SMOKING HISTORY IN MIDDLE-AGE AND SUBSEQUENT COGNITIVE PERFORMANCE INELDERLY JAPANESE-AMERICAN MEN - THE HONOLULU-ASIA AGING STUDY

The associations between cigarette smoking history and later cognitive performance were examined among 3,429 Japanese-American participants of the Honolulu Heart Program (HHP) and its extension, the Honolulu-As ia Aging Study (HAAS). Cognitive performance was measured by the Cogni tive Abilities Screening Instrument (CASI), administered as part of HA AS (mean age at HAAS exam (standard deviation (SD)): 77.7 (4.6) years) . Information on smoking history was collected during the first and th ird HHP exams (mean age (SD) at Exam III: 58.6 (4.7) years). Compared with never-smokers, those who had smoked continuously between Exams I- III and those who had quit smoking during that period had significantl y lower CASI scores, after adjustment for age, education, Japanese acc ulturation, and Exam III alcohol intake. In multiple logistic regressi on controlling for the above covariates, a significantly higher risk o f cognitive impairment (CASI score <82) was associated with continuous smoking (odds ratio (OR) = 1.36, 95% confidence interval (CI) 1.10-1. 69) and quitting between Exams I-III (OR = 1.36, 95% CI 1.03-1.80) com pared with never smoking. This excess risk of cognitive impairment amo ng continuous smokers and Exam I-III quitters was slightly diminished by further adjustment for body mass index and several vascular covaria tes. Additional analyses suggested a reduced risk of cognitive impairm ent among the longer-term quitters. This study suggests a positive ass ociation between smoking during middle age and rater risk of cognitive impairment.