The Correlation Between Tobacco Intake And Mild Cognitive Impairment In The Elderly

Objective:Mild cognitive impairment(MCI)was considered transitioanal phrase to dementia.As a common lifestyle,the tobacco intake is relevant to mild cognitive impairment.Among current studies,it is still controversible that tobacoo intake has an impact on cognitive deline while the assessment of tobacco intake was not deep and there are a few studies that investigated the potential factors involving this process.It is important to analyse the impact of multi-angles of tobacco intake on cognition to slow down or prevent cognitive decline.The aim of this study is to analyse the impact of mulit-angles of tobacco intake on the cognition in the elderly and explore the potential factors in this progress.Methods:Convenience sampling was used to select the older people aged over 60-year-old from May to November in 2016 in The First Hospital of Jilin University.109 patients who met the inclusion criteria were selected as the case group and 123 patients with normal cognitive function as the control group.The questionnaires were of three aspects:(1)general information(age,gender,marital status,the level of education,BMI,sleep,exercise,etc.);(2)tobacco intake survey(nicotine dependence test,smoking status,the level of smoking,the duration of smoking,the duration of smoking cessation,the duration of cumulative smoking,the dependence of nicotine,and passive smoking);(3)scales of cognitive function(Minimum Mental State scale,Montreal Cognitive Assessment Scale,Daily Living Ability Scale,Clinical Dementia Rating Scale,Hachinki Ischemia Index Scale).Epidata 3.1 software was used to establish a database.The data was presented as (?)±SD and incidence of MCI.Single factor analysis and multivariate logistic regression were carried out by SPSS 21 to analyze the risk factors of MCI.Logistic regression analysis was used to assess the effect of multi-angles of tobacco intake on cognitive function and the data of those results were presented as OR(odds ratios)with 95%CI(confidence internal).The p value <0.05 was considered statistical significance,and all p-values were two-sided.Results:1.The results of single factors analysis showed that the incidence of MCI was affected by age,gender,BMI,duration of sleep,exercise,hypertension,diabetes,smoking,alcohol consumption,depression and anxiety.2.If the variables were included in the logistic regression model,the incidence of MCI was still affected by age,gender,duration of sleep,alcohol consumption,smoking.3.After adjusting the age,sex,sleep and alcohol consumption,the analysis of smoking status showed that former and current smokers had higher incidence of MCI than never smokers(OR=4.200,95%CI=1.856-9.505,(OR=2.628,95%CI=1.106-6.245,p=0.029).As for the level of smoking,the incidence of MCI was higher in moderate and severe smokers than in nonsmokers(OR=3.042,95%CI=1.456-6.356,p=0.001),(OR=3.116,95%CI=1.203-8.070,p=0.019).As for the analysis of smoking duration,the incidence of MCI was higher in the groups which people's smoking duration were 30 to 39 years,40 to 49 years,50 to 59 years,over 60 years than the never smoking group(OR=3.135,95%CI=0.841-11.685,p=0.089),(OR=2.727,95%CI=1.042-7.140,p=0.041),(OR=2.870,95%CI=1.133-7.271,p=0.026),(OR=3.775,95%CI=1.328-10.731,p=0.013);As for smoking cessation,the duration of smoking cessation that was greater than 21 years may have a protective effect on cognitive function(OR=0.236,95%CI=0.079-0.707,p=0.010);As the duration of cumulative smoking increased,compared with never smoking group,there was a higher incidence of MCI in groups of the duration of cumulative smoking which was 30 to 44 years(OR=3.838,95%CI=3.838-9.233,p=0.003),and was 45 to 49 years(OR=2.407,95%CI=0.930-6.234,p=0.070),and was over 60 years(OR=15.637,95%CI=1.604-152.424,p=0.018).As for the analysis of the amount of cumulative smoking,those who got 400-599 cigarettes per month had a higher incidence of MCI(OR=3.754,95%CI=1.075-13.101,p=0.038)than those who were non-smokers.However,there was no significant difference between MCI group and control group in aspects of nicotine dependence and passive smoking(p <0.05).4.After adjusting the variables of age,gender,sleep,alcohol consumption,the direct impact of the level of smoking,the duration of smking,the duration of cumulative smoking,the amount the cumulative smkong on MCI were statistically significant(p <0.05)while the indirect impact of those on MCI via duration of sleep were also statistically significant(LL95%CI-UL95%CI did not include 0).Conclusion:1.The incidence of MCI was affected by age,gender,duration of sleep,alcohol consumption,smoking.2.Tobacco intake affected cognitive function by multi-angles of tobacco intake(smoking status,the level of smoking,the duration of smoking duration,the duration of smoking cessation,the duration of cumulative smoking,and the amount of cumulative smoking).3.The the level of smoking,the duration of smoking,the amount of cumulative smoking and the length of cumulative smoking affected the cognitive function partly through the duration of sleep.4.Nursing staff should pay more attention to assess the cognitive fuction in the elderly,especially those who are female,of short sleep duration,drinkers and smokers,to prevent or slow down cognitive decline.Meanwhile,health care personnel should emphaise the impact of current smoking,the amount of smoking and the duration of smoking on cognitive,when dessiminating knowledge about tobacco control to the elderly.As for the older people with a shorter sleep duration,health care personnel should make an effort to convince them to keep away from or reduce tobacoo intake while take nursing intervention to facilicate sleep.