Smoking & Drinking Risks

ASK DR. MINDY

MINDY KIM-MILLER, MD, PhD
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Question:

I am trying to get my mother to stop smoking and drinking. My mother had depression when she was younger, and she started smoking and drinking pretty heavily during her first serious episode of depression. She is now 74 years old and hasn’t had an episode in a very long time, but she continues to have one drink a day with one cigarette. I heard that her risk of Alzheimer’s disease might be higher because of her bad habits. Is that true?

–M.R., Chicago

Answer:

Your mother has a number of potential risk factors for Alzheimer’s disease (AD). First, a history of smoking in midlife increases one’s risk of developing AD and other dementias later in life. Additionally, elderly smokers increase their risk of AD and cognitive decline compared to former smokers and those who never smoked. Furthermore, smoking in combination with frequent or heavy alcohol consumption further increases one’s risk. So your mother has significantly increased her risk for AD and other dementias by smoking and drinking. If she also happens to carry the ApoE4 gene, smoking and drinking further increase her risk for AD exponentially. The multiple mechanisms involved in this association are complex and involve effects on blood vessels, inflammation, oxidative stress, and numerous other chemicals and processes in the body.
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Lastly, a history of depression may also affect one’s risk of developing dementia. Recent studies suggest that the presence of depressive symptoms may increase one’s risk for dementia in the near future, particularly for vascular dementia. Depressive symptoms may actually be early signs indicating the onset of vascular dementia. However, there does not appear to be an association between previous depressive episodes and dementia. Therefore, if your mother is not currently experiencing depressive symptoms, her risk of dementia may not be affected by her distant history of depression.

For more information about the complex association between alcohol consumption and AD, please read the LightBridge article, “Alcohol and Alzheimer’s Disease” at: www.LightBridgeHealthcare.com/alchohol_alzheimers.aspx

Dr. Mindy Kim-Miller is a trained medical physician who provides useful, but general answers to questions provided by online visitors. While Dr. Mindy can not provide specific medical advice or services, we hope you find her responses useful in your personal education. All information is provided for informational and educational purposes only and is not meant to be a substitute for professional medical advice, diagnosis or treatment. If you suspect you have an illness or disease, or a health related condition of any kind, seek professional medical care with an appropriate health care professional immediately. Do not postpone or delay seeking treatment or disregard professional advice based upon the general answers provided by Dr. Mindy. Dr. Mindy’s advice is not intended to substitute for a visit to your personal physician or other qualified health provider. Any specific medical concerns or questions you may have should be directed to your personal physician or other qualified health provider.

References:

Anstey KJ, von Sanden C, Salim A, O’Kearney R. Smoking as a risk factor for dementia and cognitive decline: a meta-analysis of prospective studies. Am J Epidemiol. 2007;166(4):367-78.
Duron F, Hanon O. Vascular risk factors, cognitive decline, and dementia. Vasc Health Risk Manag. 2008;4:363-81.
Fillit H, Nash DT, Rundek T, Zuckerman A. Cardiovascular risk factors and dementia. Am J Geriatr Pharmacother. 2008;6:100-18.
Ikeda A, Yamagishi K, Tanigawa T, Cui R, et al. Cigarette smoking and risk of disabling dementia in a Japanese rural community: a nested case-control study. Cerebrovasc Dis. 2008;25:324-31.
Lenoir H, Godin O, Lacombe J, Dufouil C, et al. Longitudinal analysis of the association between depressive symptoms and dementia: the three-city (3C) study. Presented at the International Conference on Alzheimer’s Disease (ICAD); Chicago. July 30, 2008.
Panza F, Capurso C, D’Introno A, Colacicco AM, et al. Vascular risk factors, alcohol intake, and cognitive decline. J Nutr Health Aging. 2008;12:376-81.
Peters R, Peters J, Warner J, Beckett H, Bulpitt C. Alcohol, dementia and cognitive decline in the elderly: a systematic review. Age Ageing. 2008 May 16. [Epub ahead of print].
Rusane M, Rovio S, Ngandu T, Nissinen A, et al. The impact of midlife smoking on the development of dementia and Alzheimer’s disease later in life: a population-based study. Presented at the International Conference on Alzheimer’s Disease (ICAD); Chicago. July 30, 2008.

 

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