adults nedices study
url https://doi.org/10.1038/s41598-023-32663-9
work_keys_str_mv AT julianbenitoleon associationbetweencumulativesmokingexposureandcognitivedeclineinnondementedolderadultsnedicesstudy
AT ritwikghosh associationbetweencumulativesmokingexposureandcognitivedeclineinnondementedolderadultsnedicesstudy
AT joselapenamotilva associationbetweencumulativesmokingexposureandcognitivedeclineinnondementedolderadultsnedicesstudy
AT cristinamartinarriscado associationbetweencumulativesmokingexposureandcognitivedeclineinnondementedolderadultsnedicesstudy
AT felixbermejopareja associationbetweencumulativesmokingexposureandcognitivedeclineinnondementedolderadultsnedicesstudy