%0 Journal Article %T Combined impact of smoking and heavy alcohol use on cognitive decline in early old age: Whitehall II prospective cohort study. %+ Department of Epidemiology and Public Health %+ Centre de Gérontologie %+ Centre de recherche en épidémiologie et santé des populations (CESP) %A Hagger-Johnson, Gareth %A Sabia, Séverine %A Brunner, Eric John %A Shipley, Martin %A Bobak, Martin %A Marmot, Michael %A Kivimaki, Mika %A Singh-Manoux, Archana %Z G.H.-J. is supported by a grant from the National Institute on Aging, NIH (R01AG034454,principal investigators: A.S-M. and M.K.) and from the NHS Leeds Flexibility & SustainabilityFund (principal investigator: Fullard). S.S is supported by a grant from the National Instituteon Aging, NIH (R01AG034454, principal investigator: A.S-M. and M.K.). A.S.-M. is supportedby a grant from the National Institute on Aging, NIH (R01AG013196; R01AG034454). M.S. issupported by the British Heart Foundation. M.K. is supported by the Medical ResearchCouncil, the National Institutes of Health (R01HL036310; R01AG034454), the Academy ofFinland, and by a professorial fellowship from the Economic and Social Research Council(ESRC). The Whitehall II study is also supported by a grant from the British MedicalResearch Council (K013351) and the British Heart Foundation. Tracing of stroke eventswas funded by a grant from the Stroke Association (principal investigator: E.J.B). %< avec comité de lecture %@ 1472-1465 %J The British journal of psychiatry : the journal of mental science %V 203 %N 2 %P 120-5 %8 2013-07-31 %D 2013 %R 10.1192/bjp.bp.112.122960 %M 23846998 %Z Life Sciences [q-bio]/Santé publique et épidémiologieJournal articles %X Identifying modifiable risk factors for cognitive decline may inform prevention of dementia. To examine the combined impact of cigarette smoking and heavy alcohol consumption on cognitive decline from midlife. Prospective cohort study (Whitehall II cohort) with three clinical examinations in 1997/99, 2002/04 and 2007/09. Participants were 6473 adults (72% men), mean age 55.76 years (s.d. = 6.02) in 1997/99. Four cognitive tests, assessed three times over 10 years, combined into a global z-score (mean 0, s.d. = 1). Age-related decline in the global cognitive score was faster in individuals who were smoking heavy drinkers than in non-smoking moderate alcohol drinkers (reference group). The interaction term (P = 0.04) suggested that the combined effects of smoking and alcohol consumption were greater than their individual effects. Adjusting for age, gender, education and chronic diseases, 10-year decline in global cognition was -0.42 z-scores (95% CI -0.45 to -0.39) for the reference group. In individuals who were heavy alcohol drinkers who also smoked the decline was -0.57 z-scores (95% CI -0.67 to -0.48); 36% faster than the reference group. Individuals who were smokers who drank alcohol heavily had a 36% faster cognitive decline, equivalent to an age-effect of 2 extra years over 10-year follow-up, compared with individuals who were non-smoking moderate drinkers. %G English %2 https://inserm.hal.science/inserm-01153653/document %2 https://inserm.hal.science/inserm-01153653/file/Hagger-Johnson%20et%20al.%20BJP.pdf %L inserm-01153653 %U https://inserm.hal.science/inserm-01153653 %~ INSERM %~ UNIV-PSUD %~ APHP %~ SANTE_PUB_INSERM %~ CESP %~ UVSQ %~ GS-SANTE-PUBLIQUE