Effects of the use of alcohol and cigarettes on cognition in elderly adults JOHN A. SCHINKA, 1,2 RODNEY D. VANDERPLOEG, 1,2,3 MILES ROGISH, 1,4 AMY BORENSTEIN GRAVES, 5 JAMES A. MORTIMER, 6 and PATRICIA ISBELL ORDORICA 1,2 1 James A. Haley VA Medical Center, Tampa, Florida 2 Department of Psychiatry, University of South Florida, Tampa, Florida 3 Department of Neurology, University of South Florida, Tampa, Florida 4 Department of Clinical Psychology and Health, University of Florida, Tampa, Florida 5 Department of Epidemiology and Biostatistics, University of South Florida, Tampa, Florida 6 Institute on Aging, University of South Florida, Tampa, Florida (Received February 2, 2001; Revised September 19, 2001; Accepted November 2, 2001) Abstract The objective of this study was to examine the independent and interactive effects of lifetime patterns of drinking and smoking on cognitive performance in the elderly. A sample of 395 individuals with varying histories of alcohol and cigarette use was drawn from the Charlotte County Healthy Aging Study, a community-based, cross-sectional study of randomly selected older adults of age 60 to 84. Dependent variables were the results of a neuropsychological battery that provided measures of general cognitive ability, executive function, and memory. Specifically, we examined (1) differences in performance among groups of abstainers, drinkers, and smokers, (2) the effects of lifetime drinking and smoking dose on cognition within the group of users, and (3) the effects of intensity of drinking and smoking on cognition. Potential methodological confounds, such as age, education, and medical history, were controlled by means of sampling and covariance procedures. Analyses failed to provide evidence for a beneficial J-curve or threshold effect for drinking, but did not reveal any detrimental effect. No detrimental effect of smoking was found in any analysis; nor was there any evidence of an interaction between alcohol and cigarette use on any cognitive measure. ( JINS, 2002, 8, 811–818.) Keywords: Aging, Cognition, Neuropsychological tests, Risk factors, Alcohol drinking, Smoking INTRODUCTION The influence of alcohol and cigarette use on cognitive func- tion in the elderly (age 601) has become a focal target of research, following reports suggesting an increase in risk among alcohol users (Fratiglioni et al., 1993) and a de- crease in risk among smokers (Lee, 1994) for Alzheimer’s disease. Several recent studies of community samples (Elias et al., 1999; Hendrie et al., 1996) have found that curvilin- ear or threshold effects best described the relation between alcohol consumption and cognitive performance. In a study by Elias et al. (1999), for example, occasional or light drink- ers performed at the same, or even slightly lower, level than abstainers, but moderate drinkers (2–8 drinks per day) per- formed at a higher level than abstainers and light drinkers on several cognitive measures. This effect was found for both men and women, but at a lower level of consumption for women. These findings are not uniformly reported, how- ever. Positive effects for women, but not for men, have been reported (Dufouil et al., 1997), and a failure to find any differences in cognitive performance between current and abstinent individuals has also been reported (Dent et al., 1997). Studies have also shown differences in the drinking– cognition relationship based on the specific cognitive abil- ity measured (Cerhan et al., 1998). Fewer studies have examined the impact of smoking on cognitive function in the elderly. Results from these studies are inconsistent, reporting no loss of cognitive function in smokers (Carmelli et al., 1997; Dufouil et al., 1997), a loss in smokers (Kilander et al., 1997), a loss in smokers and ex-smokers (Galanis et al., 1997), or a loss in smokers but not ex-smokers (Launer et al., 1996). Surprisingly, there is Reprint requests to: John A. Schinka, Ph.D., Haley VA Medical Center 0116B, 13000 B.B. Downs Boulevard, Tampa, FL 33612. E-mail: jschinka@hsc.med.usf.edu Journal of the International Neuropsychological Society (2002), 8, 811–818. Copyright © 2002 INS. Published by Cambridge University Press. Printed in the USA. DOI: 10.1017.S135561770286009X 811