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Objectively measured secondhand tobacco smoke and cognitive impairment in disability-free older adults

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dc.contributor.author García-Esquinas, Esther
dc.contributor.author Ortolá, Rosario
dc.contributor.author Lara, Elvira
dc.contributor.author Pascual Esteban, José A.
dc.contributor.author Pérez Ortuño, Raúl, 1976-
dc.contributor.author Banegas, Jose R.
dc.contributor.author Rodríguez Artalejo, Fernando
dc.date.accessioned 2022-10-26T07:09:21Z
dc.date.available 2022-10-26T07:09:21Z
dc.date.issued 2022
dc.identifier.citation García-Esquinas E, Ortolá R, Lara E, Pascual JA, Pérez-Ortuño R, Banegas JR, et al. Objectively measured secondhand tobacco smoke and cognitive impairment in disability-free older adults. Environ Res. 2022 Sep; 212(Pt D):113352. DOI: 10.1016/j.envres.2022.113352
dc.identifier.issn 0013-9351
dc.identifier.uri http://hdl.handle.net/10230/54593
dc.description.abstract Previous studies have suggested that exposure to secondhand smoke (SHS) may be associated with greater risk of cognitive impairment. However, no longitudinal study has examined the association of serum cotinine (as objective measure of SHS exposure) and cognitive function in older adults. We used data from 2087 non-smoking adults aged≥65 years participating in the ENRICA-2 cohort and free from limitations in Instrumental Activities of Daily Living. Cognitive function was assessed through the Mini-Mental State Examination (MMSE), the Digit Span Backwards subtest (DSBT), the Luria's motor series subtest from the Frontal Assessment Battery, the Trail Making Test A (TMT-A), the Free and Cued Selective Reminding Test (FCSRT), and the Categorical Verbal Fluency Test (CFT) of the 7 min test. Cross-sectional analyses were performed using multivariable logistic and ordered logistic models, while analyses on changes in cognition over time used multivariable repeated-measures mixed-effects models. Compared to the unexposed, those in the highest exposure group (≥0.161 ng/ml) were more likely to have cognitive impairment (MMSE<24) (odds ratio [OR]:1.64; 95% confidence interval [CI]:1.04-2.60) and lower DSBT scores (OR:1.25; 95%CI:1.00-1.57), as well as a non-significant higher odds of a lower score in the Luria test (OR:1.23; 95%CI:0.92-1.64) or episodic memory impairment (FCSRT<12, OR:1.38; 95%CI:0.90-2.11). In longitudinal analyses, those with baseline cotinine ≥0.161 ng/ml showed an increased risk of cognitive impairment (MMSE<24,OR:2.23; 95%CI:1.14-4.33; p-trend across cotinine categories = 0.028) and decreased DSBT (OR:1.23; 95%CI:1.01-1.51; p-trend across cotinine categories = 0.046). Findings show an increased risk of global cognitive impairment and declines in working memory performance in older adults exposed to SHS. More efforts are needed to protect older adults from SHS in areas not covered by smoke-free legislation.
dc.format.mimetype application/pdf
dc.language.iso eng
dc.publisher Elsevier
dc.rights © Elsevier http://dx.doi.org/10.1016/j.envres.2022.113352
dc.title Objectively measured secondhand tobacco smoke and cognitive impairment in disability-free older adults
dc.type info:eu-repo/semantics/article
dc.identifier.doi http://dx.doi.org/10.1016/j.envres.2022.113352
dc.subject.keyword Cognition
dc.subject.keyword Cohort study
dc.subject.keyword Cotinine
dc.subject.keyword Involuntary tobacco smoke
dc.subject.keyword Memory
dc.rights.accessRights info:eu-repo/semantics/openAccess
dc.type.version info:eu-repo/semantics/acceptedVersion


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