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Am J Geriatr Psychiatry 16:92-98, January 2008
© 2008 American Association for Geriatric Psychiatry
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Article

Smoking Is Associated With Reduced Cortical Regional Gray Matter Density in Brain Regions Associated With Incipient Alzheimer Disease

Osvaldo P. Almeida, M.D., Ph.D., F.R.A.N.Z.C.P., Griselda J. Garrido, Ph.D., Nicola T. Lautenschlager, M.D., F.R.A.N.Z.C.P., Gary K. Hulse, B.Sc., Ph.D., Konrad Jamrozik, M.B.B.S., D.Phil., F.A.F.P.H.M., and Leon Flicker, M.B.B.S., Ph.D., F.R.A.C.P.

From Western Australia Centre for Health and Ageing, School of Psychiatry and Clinical Neurosciences, University of Western Australia, Perth, Western Australia, Australia (OPA, NTL); School of Psychiatry and Clinical Neurosciences, University of Western Australia, Perth, Western Australia, Australia (GKH); School of Medicine and Pharmacology, University of Western Australia, Perth, Western Australia, Australia (LF); School of Population Health, University of Queensland, Brisbane, Queensland, Australia (KJ); and Instituto Israelita de Ensino e Pesquisa Albert Einstein, São Paulo, Brazil (GJG).

Objectives: The results of observational studies suggest that smoking increases the risk of Alzheimer disease (AD). The authors designed this study to determine if older people who smoke have decreased gray matter density in brain regions associated with incipient AD.

Methods: The authors recruited 39 pairs (N = 78) of smokers/never-smokers 70 to 83 years of age who were matched for age, sex, education, and handedness. Participants were free of clinically significant cognitive impairment, depression, stroke, or other serious medical conditions. Gray matter density was determined by voxel-based morphometry using statistical parametric mapping of T1-weighted magnetic resonance images.

Results: Smokers had decreased gray matter density in the posterior cingulum and precuneus (bilateral), right thalamus, and frontal cortex (bilateral) compared with never-smokers.

Conclusions: Smoking is associated with decreased gray matter density in brain regions previously associated with incipient AD. Longitudinal investigations are required to clarify whether these changes are progressive in nature.

Key Words: Statistical parametric mapping • smoking • tobacco • dementia • mild cognitive impairment • Alzheimer disease • brain • magnetic resonance imaging • aging • elderly






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