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Tobacco use and dementia: Evidence from the 1066 dementia population-based surveys in Latin America, China and India

Tobacco use and dementia: Evidence from the 1066 dementia population-based surveys in Latin America, China and India

Ferri, C.P.; West, R.; Moriyama, T.S.; Acosta, D.; Guerra Arteaga, Mariella; Huang, Y.; Jacob, K.S.; Ribeiro, W.; Llibre De Rodriguez, J.J.; Salas, A.; Sosa, A.L.; Williams, J.; Acosta, I.; Liu, Z.; Hernandez, M.A.G.; Prince, M.J.
URI: https://hdl.handle.net/20.500.12866/10818
Date: 2011

Abstract:

Objectives: To assess the association between tobacco consumption and dementia using the same methodology in seven developing countries, testing the specific hypotheses that higher exposure to tobacco is associated with a higher prevalence of dementia, that the association is limited to smoked tobacco and is stronger for vascular dementia compared to Alzheimer's disease. Methods: Cross-sectional surveys conducted on individuals aged 65+. A total of 15 022 residents in specified catchment areas were assessed face-to-face using a standardised protocol, which included dementia diagnosis and detailed information on past and current tobacco consumption, and on important potential confounders of this association. Results: A high proportion of participants were never smokers (52% in Dominican Republic to 83% in Peru), most of those who ever used tobacco in China and India were still smoking at age 65 and above (80% and 84%, respectively). There was a positive association between history of tobacco smoke exposure (pack years up to age 50) and dementia (pooled PR = 1.003; 95%CI 1.001-1.005), Alzheimer's disease (pooled PR = 1.007; 95% CI, 1.003-1.011) and Vascular Dementia (pooled PR = 1.003; 95% CI = 1.001-1.005). These associations were attenuated but remained significant if exposure after the age of 50 was included. In India there was no association between smokeless tobacco and dementia. Conclusions: Dementia in developing countries appears to be positively associated with history of tobacco smoking but not smokeless tobacco use. Selective quitting in later life may bias estimation of associations.

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