Almeida OP, Garrido GJ, Alfonso H, Hulse G, Lautenschlager NT, Hankey GJ, Flicker L.
Western Australian Centre for Health & Ageing, Centre for Medical Research, University of Western Australia, Australia; School of Psychiatry & Clinical Neurosciences, University of Western Australia, Australia; Department of Psychiatry, Royal Perth Hospital, Australia.
Abstract
BACKGROUND: Observational studies investigating the association between smoking, cognitive decline and dementia have produced conflicting results. We completed this trial to determine if smoking cessation decreases the progression of cognitive decline in later life.
METHODS: We recruited older smokers (n=229) and never smokers (n=98) and invited smokers to join a smoking cessation trial. The primary outcome of interest was change in Alzheimer’s Disease Assessment Scale cognitive subscale (ADAS-cog) scores over 24months. Secondary measures included the Logical Memory test and changes in gray matter density. Successful smoking cessation was defined as a minimum of 547 smoking free days during follow up.
RESULTS: The ADAS-cog scores of unsuccessful quitters (UQ) increased (i.e., became worse) 1.1±0.3 and 1.2±0.4 points more than the scores of never smokers (NS) (p=0.001) and successful quitters (SQ) (p=0.006) respectively over the 24months of follow up. Similarly, the scores of UQ declined (i.e., became worse) relative to NS on measures of immediate (p=0.004) and delayed recall (p=0.029). All analyses were adjusted for age, years of education, baseline cognitive performance, alcohol use, depression scores, and the presence of chronic respiratory disease. Thirty-six NS, 18 SQ and 48 UQ completed the imaging substudy. Compared with NS, UQ showed a disproportional loss of gray matter density in the right thalamus, right and left inferior semi-lunar lobule, as well as left superior and inferior parietal lobule over 24months. SQ showed loss of gray matter compared with NS in the right middle and inferior occipital gyri, right and left culmen, and the left superior frontal gyrus. We did not find any brain regions in which UQ had lost more gray matter than SQ over 2years.
CONCLUSION: These results are consistent with the hypothesis that smoking causes cognitive decline and loss of gray matter tissue in the brain over time.
Copyright © 2011. Published by Elsevier Inc.
PMID: 21281718 [PubMed - as supplied by publisher]

Abstract

OBJECTIVE: To examine the effect of lifestyle changes on the stability of blood lipid and lipoprotein levels from youth to adulthood.

DESIGN: Prospective cohort study.

SETTING: Australia.

PARTICIPANTS: Five hundred thirty-nine young adults who underwent measurement at baseline in 1985 when aged 9, 12, or 15 years and again at follow-up between 2004 and 2006.

MAIN EXPOSURES: Changes in adiposity, cardiorespiratory fitness, saturated fat intake, smoking, and socioeconomic position.

MAIN OUTCOME MEASURES: Child and adult blood lipid levels.

RESULTS: Using established cut points, we found that substantial proportions of individuals with high-risk blood lipid and lipoprotein levels at baseline no longer had high-risk levels at follow-up. Of the participants who had high-risk levels in youth, those with greater increases in adiposity or who commenced or continued smoking were more likely to maintain high-risk blood lipid and lipoprotein levels (P < .05). Participants who became high risk at follow-up had greater increases in adiposity, were less likely to improve their socioeconomic position, and tended to become less fit between surveys compared with those who maintained normal-risk levels (P ? .05). These effects tended to remain (P ? .10) after adjustment for all predictive lifestyle variables.

CONCLUSIONS: Unhealthy lifestyle changes that occur between youth and adulthood affect whether an individual maintains, loses, or develops high-risk blood lipid and lipoprotein levels in adulthood. Interventions that promote weight control in the first instance, but also physical activity, not smoking, and improved socioeconomic position in the transition from youth to adulthood, are likely to be of benefit in preventing adult dyslipidemia. ]]> http://thelongevityproject.com/factors-affecting-the-stability-of-blood-lipid-and-lipoprotein-levels-from-youth-to-adulthood-evidence-from-the-childhood-determinants-of-adult-health-study/feed/ 0