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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
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