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Departments of Epidemiology (Drs. Brenner and Kukull), Environmental Health Dr. van Belle), Keulology (Dr. Bowen). Medicine (Drs. McCormick and Larson), and Psychiatry (Dr. Teri), University of Washington, Seattle, WA.
We investigated whether cigarette smoking is negatively associated with Alzheimer's disease (AD) in a population-based, frequency-matched, case-control study of 152 AD patients and 180 controls. Ever having smoked was associated with lower risk of AD (adjusted odds ratio = 0.61; 95% confidence interval: 0.37–0.99). Additional multivariate analyses demonstrated that education and history of hypertension modified this association. The direction of the modification was for higher education level and history of hypertension to further reduce the risk. The "dose response" pattern showed the greatest risk reduction among those who smoked least and suggests a biologic mechanism of a dose-dependent up-regulation of nicotinic (cholinergic) brain receptors. These data, although consistent with current opinion about pathophysiology of AD, do not suggest smoking should be used as a preventive strategy for AD.
Address correspondence and reprint requests to Dr. Walter A. Kukull, Department of Epidemiology, SC-36, University of Washington, Seattle, WA
Supported in part by research grants R01 AG07584, U01 AG06781, and P50 AG05136 from the National Institute of Aging. Dr. Brenner is a fellow of the Swiss National Foundation for Scientific Research.
Received April 6, 1992. Accepted for publication in final form June 17, 1992.
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