Assessment of nicotine dependence in subjects with vascular dementia

Abstract

INTRODUCTIONNicotine dependence has been known to contribute to cognitive decline in non-demented elderly, Alzheimer's disease as well as vascular dementia.1-4 Vascular dementia is the second most prevalent dementia 5,6 and the commonest type of preventable dementia. While several factors like hypertension, diabetes, dyslipidaemia, coronary artery disease and nicotine dependence 7 have been known to contribute to vascular dementia, it is nicotine use which is a completely preventable risk factor and should be a focus of clinical intervention as well as public health campaigns.Nicotine dependence has been postulated to increase the risk of vascular dementia through several mechanisms like by affecting blood coagulation mechanisms, causing atherosclerotic damage, and by increasing the likelihood of other vascular risk factors like hypertension, coronary heart disease, diabetes and homocysteine level as well as silent infarcts and white matter hyperintensities. [8][9][10][11][12][13][14][15][16] It also results in neuronal injury due to oxidative stress, ABSTRACT Background: Nicotine dependence is an important public health issue. Nicotine dependence is a risk factor for vascular diseases like myocardial infarction and vascular dementia. The rate of nicotine dependence in Indian subjects with vascular dementia is not known. Hence we decided to assess nicotine dependence in subjects with vascular dementia. Methods: Nicotine dependence in subjects with vascular dementia was assessed among subjects presenting to memory clinic of a tertiary care hospital over a period of 16 months. Data regarding sociodemographic profile and severity of nicotine dependence as per Fagerstrom nicotine dependence scale for smoking and smokeless tobacco was analysed using SPSS version 17. Results: Our study shows that in 159 subjects with vascular dementia continuing nicotine dependence was seen in nearly 12% of the subjects. Though the rates are less than the population prevalence for India, it is still relevant as nicotine is not just a risk factor for development of vascular dementia but severe nicotine dependence and longer duration of nicotine use were found to be poor prognostic factors associated with severe dementia. Further as all subjects continued to be nicotine dependent despite having been advised to quit tobacco, suggesting the need for a more comprehensive tobacco cessation intervention be offered to subjects with vascular dementia to improve outcomes. Conclusion: In subjects with vascular dementia continuing nicotine dependence is an important risk factor which must be addressed.

Exposure to copper nanoparticles induces oxidative stress and alters Hsp70 and Sod2 gene expression in Drosophila melanogaster

“…In the third generation, the mutations were raised to 8.14% and 13.12 % in 100 ppm CuNPs and 50 ppm Cu +2 , respectively. These data were consistent with previous findings that showed the phenotypic defect in the flies' eye, wing, and bristle exposed to different types of metal nanoparticles [42][43][44][45] .…”

“…This irregular trend in Sod2 expression was also observed in earthworms exposed to zinc oxide NPs [57] . Meanwhile, downregulation of Sod2 was also previously reported in D. melanogaster [44,58] . Moreover, the upregulation of the Sod2 has been previously reported in D. melanogaster [59] .…”

Obesity in Indian subjects with vascular dementia

“…Further the severe dementia subjects were significantly older than subjects with mild or moderate dementia (P = 0.002). 34 The normalisation of weight in this group may actually represent a loss of weight and reduction in BMI from pre morbid midlife obese state with ageing as well as progression of dementia. [35][36][37][38][39][40][41][42] Thus cross sectional absolute BMI may not be an appropriate predictor of severity which is consonance with findings that midlife obesity is a better predictor of late life dementia.…”