Mid-life smoking and late-life dementia: the Honolulu-Asia Aging Study.

We studied the association between mid-life smoking and late-life dementia in the Honolulu Heart Program (1965-1971) and follow-up assessment for dementia (1991-1996) of 3734 Japanese-American men (80% of survivors). Neuropathologic data were available for 218 men. Adjusting for age, education and apolipoprotein E (APOE) genotype, the risk of Alzheimer's disease (AD) in smokers increased with pack-years of smoking at medium (odds ratio (OR)=2.18, 95% confidence interval (CI)=1.07-4.69) and heavy (OR=2.40; 95% CI=1.16-5.17) smoking levels. Very heavy smoking was not associated with AD (OR=1.08; 95% CI=0.43-2.63). Findings were similar when AD cases included those with cerebrovascular disease and for all dementias combined. Adjustment for cardiovascular and respiratory factors or stratification by apolipoprotein E genotype did not change these associations. In an autopsied subsample, the number of neuritic plaques increased with amount smoked. This study suggests that amount smoked is associated with an increasing risk of AD and Alzheimer-type neuropathology up to heavy smoking levels. The lack of association in very heavy smokers may be due to a hardy survivor effect.

Japan's silver human resource centers and participant well-being.

Japan's Silver Human Resource Center (SHRC) program provides part-time, paid employment to retirement-aged men and women. We studied 393 new program participants and examined whether part-time work influenced their well-being or "ikigai." The participants were divided into those who had worked in SHRC-provided jobs in the preceding year, and those who had not. Gender-stratified regression models were fitted to determine whether SHRC employment was associated with increased well-being. For men, actively working at a SHRC job was associated with greater well-being, compared to inactive members. And men with SHRC jobs and previous volunteering experience had the greatest increase in well-being. Women SHRC job holders did not experience increased well-being at the year's end. The study concludes that there is justification for exploring the usefulness of a similar program for American retirees who desire post-retirement part-time work.

Driving life expectancy of persons aged 70 years and older in the United States.

OBJECTIVES: We estimated total life expectancy and driving life expectancy of US drivers aged 70 years and older. METHODS: Life table methods were applied to 4699 elderly persons who were driving in 1993 and reassessed in a 1995 survey. RESULTS: Drivers aged 70 to 74 years had a driving life expectancy of approximately 11 years. A higher risk of mortality among men as a cause of driving cessation offset a higher risk of driving cessation not related to mortality among women that resulted in similar driving life expectancies. CONCLUSIONS: Nationwide, many elderly drivers quit driving each year and must seek alternative sources of transportation. Because of differences in life expectancy, women require more years of support for transportation, on average, than men after age 70.