Effect of alcohol and tobacco use on vascular dementia: A matched case control study

Paul Y Takahashi, Casey R. Caldwell, Paul V. Targonski

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Background: Vascular dementia is the second most common type of dementia in the United States. The underlying association of tobacco and alcohol with vascular dementia is not completely understood. Purpose: Determine the relationship of tobacco and alcohol use with the development of vascular dementia (VaD). Methods: This was a matched case-control study of subjects living in Olmsted County, MN. Cases of VaD were identified through medical record abstraction using conventionally accepted definitions of VaD, using the National Institute of Neurological Disorders and Stroke and the Association Internationale pour la Recherche et l'Ensignement en Neurosicences (NINDS-AIRENS) criteria and were matched to controls by gender and age within 3 years among persons free of dementia on the index date. Exposure data for alcohol and tobacco use were abstracted by trained nurses, along with demographic, lifestyle, cerebrovascular, cardiovascular, and vascular comorbid disease characteristics. Matched conditional logistic regression for univariate and multivariate evaluation of the association of tobacco and alcohol use with VaD was utilized. Results: Current alcohol exposure was associated with a decreased risk of VaD with an odds ratio of 0.48 (95% confidence interval: 0.31-0.74). This protective effect of alcohol was seen in men, women, and subjects under 80 years of age. Tobacco use was not associated with VaD in univariate and multivariate analysis, and stratified analysis did not reveal any subgroup-specific associations between tobacco use and VaD in the study population. Conclusion: Current alcohol use appears to have protective effects against the development of vascular dementia. The effects are more pronounced in subjects under age 80. This may reflect the direct vascular effects of alcohol on the vascular system or may represent a surrogate for better social or functional status. Previous alcohol use was not protective. Tobacco use was not a risk factor for VaD status, which was possibly an indication of survivorship bias in the cohort.

Original languageEnglish (US)
Pages (from-to)685-691
Number of pages7
JournalVascular Health and Risk Management
Volume7
Issue number1
DOIs
StatePublished - 2011

Fingerprint

Vascular Dementia
Tobacco Use
Case-Control Studies
Alcohols
National Institute of Neurological Disorders and Stroke
Blood Vessels
Dementia
Vascular Diseases
Tobacco
Medical Records
Life Style
Multivariate Analysis
Survival Rate
Logistic Models
Odds Ratio
Nurses
Demography
Confidence Intervals

Keywords

  • Alcohol
  • Elderly
  • Tobacco
  • Vascular dementia

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Pharmacology (medical)
  • Public Health, Environmental and Occupational Health
  • Hematology
  • Endocrinology, Diabetes and Metabolism

Cite this

Effect of alcohol and tobacco use on vascular dementia : A matched case control study. / Takahashi, Paul Y; Caldwell, Casey R.; Targonski, Paul V.

In: Vascular Health and Risk Management, Vol. 7, No. 1, 2011, p. 685-691.

Research output: Contribution to journalArticle

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abstract = "Background: Vascular dementia is the second most common type of dementia in the United States. The underlying association of tobacco and alcohol with vascular dementia is not completely understood. Purpose: Determine the relationship of tobacco and alcohol use with the development of vascular dementia (VaD). Methods: This was a matched case-control study of subjects living in Olmsted County, MN. Cases of VaD were identified through medical record abstraction using conventionally accepted definitions of VaD, using the National Institute of Neurological Disorders and Stroke and the Association Internationale pour la Recherche et l'Ensignement en Neurosicences (NINDS-AIRENS) criteria and were matched to controls by gender and age within 3 years among persons free of dementia on the index date. Exposure data for alcohol and tobacco use were abstracted by trained nurses, along with demographic, lifestyle, cerebrovascular, cardiovascular, and vascular comorbid disease characteristics. Matched conditional logistic regression for univariate and multivariate evaluation of the association of tobacco and alcohol use with VaD was utilized. Results: Current alcohol exposure was associated with a decreased risk of VaD with an odds ratio of 0.48 (95{\%} confidence interval: 0.31-0.74). This protective effect of alcohol was seen in men, women, and subjects under 80 years of age. Tobacco use was not associated with VaD in univariate and multivariate analysis, and stratified analysis did not reveal any subgroup-specific associations between tobacco use and VaD in the study population. Conclusion: Current alcohol use appears to have protective effects against the development of vascular dementia. The effects are more pronounced in subjects under age 80. This may reflect the direct vascular effects of alcohol on the vascular system or may represent a surrogate for better social or functional status. Previous alcohol use was not protective. Tobacco use was not a risk factor for VaD status, which was possibly an indication of survivorship bias in the cohort.",
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