ArticleJournal of general internal medicine2022
Early to Midlife Smoking Trajectories and Cognitive Function in Middle-Aged US Adults: the CARDIA Study.
Article in Journal of general internal medicine, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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Who cites it
12 citing papers in PubMed, 17 citations in OpenAlex.
- Midlife depressive symptoms, smoking status, hypertension, diabetes, dyslipidemia and obesity modify the association of long-term vascular risk factor variability from childhood with midlife cognitive function: The Bogalusa Heart Study.International journal of cardiology. Cardiovascular risk and prevention · 2026Article
- Sociodemographic and intersecting sociodemographic subgroups in relation to US adult tobacco use trajectories over a 10-year period: Analysis of Population Assessment of Tobacco and Health (PATH) data.Drug and alcohol dependence · 2026Article
- The impact of healthy lifestyles on cognitive function in community-dwelling older adults: A cross-sectional study in Shanghai, China.Global health & medicine · 2025Article
- 2025 Heart Disease and Stroke Statistics: A Report of US and Global Data From the American Heart Association.Circulation · 2025Review
- The association between cognitive impairment and oral health or oral hygiene behaviors among multiethnic older adults in Western China: a cross-sectional multicenter study.BMC public health · 2025Article
- Smoking Impacts Alzheimer's Disease Progression Through Oral Microbiota Modulation.Molecular neurobiology · 2025Review
- Next generation brain health: transforming global research and public health to promote prevention of dementia and reduce its risk in young adult populations.The lancet. Healthy longevity · 2024Review
- Association of Changes in C-Reactive Protein Level Trajectories Through Early Adulthood With Cognitive Function at Midlife: The CARDIA Study.Neurology · 2024Article
- 2024 Heart Disease and Stroke Statistics: A Report of US and Global Data From the American Heart Association.Circulation · 2024Review
- Clustering and trajectories of key noncommunicable disease risk factors in Norway: the NCDNOR project.Scientific reports · 2023Article
- Heart Disease and Stroke Statistics-2023 Update: A Report From the American Heart Association.Circulation · 2023Review
- Observational studies in Alzheimer disease: bridging preclinical studies and clinical trials.Nature reviews. Neurology · 2022Review
Corrections and comments
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Authors and funding
7 authors at 6 institutions in 1 country.
Funding
Abstract
backgroundSmoking starts in early adulthood and persists throughout the life course, but the association between these trajectories and midlife cognition remains unclear.
objectiveDetermine the association between early to midlife smoking trajectories and midlife cognition.
designProspective cohort study.
participantsParticipants were 3364 adults (mean age = 50.1 ± 3.6, 56% female, 46% Black) from the Coronary Artery Risk Development in Young Adults (CARDIA) study: 1638 ever smokers and 1726 never smokers. MAIN MEASURES: Smoking trajectories were identified in latent class analysis among 1638 ever smokers using smoking measures every 2-5 years from baseline (age 18-30 in 1985-1986) through year 25 (2010-2011). Poor cognition was based on cognitive domain scores ≥ 1 SD below the mean on tests of processing speed (Digit Symbol Substitution Test), executive function (Stroop), and memory (Rey Auditory Verbal Learning Test) at year 25.
resultsFive smoking trajectories emerged over 25 years: quitters (19%), and minimal stable (40%), moderate stable (20%), heavy stable (15%), and heavy declining smokers (5%). Heavy stable smokers showed poor cognition on all 3 domains compared to never smoking (processing speed AOR = 2.22 95% CI 1.53-3.22; executive function AOR = 1.58 95% CI 1.05-2.36; memory AOR = 1.48 95% CI 1.05-2.10). Compared to never smoking, both heavy declining (AOR = 1.95 95% CI 1.06-3.68) and moderate stable smokers (AOR = 1.56 95% CI 1.11-2.19) exhibited slower processing speed, and heavy declining smokers additionally had poor executive function. For minimal stable smokers (processing speed AOR = 1.12 95% CI 0.85-1.51; executive function AOR = 0.97 95% CI 0.71-1.31; memory AOR = 1.21 95% CI 0.94-1.55) and quitters (processing speed AOR = 0.96 95% CI 0.63-1.48; executive function AOR = 0.98 95% CI 0.63-1.52; memory AOR = 0.97 95% CI 0.67-1.39), no association was observed.
conclusionsThe association between early to midlife smoking trajectories and midlife cognition was dose-dependent. Results underscore the cognitive health risk of moderate and heavy smoking and the potential benefits of quitting on cognition, even in midlife.
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