吸烟与老年认知损害的相关性研究进展
Research Progress on the Correlation between Smoking and Cognitive Impairment in the Elderly
徐成荫 1丁玎 2邓伟1
作者信息
- 1. 复旦大学公共卫生学院生物统计教研室,上海 200032;公共卫生安全教育部重点实验室,上海 200032;国家卫生健康委员会卫生技术评估重点实验室(复旦大学),上海 200032
- 2. 复旦大学神经病学研究所,上海 200040
- 折叠
摘要
国内外队列研究结果显示主动吸烟与认知损害呈正相关,然而部分病例对照研究发现主动吸烟可能降低患痴呆的风险或对患阿尔茨海默病无影响,被动吸烟则被证明与认知损害呈正相关.此外,吸烟减弱饮食多样性对老年女性认知功能的保护作用;ApoE ε4等位基因可对吸烟与认知损害的相关性产生修饰作用;吸烟和患有慢性病对痴呆症的发展具有协同作用;吸烟与饮酒的交互作用对认知损害的影响则因个体乙醇代谢能力、饮酒模式的差异而不同.吸烟主要通过作用于胆碱能系统、诱导氧化应激、激发炎症反应、改变大脑结构的生物病理学机制增加老年认知损害的风险.然而,烟草中的低剂量尼古丁暴露可通过上调神经元烟碱乙酰胆碱受体、增强中脑-边缘系统多巴胺(DA)通路和中脑-皮质DA通路中的DA信号以及作为抗氧化剂增强认知功能.文中对现已发表的吸烟与老年认知损害的相关性文献进行检索并总结,为预测老年群体患痴呆的风险以及确定个性化医疗方案提供帮助.
Abstract
The results of cohort studies both domestically and internationally indicate that active smoking is positively correlated with cognitive impairment.However,some case-control studies have found that active smoking may reduce the risk of dementia or have no effect on Alzheimer's disease,while second-hand smoke has been proven to be positively correlated with cognitive impairment.Additionally,smoking diminishes the protective effect of dietary diversity on cognitive function among older women.The ApoE ε4 allele could modify the correlation between smoking and cognitive impairment.Smoking and chronic diseases have a synergistic effect on incident dementia.The impact of the interaction between smoking and alcohol consumption on cognitive impairment varies due to differences in individual ethanol metabolism and drinking patterns.Smoking mainly increases the risk of cognitive impairment in the elderly through its biological and pathological mechanisms,including acting on the cholinergic system,inducing oxidative stress,triggering inflammatory responses,and altering brain structure.However,low-dose nicotine exposure from tobacco can enhance cognitive function by upregulating neuronal nicotinic acetylcholine receptors,enhancing dopamine(DA)signaling in the mesolimbic and mesocortical DA pathways,and acting as an antioxidant.The literature on the correlation between smoking and cognitive impairment in the elderly was retrieved and summarized,providing assistance in predicting the risk of dementia in the elderly population and determining personalized medical treatment plans.
关键词
认知损害/老年/痴呆/阿尔茨海默病/吸烟/被动吸烟/烟草Key words
cognitive impairment/senile/dementia/Alzheimer's disease/smoking/second-hand smoke/tobacco引用本文复制引用
出版年
2024
NETL
NSTL
万方数据