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This Week in Psychiatry – 11/15/10

November 12, 2010

Heavy Smoking Greatly Increases Risk for Later Dementia

A prospective study, published recently in the Archives of Internal Medicine, calculated the association between heavy smoking in midlife and later dementia. Over 21,000 adults participated in a survey between 1978 and 1985; confirmed diagnoses of dementia, Alzheimer’s, and vascular dementia were verified later, from 1994 to 2008. Cases of confirmed dementia diagnoses (N=5,367; 25.4%) over 23-year follow-up were adjusted for a host of demographic and health factors. Most significantly, smoking >2 packs/day in midlife was associated with a greater risk of dementia (adjusted hazard ratio 2.14; 95% CI, 1.65-2.78), Alzheimer’s (HR 2.57, 1.63-4.03), and vascular dementia (HR 2.72, 1.20-6.18). Essentially, heavy midlife smoking was associated with a >100% increase of risk for later dementia-spectrum disease.

Adoptive, Socioeconomic Status Linked to Psychosis Risk

In a recent American Journal of Psychiatry study, investigators assessed psychosis risk factors for a large sample (n=13,163) of children born in Sweden who were raised by Swedish adoptive parents. Socioeconomic status in childhood, and genetic liability (assessed by biological parent inpatient care for psychosis), were compared to that of the Swedish population. Adopted children with a disadvantaged socioeconomic status in childhood had an increased risk for psychosis—with and without history of psychosis in biological parents. Adoptive parent unemployment (hazard ratio=2.0), single-parent household (HR=1.2), and living in apartments (HR=1.3), were associated with greater risk for psychosis, as well as genetic liability alone (HR=4.7). Children with genetic liability and disadvantaged upbringing had a significantly greater risk for psychosis (HR=15).

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