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Smoking status is associated with mild cognitive impairment assessed with the mini-mental state examination in Japanese diabetic patients

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Abstract

Aims

We assessed the association between smoking status and mild cognitive impairment (MCI) in Japanese diabetic patients.

Methods

This cross-sectional study included 323 diabetic patients, aged 40–79 years, who were referred to an outpatient diabetic clinic between January and July 2013 at Shiga University of Medical Science Hospital (Otsu, Japan). Cognitive function was assessed using the mini-mental state examination (MMSE), and patients were classified into two categories: normal cognitive function (MMSE score ≥27) and MCI (MMSE score 22–26). Logistic regression analysis was used to estimate the multivariable-adjusted odds ratios (ORs) and 95 % confidence intervals (CIs) for MCI in current smokers and ex-smokers compared with never-smokers.

Results

Of the 323 patients, 55 (17.0 %), 134 (41.5 %), and 134 (41.5 %) were current smokers, ex-smokers, and never-smokers, respectively. Of these, 68 (21.0 %) patients had MCI. After adjusting for age, sex, systolic blood pressure, body mass index, high-density lipoprotein cholesterol, estimated glomerular filtration rate, hemoglobin A1c, insulin therapy, sulfonylurea, history of coronary heart disease, exercise habit, drinking status, and education, the OR for MCI was 3.62 (95 % CI 1.26–10.40) in current smokers compared with never-smokers. In addition, the multivariable-adjusted ORs for MCI were 3.02 (95 % CI 0.64–14.32) in current smokers <30.0 pack-years and 4.90 (95 % CI 1.32–18.16) in current smokers ≥30.0 pack-years, compared with never-smokers (p for trend = 0.017).

Conclusions

Current smoking, especially current smoking for which cumulative lifetime exposure was high, was associated with MCI, as assessed using the MMSE in Japanese diabetic patients.

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References

  1. Kawamura T, Umemura T, Hotta N. Cognitive impairment in diabetic patients: can diabetic control prevent cognitive decline? J Diabetes Invest. 2012;3:413–23.

    Article  Google Scholar 

  2. Kawamura T, Umemura T. Is cognitive impairment the fourth diabetic microvascular complication? J Diabetes Invest. 2011;2:351–3.

    Article  Google Scholar 

  3. Ohara T, Doi Y, Ninomiya T, et al. Glucose tolerance status and risk of dementia in the community: the Hisayama study. Neurol. 2011;77:1126–34.

    Article  CAS  Google Scholar 

  4. Ott A, Stolk RP, Van Harskamp F, et al. Diabetes mellitus and the risk of dementia: the Rotterdam Study. Neurol. 1999;53:1937–42.

    Article  CAS  Google Scholar 

  5. Cheng G, Huang C, Deng H, et al. Diabetes as a risk factor for dementia and mild cognitive impairment: a meta-analysis of longitudinal studies. Intern Med J. 2012;5:484–91.

    Article  Google Scholar 

  6. Petersen RC, Smith GE, Waring SC, et al. Mild cognitive impairment: clinical characterization and outcome. Arch Neurol. 1999;56:303–8.

    Article  CAS  PubMed  Google Scholar 

  7. Morris JC, Storandt M, Miller JP, et al. Mild cognitive impairment represents early-stage Alzheimer disease. Arch Neurol. 2001;58:397–405.

    CAS  PubMed  Google Scholar 

  8. Elrod K, Buccafusco JJ, Jackson WJ. Nicotine enhances delayed matching-to-sample performance by primates. Life Sci. 1988;43:277–87.

    Article  CAS  PubMed  Google Scholar 

  9. Salomon AR, Marcinowski KJ, Friedland RP, et al. Nicotine inhibits amyloid formation by the beta-peptide. Biochemistry. 1996;35:13568–78.

    Article  CAS  PubMed  Google Scholar 

  10. Brayne C. Smoking and the brain. BMJ. 2000;320:1087–8.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  11. Rusanen M, Kivipelto M, Quesenberry CP Jr, et al. Heavy smoking in midlife and long-term risk of Alzheimer disease and vascular dementia. Arch Intern Med. 2011;171:333–9.

    Article  PubMed  Google Scholar 

  12. Ikeda A, Yamagishi K, Tanigawa T, et al. Cigarette smoking and risk of disabling dementia in a Japanese rural community: a nested case-control study. Cerebrovasc Dis. 2008;25:324–31.

    Article  PubMed  Google Scholar 

  13. Morimoto A, Sonoda N, Ugi S, et al. Association between symptoms of bilateral numbness and/or paresthesia in the feet and postural instability in Japanese patients with diabetes. Diabetol Int. 2015;. doi:10.1007/s13340-015-0214-2.

    Google Scholar 

  14. Morimoto A, Sonoda N, Ugi S, et al. Association between attentional function and postural instability in Japanese elderly patients with diabetes. Diabetol Int. 2015;. doi:10.1007/s13340-015-0231-1.

    Google Scholar 

  15. Kashiwagi A, Kasuga M, Araki E, et al. International clinical harmonization of glycated hemoglobin in Japan: from Japan Diabetes Society to National Glycohemoglobin Standardization Program values. J Diabetes Invest. 2012;3:39–40.

  16. Folstein MF, Folstein SE, McHugh PR. “Mini-mental state”. A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res. 1975;12:189–98.

    Article  CAS  PubMed  Google Scholar 

  17. O’Bryant SE, Humphreys JD, Smith GE, et al. Detecting dementia with the mini-mental state examination (MMSE) in highly educated individuals. Arch Neurol. 2008;65:963–7.

    PubMed  PubMed Central  Google Scholar 

  18. Ihara M, Nishino M, Taguchi A, et al. Cilostazol add-on therapy in patients with mild dementia receiving donepezil: a retrospective study. PLoS One. 2014;9:e89516.

    Article  PubMed  PubMed Central  Google Scholar 

  19. Berr C, Balansard B, Arnaud J, et al. Cognitive decline is associated with systemic oxidative stress: the EVA study. Etude du Vieillissement Artériel. J Am Geriatr Soc. 2000;48:1285–91.

    Article  CAS  PubMed  Google Scholar 

  20. Soonenn JA, Larson EB, Gray SL, et al. Free radical damage to cerebral cortex in Alzheimer’s disease, microvascular brain injury, and smoking. Ann Neurol. 2009;65:226–9.

    Article  Google Scholar 

  21. Ott A, Stolk RP, Hofman A, et al. Association of diabetes mellitus and dementia: the Rotterdam Study. Diabetologia. 1996;39:1392–7.

    Article  CAS  PubMed  Google Scholar 

  22. Araki A, Ito H. Asymptomatic cerebral infarction on brain MR images and cognitive function in elderly diabetic patients. Geriatr Gerontol Int. 2002;2:206–14.

    Article  Google Scholar 

  23. Sabia S, Elbaz A, Dugravot A, et al. Impact of smoking on cognitive decline in early old age: the Whitehall II cohort study. Arch Gen Psychiatry. 2012;69:627–35.

    Article  PubMed  PubMed Central  Google Scholar 

  24. Petersen RC, Stevens JC, Ganguli M, et al. Practice parameter: early detection of dementia: mild cognitive impairment (an evidence-based review). Report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology. 2001;56:1133–42.

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Acknowledgments

This work was supported by the Fund for Care Prevention from NPO Biwako Health and Welfare Consortium and Shiga Prefecture. This work was supported by a Japan Society for the Promotion of Science (JSPS) Grant-in-Aid for Young Scientists (B) (Grant Number: 25862144, 15K20762).

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Correspondence to Nao Sonoda.

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Conflicts of interest

Nao Sonoda, Akiko Morimoto, and Naomi Miyamatsu declare that they have no conflict of interest. Satoshi Ugi, Katsutaro Morino, Osamu Sekine, Ken-ichi Nemoto, and Hiroshi Maegawa received scholarship grants from Takeda Pharmaceutical Co., Ltd., Astellas Pharma Inc., Merck Sharp & Dohme Corp., Kowa Pharmaceutical Co., Ltd., AstraZeneca K.K., Teijin Pharma Ltd., Nippon Boehringer Ingelheim Co., Ltd., Kyowa Hakko Kirin Co., Ltd., Taisho Toyama Pharmaceutical Co., Ltd., and Ono Pharmaceutical Co., Ltd..

Human rights statement and informed consent

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (Ethics Committee of Shiga University of Medical Science) and with the Helsinki Declaration of 1964 and later revisions. Informed consent was obtained from all patients included in the study.

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Sonoda, N., Morimoto, A., Ugi, S. et al. Smoking status is associated with mild cognitive impairment assessed with the mini-mental state examination in Japanese diabetic patients. Diabetol Int 7, 361–367 (2016). https://doi.org/10.1007/s13340-016-0256-0

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  • DOI: https://doi.org/10.1007/s13340-016-0256-0

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