Smoking, Drinking, Cholesterol May Be Alzheimer's Risk Factors

Behaviors in midlife can have an impact decades later, studies suggest

By Ed Edelson
HealthDay Reporter

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WEDNESDAY, April 16 (HealthDay News) -- Heavy drinking, heavy smoking and high cholesterol levels in midlife are associated with the onset of Alzheimer's disease in later years, news research shows.

The apparent link between behavior in the 40s and the development of dementia decades later come from two reports presented Wednesday at the American Academy of Neurology annual meeting, in Chicago.

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A study of 938 people 60 and older diagnosed with possible or probable Alzheimer's found an earlier onset for the disease for heavy drinkers (more than two drinks a day) and heavy smokers (a pack of cigarettes or more a day), said Dr. Ranjan Duara, director of the Mount Sinai Medical Center Wien Center for Alzheimer's Disease in Miami Beach, Fla.

"The current thinking is that the pathology of Alzheimer's disease builds up over many years before clinical symptoms are manifest," Duara said. "People who start with a good cognitive reserve, who remain active mentally, are able to compensate for the pathology of the brain for a much longer period of time."

The 20 percent of the people in the study defined as heavy smokers developed Alzheimer's 2.3 years sooner than those who were not heavy smokers. Heavy drinkers developed Alzheimer's 4.8 years earlier.

Both smoking and drinking can have a direct physical effect on the brain, damaging cells and synapses, which are the connections between cells, Duara said. While any amount of smoking is bad -- increasing the risk of heart attack, stroke and other medical problems -- there is "a bit of controversy" about heavy drinking and Alzheimer's, he said, specifically, about exactly what "heavy" means.

Studies have shown that moderate drinking can have a beneficial health effect, reducing the risk of coronary disease, Duare said. One influential study, done in the Netherlands, defined moderate drinking as three or four drinks a day. "They consider more than four drinks a day to be severe," he said of the Amsterdam researchers.

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