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The Relation of Cigarette Smoking to Incident Alzheimer’s Disease in a Biracial Urban Community Population

Aggarwal N.T.a, c · Bienias J.L.b, d · Bennett D.A.a, c · Wilson R.S.a, c, f · Morris M.C.b, e · Schneider J.A.a, c · Shah R.C.a, g · Evans D.A.b, d
aRush Alzheimer’s Disease Center; bRush Institute for Healthy Aging; cDepartment of Neurological Sciences; dInternal Medicine; ePreventive Medicine; fPsychology; gFamily Medicine, Rush University Medical Center, Chicago, Ill., USA Neuroepidemiology 2006;26:140–146 (DOI:10.1159/000091654)


The relationship between smoking status and incident Alzheimer’s disease (AD) was investigated in a random stratified sample of a biracial community in Chicago. Analyses are based on 1,064 persons (of 1,134 evaluated) who had data on smoking status, disease incidence, and key covariates such as apolipoprotein allele status. During a mean of about 4 years of follow-up, 170 persons met criteria for incident AD. Current smoking was associated with increased risk of incident AD (OR = 3.4, 95% CI = 1.4–8.0) compared to persons who never smoked. There was no apparent increase in risk of AD for former smokers compared to persons who never smoked (OR = 0.9, 95% CI = 0.5–1.7). Apolipoprotein E allele status modified this association in that former smokers with a υ4 allele were less likely to develop AD (p = 0.04) than those who never smoked. Former smokers also appeared to have a reduced risk of developing AD as their pack-years of smoking increased (p = 0.02)such that the odds of developing AD increased by 50% for every 10 years of smoking cessation (OR = 1.3, CI = 0.9–1.7). The results suggest that older people who currently smoke are more likely to develop AD compared to those who never smoked; the relation between those who used to smoke but quit and the risk of AD is complex and requires further research.


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