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[P3–546]: PASSIVE SMOKING AS A RISK FACTOR FOR DEMENTIA AND COGNITIVE IMPAIRMENT: SYSTEMATIC REVIEW OF LONGITUDINAL AND CROSS‐SECTIONAL STUDIES
Author(s) -
Stirland Lucy E.,
O'Shea Chris I.,
Russ Tom C.
Publication year - 2017
Publication title -
alzheimer's and dementia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 6.713
H-Index - 118
eISSN - 1552-5279
pISSN - 1552-5260
DOI - 10.1016/j.jalz.2017.06.1766
Subject(s) - dementia , data extraction , systematic review , risk factor , cognition , cognitive impairment , medicine , cognitive decline , psychology , gerontology , medline , psychiatry , disease , pathology , political science , law
communities in the USA. Participants were followed with annual clinical and neuropsychological evaluations and at time of death all had an autopsy. AD neuropathology was quantified using established CERAD criteria. Frailty was operationalized using the deficit accumulation approach, with a frailty index constructed from 38 health variables including function, comorbidities, symptoms, and signs. Cognition was operationalized using a clinical cognitive diagnosis of probable or definite AD. Multiple logistic regression was used to test the relationship between frailty and cognition after controlling for age, sex, education, APOE genotype, and neuropathological burden. Results:412 adults (82.665.7 years, 68.2% female) were included in this analysis. At time of death, 11.9% suffered from AD-type dementia, and 68.2% met neuropathological criteria for AD. Participants with dementia were significantly more frail (F1⁄415.08, p<0.001) and were more likely to have high neuropathological burden (F1⁄413.44, p<0.001) than those without dementia. Interestingly, participants with high burden of AD neuropathology were not more frail (F1⁄41.15, p1⁄40.28). Regression analyses demonstrated that frailty was associated with odds of AD-dementia after controlling for relevant risk factors including AD neuropathology. Specifically, for each 0.1 increase in frailty index score, odds of a clinical cognitive diagnosis increased by 15%. Conclusions:Results here suggest that frailty is associated with the clinical presentation of dementia independently from AD neuropathology burden. This needs to be assessed longitudinally to better elucidate this complex relationship.