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Secondhand SmokeAssociate with Mild

Cognitive Impairment(MCI)ByMohd Rodzi bin Rashid

03008279

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Introduction

Mild cognitive impairment (MCI) has been diagnosed

estimately 5.4 million people (22.2%) in the United States

There's no single cause of MCI, just as there's no single

outcome for the disorder, it relatively caused by a few factors

such as smoking, diabetes, depression, hypertension, elevatedcholesterol, infrequency participant in mentally or socially

stimulating activities and lack of physical activities.

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Mild Cognitive Impairment

MCI is an intermediate stage between the expected cognitive

decline of normal aging and the more pronounced decline of

dementia.

It involves problems with memory, language, thinking and

judgment that are greater than typical age-related changes. Symptoms of MCI may remain stable for years, progress to

Alzheimer's disease or another type of dementia, or improve

over time

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Brain-imaging studies show that the following changes:

o Shrinkage of the hippocampus, a brain region important for

memory

o Plaques (abnormal clumps of beta-amyloid protein) throughout

the braino Enlargement of the brain's fluid-filled spaces (ventricles)

o Reduced use of glucose

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Secondhand Smoke

Secondhand smoke is composed of sidestream smoke (the

smoke released from the burning end of a cigarette) and

exhaled mainstream smoke (the smoke exhaled by the

smoker).

Cigarette smoke contains more than 4,000 chemicalcompounds

Because sidestream smoke is generated at lower

temperatures and under different conditions than mainstream

smoke, it contains higher concentrations of many of the toxins

found in cigarette smoke.

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Association between secondhand

smoke and MCI Survey

Total participants : 11 234 people who took part in both the

Health Survey for England and the English Longitudinal Study of

Ageing

the remaining 4809 participants formed the sample for theanalyses

The others were diagnosed by :

dementia

nicotine products users

missing values on one or more of the neuropsychological measuresused to assess cognitive impairment

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Metode

Secondhand smoke :

Measure salivary cotinine cotinine is a metabolite of nicotine

that has a half life of around 16-25 hours

MCI :

Mini-Mental State Examination

Immediate and Delayed Verbal Memory

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Table 1. Odds of cognitive impairment in 4809 non-

smokers by salivary continine levelsVariable

salivary cotinine

(ng/ml)

Basic adjusted

model

Fully adjust

model

Fully adjusted

model plus medical

history

Lowest 0.2-0.3 1.13 (0.8-1.54) 1.08 (0.78-1.48) 1.08 (0.79-1.48)

Second 0.4-0.7 1.26 (0.92-1.72) 1.13 (0.81-1.56) 1.12 (0.81-1.56)

Highest 0.8-1.35 1.68 (1.27-2.22) 1.44 (1.07-1.94) 1.44 (1.07-1.93)

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Table 2. Odds of cognitive impairment in former

and never smokers by salivary continine levels

Variable

salivary

cotinine

(ng/ml)

Never Smokers (n=2014) Former smokers (n=2795)

Basic adjusted

model

Fully adjust

model

Basic adjusted

model

Fully adjust

model

Lowest 0.2-0.3 1.44 (0.90-2.31) 1.42 (0.88-2.31) 0.95 (0.63-1.45) 0.88 (0.57-1.34)

Second 0.4-0.7 1.26 (0.77-2.08) 1.16 (0.68-1.97) 1.26 (0.85-1.86) 1.11 (0.74-1.67)

Highest 0.8-

1.35

1.75 (1.10-2.78) 1.70 (1.03-2.80) 1.62 (1.14-2.30) 1.32 (0.92-1.91)

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Possible Mechanism

Cardiovasculardisease

(Dysfunctional

endothelial cells)

Secondhand

smokevasoconstriction,

atherogenesis, and

thrombosis

compromise the blood

supply to the brain

alterations of brainfunction

mild cognitive

impairment

diabetes

depression

hypertension

elevated

cholesterol

The pathophysiology

MCI that caused by

secondhand smoke is

not clearly

understand but

several mechanismshave been proposed

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Changes in Brain Structure

In some cases studied at autopsy, pathologists have observed

changes in brain structure. Some of these changes have been

identified in autopsy studies of people with MCI. These

changes include:

Plaques and tangles (which are microscopic protein clumpscharacteristic of Alzheimer's disease)

Lewy bodies (which are microscopic clumps of another protein

associated with Parkinson's disease, dementia with Lewy bodies

and some cases of Alzheimer's disease)

Small strokes or reduced blood flow through brain blood vessels

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Treatment

Currently, no MCI drugs or other treatments are specifically

approved by the Food and Drug Administration (FDA)

But MCI is an active area of research and treating these conditions

can help improve your memory and overall mental function:

high blood pressure

Depression

Sleep apnea

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Conclusion

Based on the study, we can conclude that, in a large diverse

sample of non-smoking adults, high levels of cotinine may be

associated with increased odds of cognitive impairment.

In others hand, secondhand smoke may result cardiovascular

disease and impotency as a risk a factor.

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References1. Llewellyn D, Lang I, Langa K. Exposure to secondhand smoke and cognitive

impairment in non-smokers: national cross sectional study with cotininemeasurement. BMJ 2009;338:b462.

2. Anstey KJ, Von Sanden C, Salim A, OKearney R. Smoking as a risk factor for dementiaand mild cognitive impairment : a meta-analysis of prospective studies. Am Iepidomiol 2007 ;166: 367-78

3. Penn A, Chen LC, Snyder CA. Inhalation of steady-state sidestream smoke from oneciggarete promote arteriosclerotic plaque development. Circulation ; 1994;90:1363-7

4. The Health Consequences of Involuntary Exposure to Tobacco Smoke. ExecutiveSummary. Surgeon General of the United States. 2006. Retrieved 2009-01-28.

5. NYU medical center. Mild Cognitive Impairment. Available at:http://www.med.nyu.edu/adc/forpatients/cognitiveimpair.html#causes . Accessed on22nd Sept 2011.

6. Mayo clinic. Mild cognitive impairment. Available at:http://www.mayoclinic.com/health/mild-cognitive-impairment/DS00553. Accessed

on 22nd

Sept 2011.7. Medicine.Net.com. Second hand smoke definition. Available at:

http://www.medterms.com/script/main/art.asp?articlekey=13423. Accessed on 22ndSept 2011

http://en.wikipedia.org/wiki/Surgeon_General_of_the_United_Stateshttp://en.wikipedia.org/wiki/Surgeon_General_of_the_United_Stateshttp://www.med.nyu.edu/adc/forpatients/cognitiveimpair.htmlhttp://www.med.nyu.edu/adc/forpatients/cognitiveimpair.htmlhttp://www.mayoclinic.com/health/mild-cognitive-impairment/DS00553http://www.mayoclinic.com/health/mild-cognitive-impairment/DS00553http://www.medterms.com/script/main/art.asp?articlekey=13423http://www.medterms.com/script/main/art.asp?articlekey=13423http://www.medterms.com/script/main/art.asp?articlekey=13423http://www.mayoclinic.com/health/mild-cognitive-impairment/DS00553http://www.mayoclinic.com/health/mild-cognitive-impairment/DS00553http://www.mayoclinic.com/health/mild-cognitive-impairment/DS00553http://www.mayoclinic.com/health/mild-cognitive-impairment/DS00553http://www.mayoclinic.com/health/mild-cognitive-impairment/DS00553http://www.med.nyu.edu/adc/forpatients/cognitiveimpair.htmlhttp://en.wikipedia.org/wiki/Surgeon_General_of_the_United_States