Abstract P063: Cigarette Smoking and Neuroimaging Indices of Cerebrovascular Health in a Population-based Cohort of Middle-aged Adults

Introduction: Several studies report an association between cigarette smoking and dementia. One proposed hypothesis is that smoking leads to adverse cognitive and brain changes through vascular pathways. To date, few data exist on the link between smoking and vascular brain measures. We examined, in a population-based middle-aged cohort, the association of history of cigarette smoking with three indicators of cerebrovascular health: (i) white matter (WM) integrity measured using WM-fractional anisotropy, (ii) abnormal WM volume, and (iii) cerebral blood flow (CBF) in the gray matter. We focused on lobar measures of these indicators to detect whether specific regional cerebrovascular indicators are differently related to smoking. Hypothesis: We assessed the hypothesis that smoking history is associated with more adverse cerebrovascular measures (lower fractional anisotropy, larger abnormal WM volumes, and lower CBF). Methods: Data come from the Coronary Artery Risk Development in Young Adults CARDIA-brain magnetic resonance imaging sub-study (n=538). Brain measures and self-reported smoking history were obtained at the 25th year follow-up (mean age=50). We used linear (for CBF and WM-fractional anisotropy) and multinomial logistic (for abnormal WM volume) regression models, adjusted for potential confounders (including vascular and lifestyle risk factors and medical conditions). Results: Compared to never-smokers, current smokers had lower WM-fractional anisotropy in all brain lobes (-0.005 lower fractional anisotropy in the occipital lobe and -0.006 in the other lobes; p<0.05). Smoking history was also associated with larger abnormal WM volumes: Compared to never-smokers, smokers and/or former-smokers had patterns of larger abnormal WM volumes in all lobes, with pronounced associations observed in the frontal lobe wherein smokers and former-smokers had up to twice the risk of having larger abnormal frontal WM volumes as never-smokers (p<0.05). Smoking history was associated with lower CBF in the occipital (-2.89 ml/100g/min (95%CI=-5.43, -0.36); p=0.03) and parietal lobes (-3.31 (95%CI=-5.91, -0.71); p=0.01). Conclusions: In this cohort of middle-aged adults, associations between smoking and adverse WM measures were observed in all brain lobes, whereas associations of smoking with CBF were localized in the occipital and parietal lobes. This localization may reflect a link between smoking and blood flow processes related to sensory-cognitive networks. In conclusion, results suggest that smoking is associated with three early-indicators of cerebrovascular burden (WM-fractional anisotropy, WM abnormal volume, and CBF) across the brain and that it may be differentially related to different regional cerebrovascular indicators.

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Cigarette smoking and cerebral blood flow in a cohort of middle-aged adults

Journal of Cerebral Blood Flow & Metabolism ◽

10.1177/0271678x20905609 ◽

2020 ◽

Vol 40 (4) ◽

pp. 904-905

Author(s):

Olaf B Paulson ◽

Ida Vigdis

Keyword(s):

Carbon Monoxide ◽

Blood Flow ◽

Cerebral Blood Flow ◽

Cigarette Smoking ◽

Middle Aged ◽

High Affinity ◽

Former Smokers ◽

Middle Aged Adults

Cigarette smoking increases cerebral blood flow. Both nicotine and carbon monoxide contribute to the flow increase. Due to carbon monoxide’s high affinity to hemoglobin and slow clearance from the blood, the effect lasts for hours. Nicotine also stays in the organism for some hours. This immediate effect of smoking may explain a recently observed higher cerebral blood flow in current-smokers as compared to former-smokers.

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Factors associated with sarcopenia screened by finger-circle test among middle-aged and older adults: a population-based multisite cross-sectional survey in Japan

BMC Public Health ◽

10.1186/s12889-021-10844-3 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Daiki Watanabe ◽

Tsukasa Yoshida ◽

Takashi Nakagata ◽

Naomi Sawada ◽

Yosuke Yamada ◽

...

Keyword(s):

Older Adults ◽

Smoking Status ◽

Multiple Logistic Regression Analysis ◽

Population Based ◽

Middle Aged ◽

Cross Sectional ◽

Factors Associated ◽

Mail Surveys ◽

Osaka Prefecture ◽

Middle Aged Adults

AbstractBackgroundPrevious epidemiological studies have demonstrated the prevalence and relationship of various factors associated with sarcopenia in older adults; however, few have examined the status of sarcopenia in middle-aged adults. In this study, we aimed to, 1) evaluate the validity of the finger-circle test, which is potentially a useful screening tool for sarcopenia, and 2) determine the prevalence and factors associated with sarcopenia in middle-aged and older adults.MethodsWe conducted face-to-face surveys of 525 adults, who were aged 40–91 years and resided in Settsu City, Osaka Prefecture, Japan to evaluate the validity of finger-circle test. The finger-circle test evaluated calf circumference by referring to an illustration printed on the survey form. The area under the receiver operating characteristic curves (AUROC) was plotted to evaluate the validity of the finger-circle test for screening sarcopenia and compared to that evaluated by skeletal muscle mass index (SMI) measured using bioimpedance. We also conducted multisite population-based cross-sectional anonymous mail surveys of 9337 adults, who were aged 40–97 years and resided in Settsu and Hannan Cities, Osaka Prefecture, Japan. Participants were selected through stratified random sampling by sex and age in the elementary school zones of their respective cities. We performed multiple logistic regression analysis to explore associations between characteristics and prevalence of sarcopenia.ResultsSarcopenia, defined by SMI, was moderately predicted by a finger-circle test response showing that the subject’s calf was smaller than their finger-circle (AUROC: 0.729, < 65 years; 0.653, ≥65 years); such subjects were considered to have sarcopenia. In mail surveys, prevalence of sarcopenia screened by finger-circle test was higher in older subjects (approximately 16%) than in middle-aged subjects (approximately 8–9%). In a multiple regression model, the factors associated with sarcopenia were age, body mass index, smoking status, self-reported health, and number of meals in all the participants.ConclusionsSarcopenia, screened by the finger-circle test, was present not only among older adults but also among middle-aged adults. These results may provide useful indications for developing public health programs, not only for the prevention, but especially for the management of sarcopenia.Trial registrationUMIN000036880, registered prospectively May 29, 2019, https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000042027

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Incidence and risk of major heart diseases in middle-aged adults with moderate to severe vision impairment: a population-based cohort study

British Journal of Ophthalmology ◽

10.1136/bjophthalmol-2018-312471 ◽

2018 ◽

Vol 103 (8) ◽

pp. 1054-1059 ◽

Cited By ~ 1

Author(s):

Chun-Mei Hsueh ◽

Jing-Hwa Wey ◽

Jong-Shiuan Yeh ◽

Chien-Hua Wu ◽

Tsan-Hon Liou ◽

...

Keyword(s):

Cohort Study ◽

Heart Diseases ◽

Population Based ◽

Vision Impairment ◽

Major Adverse Cardiovascular Events ◽

Research Database ◽

Middle Aged ◽

Visual Disability ◽

Aged People ◽

Middle Aged Adults

Background/aimTo estimate the incidence and risk of major adverse cardiovascular events (MACEs), including heart failure and ischaemic heart disease, among middle-aged people with a visual disability (VD).MethodsWe used a national health insurance research database to conduct a population-based cohort study from 1 January 2000 to 31 December 2013. Patients with VD aged 35~65 years were recruited. For each VD patient, five age-matched, sex-matched and comorbidity-matched patients were randomly selected and recruited as controls. Control patients had no documented disability.ResultsThis study recruited 978 patients with VD (mean age±SD, 55.1±7.8 years; 48.9% male) and 4677 controls. Compared with the same sex of the controls, women with VD had higher incidence of MACE 1 (7.9 vs 2.8/1000 person-years, p<0.001), MACE 2 (27.5 vs 16.9/1000 person-years, p<0.001), MACE 3 (3.7 vs 1.4/1000 person-years, p<0.005) and MACE 4 (4.5 vs 2.5/1000 person-years, p<0.05), and men with VD had higher incidence of MACE 1 (4.6 vs 2.0/1000 person-years, p<0.005). Compared with the controls, patients with VD had lower cumulative MACE 1~MACE 4-free probabilities and had an independently higher risk of MACE 1~MACE 4 during the 13-year study, yielding an adjusted hazard ratio range of 1.31~2.75. Those persons with VD who had diabetes and hypertension had greater risks of MACE 1~MACE 4.ConclusionsMiddle-aged adults with VD were at risk of MACEs. A programme for MACE prevention is important for middle-aged people with VD. This is especially true for women and for those who also have diabetes and hypertension.

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Cigarette smoking and cerebral blood flow in a cohort of middle-aged adults

Journal of Cerebral Blood Flow & Metabolism ◽

10.1177/0271678x18754973 ◽

2018 ◽

Vol 39 (7) ◽

pp. 1247-1257 ◽

Cited By ~ 1

Author(s):

Martine Elbejjani ◽

Reto Auer ◽

Sudipto Dolui ◽

David R Jacobs ◽

Thaddeus Haight ◽

...

Keyword(s):

Blood Flow ◽

Cerebral Blood Flow ◽

Cigarette Smoking ◽

Smoking Behavior ◽

Smoking Initiation ◽

Linear Regression Models ◽

Compensatory Mechanisms ◽

Former Smokers ◽

Never Smokers ◽

Using Data

Cigarette smoking is often associated with dementia. This association is thought to be mediated by hypoperfusion; however, how smoking behavior relates to cerebral blood flow (CBF) remains unclear. Using data from the Coronary Artery Risk Development in Young Adults (CARDIA) cohort (mean age = 50; n = 522), we examined the association between smoking behavior (status, cumulative pack-years, age at smoking initiation, and years since cessation) and CBF (arterial spin labeling) in brain lobes and regions linked to dementia. We used adjusted linear regression models and tested whether associations differed between current and former-smokers. Compared to never-smokers, former-smokers had lower CBF in the parietal and occipital lobes, cuneus, precuneus, putamen, and insula; in contrast, current-smokers did not have lower CBF. The relationship between pack-years and CBF was different between current and former-smokers ( p for interaction < 0.05): Among current-smokers, higher pack-years were associated with higher occipital, temporal, cuneus, putamen, insula, hippocampus, and caudate CBF; former-smokers had lower caudate CBF with increasing pack-years. Results show links between smoking and CBF at middle-age in regions implicated in cognitive and compulsive/addictive processes. Differences between current and former smoking suggest that distinct pathological and/or compensatory mechanisms may be involved depending on the timing and history of smoking exposure.

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Abstract P204: Tobacco Use And The AHA 2030 Impact Goals: A Simulation

Circulation ◽

10.1161/circ.143.suppl_1.p204 ◽

2021 ◽

Vol 143 (Suppl_1) ◽

Author(s):

Douglas Levy ◽

Sydney L Goldberg ◽

Emily P Hyle ◽

Krishna P Reddy

Keyword(s):

Cigarette Smoking ◽

Smoking Prevalence ◽

Smoking Initiation ◽

Potential Contribution ◽

Cvd Risk ◽

The Us ◽

Former Smokers ◽

Never Smokers ◽

Projected Changes ◽

The Impact

Background: The AHA’s 2030 Impact Goals seek to increase population health-adjusted life expectancy (LE) by 2y. Tobacco is a top contributor to all-cause mortality and cardiovascular disease (CVD). We estimated the potential contribution of improved tobacco control to achieve the 2030 Impact Goals in the US. Methods: We used the validated STOP microsimulation model with NHIS estimates of age- and sex-stratified mortality and CVD incidence to project changes in LE, as well as 10y, 20y, and lifetime CVD cumulative incidence, if cigarette smoking declined among the current US population. We assessed the impact of preventing initiation (current v never smokers) or increasing cessation (current v former smokers) at different ages. To examine the maximum impact of population-wide cessation, we projected changes in population LE and CVD incidence if smoking prevalence among those ≥20yo went immediately to 0%. Results: Preventing smoking initiation increases LE by 10.2y (men [M]) and 9.1y (women [W]) and reduces lifetime CVD incidence by 16.8% (M) and 26.2% (W) compared to lifetime smoking. Even cessation at age 60 extends LE by 3.7y (M) and 2.5y (W) and reduces 10y CVD incidence by 39.1% (M) and 59.4% (W) (Table). Total elimination of cigarette smoking in the 2020 US population aged ≥20y (e.g. by outlawing cigarettes) would increase the cohort LE by 0.4 (M) and 0.2 (W) years and reduce 20y CVD incidence by 6.0% (M) and 7.0% (W). Conclusion: Preventing smoking initiation offers the greatest benefit, but cessation at any age substantially improves LE and reduces CVD risk. The modest potential contribution of tobacco elimination to achieving the 2030 Impact Goals is due to already low smoking prevalence: <14% (projected) in 2020.

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Use of Cigarette-Smoking History to Estimate the Likelihood of Mutations in Epidermal Growth Factor Receptor Gene Exons 19 and 21 in Lung Adenocarcinomas

Journal of Clinical Oncology ◽

10.1200/jco.2005.04.3224 ◽

2006 ◽

Vol 24 (11) ◽

pp. 1700-1704 ◽

Cited By ~ 147

Author(s):

DuyKhanh Pham ◽

Mark G. Kris ◽

Gregory J. Riely ◽

Inderpal S. Sarkaria ◽

Tiffani McDonough ◽

...

Keyword(s):

Epidermal Growth Factor Receptor ◽

Receptor Gene ◽

Growth Factor Receptor ◽

Smoking History ◽

Egfr Mutations ◽

Epidermal Growth ◽

Former Smokers ◽

Never Smokers ◽

Lung Adenocarcinomas ◽

Exon 19

Purpose Lung adenocarcinomas with mutations in exons 19 and 21 of the epidermal growth factor receptor gene (EGFR) demonstrate sensitivity to gefitinib or erlotinib. Investigators have reported an association between EGFR mutations and the amount and duration of cigarette smoking, with the highest incidence of mutations seen in never smokers. Methods EGFR exon 19 and 21 mutation status was determined in 265 tumor samples using direct sequencing, polymerase chain reaction (PCR), or PCR-based restriction fragment length polymorphism analysis. A detailed smoking history was obtained. Patients were categorized as never smokers (< 100 lifetime cigarettes), former smokers (quit ≥ 1 year ago), or current smokers (quit < 1 year ago). Results We detected EGFR mutations in 34 (51%) of 67 never smokers (95% CI, 38% to 64%), 29 (19%) of 151 former smokers (95% CI, 13% to 27%), and two (4%) of 47 current smokers (95% CI, 1% to 16%). Significantly fewer EGFR mutations were found in people who smoked for more than 15 pack-years (P < .001) or stopped smoking less than 25 years ago (P < .02) compared with individuals who never smoked. The number of smoking pack-years and smoke-free years predicted the prevalence of EGFR mutations (areas under receiver operating characteristic curve = 0.78 and 0.77, respectively). Conclusion The likelihood of EGFR mutations in exons 19 and 21 decreases as the number of pack-years increases. Mutations were less common in people who smoked for more than 15 pack-years or who stopped smoking cigarettes less than 25 years ago. These data can assist clinicians in assessing the likelihood of exon 19 and 21 EGFR mutations in patients with lung adenocarcinoma when mutational analysis is not feasible.

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Defining adult e-cigarette prevalence: comparing a categorical definition with days of use

Tobacco Control ◽

10.1136/tobaccocontrol-2020-055641 ◽

2020 ◽

pp. tobaccocontrol-2020-055641

Author(s):

Raymond G Boyle ◽

Sara Richter ◽

Ann W St. Claire

Keyword(s):

Young Adults ◽

Cigarette Smoking ◽

Population Based ◽

Cigarette Use ◽

Market Place ◽

The Past ◽

Never Smokers ◽

Definition Of ◽

Low Prevalence ◽

Use Categories

IntroductionElectronic cigarette use has grown substantially and the health effects are being closely monitored. Tracking the evolving market place and the profile of adult users is important for tobacco control efforts; however, several different ways of measuring current use have been reported. This paper examines how well a categorical definition aligns with days of use.MethodsData from the 2018 Minnesota Adult Tobacco Survey assessed e-cigarette use based on days of use in the past month and currently using ‘every day, some days, or not at all’. Prevalence of current use and agreement of >1, >5 and >20 days of use with every day or some days were calculated.ResultsThe prevalence of e-cigarette use varied by category of use from 2.4% (≥20 days/30) to 6.0% (≥1 day/30). The highest prevalence was found among young adults reporting any use in the past 30 days (21.9%). Never smokers had low prevalence overall; however, 4.4% reported using in the past 30 days. Using at least 1 day in the past 30 days included a higher proportion of young adults (p<0.001) and never smokers (p<0.001) compared with other current use categories. Compared with every day or some days, the per cent agreement with days of use categories ranged from 89.7% to 94.4% and kappa ranged from 0.60 to 0.81.ConclusionsPrevalence and sociodemographics varied by definition of use. Asking ‘every day, some days or not at all’ in population-based studies has the advantage of aligning with cigarette smoking current use definition.

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Smoking history and frequency of somatic KRAS mutations in adenocarcinoma of the lung

Journal of Clinical Oncology ◽

10.1200/jco.2007.25.18_suppl.7573 ◽

2007 ◽

Vol 25 (18_suppl) ◽

pp. 7573-7573

Author(s):

V. A. Miller ◽

G. J. Riely ◽

M. G. Kris ◽

D. Rosenbaum ◽

J. Marks ◽

...

Keyword(s):

Cigarette Smoking ◽

Mutational Analysis ◽

Smoking History ◽

Egfr Mutations ◽

Molecular Testing ◽

Kras Mutations ◽

Exon 2 ◽

Significant Difference ◽

Never Smokers ◽

Lung Adenocarcinomas

7573 Background: Somatic mutations in the epidermal growth factor receptor (EGFR) gene are more common in patients with adenocarcinoma, especially those who smoked < 15 pack years (py). KRAS mutations are found in ∼25% of lung adenocarcinomas, most commonly in codons 12 and 13 of exon 2 (∼85%) and have been associated with poor prognosis in resected disease [Winton NEJM 2005] and resistance to EGFR tyrosine kinase inhibitors [Pao PLoS Med 2005]. KRAS mutations are uncommon in non-small cell lung cancer histologies other than adenocarcinoma. We sought to determine the association between quantitative measures of cigarette smoking and presence of KRAS mutations in lung adenocarcinomas. Methods: Standard direct sequencing techniques were used to identify KRAS codon 12 and 13 mutations in lung adenocarcinoma specimens from surgical resections between 2001 and 2006 and tumor specimens sent for KRAS molecular analysis in 2006. Surgical specimens were obtained from an institutional tumor bank. Detailed smoking history (age at first cigarette, packs per day, years smoked, years since quitting smoking) was obtained from the medical record and a patient-completed smoking questionnaire. Results: KRAS mutational analysis was performed on 408 lung adenocarcinomas from 242 women and 166 men. Median age was 68 (range 33–89). KRAS mutations were present in 19% (78/408, 95% CI 15 to 23%). The frequency of KRAS mutation was not associated with age or gender. The presence of KRAS mutations was not related to smoking history with 15% (9/61) of never smokers having KRAS mutations compared with 19% (51/275) of former smokers. When compared with never smokers, there was no significant difference in frequency of KRAS mutations for tumors from patients with 1–5 py (5%, p=0.44), 6- 10 py (12%, p=0.99), 11–15 py (25%, p=0.45), 16–25 py (16%, p=0.99), 26–50 py (25%, p=0.129), 51–75 py (20%, p=0.48), >75 py (20%, p=0.47) history of cigarette smoking. Conclusions: While the incidence of EGFR mutations has a strong inverse relationship with the amount of cigarettes smoked, allowing the selective molecular testing for EGFR mutations, the frequency of KRAS mutations cannot be predicted by age, gender, or smoking history. KRAS mutational analysis of all adenocarcinomas is required to reliably identify patients with KRAS mutations. No significant financial relationships to disclose.

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Executive dysfunction following SARS-CoV-2 infection: A cross-sectional examination in a population-representative sample

10.1101/2022.01.01.22268614 ◽

2022 ◽

Author(s):

Peter A Hall ◽

Gang Meng ◽

Anna Hudson ◽

Mohammad Nazmus Sakib ◽

Sara C Hitchman ◽

...

Keyword(s):

Symptom Severity ◽

Executive Dysfunction ◽

Population Based ◽

Community Dwelling ◽

Middle Aged ◽

Observation Study ◽

Cross Sectional ◽

French Speaking ◽

National Cohort ◽

Middle Aged Adults

Objective: To determine whether SRS-CoV-2 infection and COVID-19 symptom severity are associated with executive dysfunction among members of the general population, including those not hospitalized or exposed to intubation. Design: Cross-sectional observation study with data from an ongoing national cohort study of young and middle-aged adults. The Canadian COVID-19 Experiences Project (CCEP) survey involves 1,958 adults with equal representation of vaccinated and vaccine hesitant adults between the ages of 18 and 54 years. Setting: Population-based survey of community dwelling adults, representative of the broader Canadian population. Participants: Men and women between 18 and 54 years of age from English and French speaking provinces. The sample comprised 1,958 adults with a mean age of 37 years (SD=10.4); 60.8% were female. Exposures: SARS-CoV-2 infection with COVID-19 symptoms of any severity, ranging from negligeable to life-threatening infection requiring hospitalization. Primary Outcome: Symptoms of cognitive dysfunction assessed via an abbreviated form of the Barkley Deficits in Executive Functioning Scale (BDEFS). Results: Those who reported a prior SARS-CoV-2 infection regardless of COVID-19 symptom severity (Madj=1.89, SE=0.08, CI: 1.74, 2.04; n=175) reported a significantly higher number of symptoms of executive dysfunction than their non-infected counterparts (Madj=1.63, SE=0.08, CI: 1.47,1.80; n=1,599; β=0.26, p=.001). Among those infected, there was a dose-response relationship between COVID-19 symptom severity and level of executive dysfunction, with moderate (β=0.23, CI: 0.003-0.46) and very/extremely severe (β= 0.69, CI: 0.22-1.16) COVID-19 symptoms being associated with significantly greater dysfunction, compared to asymptomatic. These effects remained reliable and of similar magnitude after removing those who had been received intubation and when controlling for vaccination status. Conclusions: Positive SARS-CoV-2 infection history and COVID-19 symptom severity are associated with executive dysfunction among young and middle-aged adults with no history of medically induced coma.

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