Institute of Preventive Oncology, HI Building, 1-2 Sadohara-cho, Ichigaya, Shinjuku-ku, Tokyo, Japan 162 Hirayama Abstract Objective -To examine the association between senile dementia and cigarette smoking. Design Prospective cohort study with 17 years of follow up (1966-82). Subjects 265118 adults ^ 40 years of age (95% sample of the census population) residing in 29 health centre districts in six prefectures in Japan. Main outcome measures Cause specific mortality rates associated with various lifestyles including diet, smoking, and alcohol use. For this analysis the main outcome measures were senile dementia with or without cerebrovascular lesions as the direct cause of death, the under lying cause of death, or a coexisting disease. Results The risk of death reported as senile dementia without cerebrovascular lesions (n = 120), mostly composed of Alzheimer's disease, was significantly higher in cigarette smokers relative to never smokers (relative risk 1*61, 90% confidence interval 110 to 2-38; two sided = 0042). A significant dose-response relation was observed for men of 75 and older, with relative risks for never smokers and for daily smokers of 1-14, 15-19, and ^ 20 cigarettes per day equal to 1 00, 1 73, 3 15, and 3 10, respectively (two sided = 0 036 for trend). A similar trend was seen for men of 70 and older. Conclusions Although misclassification of cerebrovascular causes of death as senile dementia cannot be excluded com pletely, the positive association between cigarette smoking and senile dementia without cerebrovascular lesions provides further rationale for smoking prevention and cessation.
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Takeshi Hirayama (1992) studied this question.