Inverse association between cancer and Alzheimer's disease: Results from the Framingham Heart Study

Jane A. Driver, Alexa Beiser, Rhoda Au, Bernard E. Kreger, Greta Lee Splansky, Tobias Kurth, Douglas P. Kiel, Kun Ping Lu, Sudha Seshadri, Phillip A. Wolf

Research output: Contribution to journalArticle

170 Citations (Scopus)

Abstract

Objectives: To relate cancer since entry into the Framingham Heart Study with the risk of incident Alzheimer's disease and to estimate the risk of incident cancer among participants with and without Alzheimer's disease. Design: Community based prospective cohort study; nested age and sex matched case-control study. Setting: Framingham Heart Study, USA. Participants: 1278 participants with and without a history of cancer who were aged 65 or more and free of dementia at baseline (1986-90). Main outcome measures: Hazard ratios and 95% confidence intervals for the risks of Alzheimer's disease and cancer. Results: Over a mean follow-up of 10 years, 221 cases of probable Alzheimer's disease were diagnosed. Cancer survivors had a lower risk of probable Alzheimer's disease (hazard ratio 0.67, 95% confidence interval 0.47 to 0.97), adjusted for age, sex, and smoking. The risk was lower among survivors of smoking related cancers (0.26, 0.08 to 0.82) than among survivors of non-smoking related cancers (0.82, 0.57 to 1.19). In contrast with their decreased risk of Alzheimer's disease, survivors of smoking related cancer had a substantially increased risk of stroke (2.18, 1.29 to 3.68). In the nested case-control analysis, participants with probable Alzheimer's disease had a lower risk of subsequent cancer (0.39, 0.26 to 0.58) than reference participants, as did participants with any Alzheimer's disease (0.38) and any dementia (0.44). Conclusions: Cancer survivors had a lower risk of Alzheimer's disease than those without cancer, and patients with Alzheimer's disease had a lower risk of incident cancer. The risk of Alzheimer's disease was lowest in survivors of smoking related cancers, and was not primarily explained by survival bias. This pattern for cancer is similar to that seen in Parkinson's disease and suggests an inverse association between cancer and neurodegeneration.

Original languageEnglish (US)
Article numbere1442
Number of pages1
JournalBMJ (Online)
Volume344
Issue number7850
DOIs
StatePublished - Mar 31 2012
Externally publishedYes

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Alzheimer Disease
Neoplasms
Survivors
Smoking
Dementia
Confidence Intervals
Parkinson Disease
Case-Control Studies
Cohort Studies
Stroke
Outcome Assessment (Health Care)
Prospective Studies

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Driver, J. A., Beiser, A., Au, R., Kreger, B. E., Splansky, G. L., Kurth, T., ... Wolf, P. A. (2012). Inverse association between cancer and Alzheimer's disease: Results from the Framingham Heart Study. BMJ (Online), 344(7850), [e1442]. https://doi.org/10.1136/bmj.e1442

Inverse association between cancer and Alzheimer's disease : Results from the Framingham Heart Study. / Driver, Jane A.; Beiser, Alexa; Au, Rhoda; Kreger, Bernard E.; Splansky, Greta Lee; Kurth, Tobias; Kiel, Douglas P.; Lu, Kun Ping; Seshadri, Sudha; Wolf, Phillip A.

In: BMJ (Online), Vol. 344, No. 7850, e1442, 31.03.2012.

Research output: Contribution to journalArticle

Driver, JA, Beiser, A, Au, R, Kreger, BE, Splansky, GL, Kurth, T, Kiel, DP, Lu, KP, Seshadri, S & Wolf, PA 2012, 'Inverse association between cancer and Alzheimer's disease: Results from the Framingham Heart Study', BMJ (Online), vol. 344, no. 7850, e1442. https://doi.org/10.1136/bmj.e1442
Driver JA, Beiser A, Au R, Kreger BE, Splansky GL, Kurth T et al. Inverse association between cancer and Alzheimer's disease: Results from the Framingham Heart Study. BMJ (Online). 2012 Mar 31;344(7850). e1442. https://doi.org/10.1136/bmj.e1442
Driver, Jane A. ; Beiser, Alexa ; Au, Rhoda ; Kreger, Bernard E. ; Splansky, Greta Lee ; Kurth, Tobias ; Kiel, Douglas P. ; Lu, Kun Ping ; Seshadri, Sudha ; Wolf, Phillip A. / Inverse association between cancer and Alzheimer's disease : Results from the Framingham Heart Study. In: BMJ (Online). 2012 ; Vol. 344, No. 7850.
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abstract = "Objectives: To relate cancer since entry into the Framingham Heart Study with the risk of incident Alzheimer's disease and to estimate the risk of incident cancer among participants with and without Alzheimer's disease. Design: Community based prospective cohort study; nested age and sex matched case-control study. Setting: Framingham Heart Study, USA. Participants: 1278 participants with and without a history of cancer who were aged 65 or more and free of dementia at baseline (1986-90). Main outcome measures: Hazard ratios and 95{\%} confidence intervals for the risks of Alzheimer's disease and cancer. Results: Over a mean follow-up of 10 years, 221 cases of probable Alzheimer's disease were diagnosed. Cancer survivors had a lower risk of probable Alzheimer's disease (hazard ratio 0.67, 95{\%} confidence interval 0.47 to 0.97), adjusted for age, sex, and smoking. The risk was lower among survivors of smoking related cancers (0.26, 0.08 to 0.82) than among survivors of non-smoking related cancers (0.82, 0.57 to 1.19). In contrast with their decreased risk of Alzheimer's disease, survivors of smoking related cancer had a substantially increased risk of stroke (2.18, 1.29 to 3.68). In the nested case-control analysis, participants with probable Alzheimer's disease had a lower risk of subsequent cancer (0.39, 0.26 to 0.58) than reference participants, as did participants with any Alzheimer's disease (0.38) and any dementia (0.44). Conclusions: Cancer survivors had a lower risk of Alzheimer's disease than those without cancer, and patients with Alzheimer's disease had a lower risk of incident cancer. The risk of Alzheimer's disease was lowest in survivors of smoking related cancers, and was not primarily explained by survival bias. This pattern for cancer is similar to that seen in Parkinson's disease and suggests an inverse association between cancer and neurodegeneration.",
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AU - Splansky, Greta Lee

AU - Kurth, Tobias

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N2 - Objectives: To relate cancer since entry into the Framingham Heart Study with the risk of incident Alzheimer's disease and to estimate the risk of incident cancer among participants with and without Alzheimer's disease. Design: Community based prospective cohort study; nested age and sex matched case-control study. Setting: Framingham Heart Study, USA. Participants: 1278 participants with and without a history of cancer who were aged 65 or more and free of dementia at baseline (1986-90). Main outcome measures: Hazard ratios and 95% confidence intervals for the risks of Alzheimer's disease and cancer. Results: Over a mean follow-up of 10 years, 221 cases of probable Alzheimer's disease were diagnosed. Cancer survivors had a lower risk of probable Alzheimer's disease (hazard ratio 0.67, 95% confidence interval 0.47 to 0.97), adjusted for age, sex, and smoking. The risk was lower among survivors of smoking related cancers (0.26, 0.08 to 0.82) than among survivors of non-smoking related cancers (0.82, 0.57 to 1.19). In contrast with their decreased risk of Alzheimer's disease, survivors of smoking related cancer had a substantially increased risk of stroke (2.18, 1.29 to 3.68). In the nested case-control analysis, participants with probable Alzheimer's disease had a lower risk of subsequent cancer (0.39, 0.26 to 0.58) than reference participants, as did participants with any Alzheimer's disease (0.38) and any dementia (0.44). Conclusions: Cancer survivors had a lower risk of Alzheimer's disease than those without cancer, and patients with Alzheimer's disease had a lower risk of incident cancer. The risk of Alzheimer's disease was lowest in survivors of smoking related cancers, and was not primarily explained by survival bias. This pattern for cancer is similar to that seen in Parkinson's disease and suggests an inverse association between cancer and neurodegeneration.

AB - Objectives: To relate cancer since entry into the Framingham Heart Study with the risk of incident Alzheimer's disease and to estimate the risk of incident cancer among participants with and without Alzheimer's disease. Design: Community based prospective cohort study; nested age and sex matched case-control study. Setting: Framingham Heart Study, USA. Participants: 1278 participants with and without a history of cancer who were aged 65 or more and free of dementia at baseline (1986-90). Main outcome measures: Hazard ratios and 95% confidence intervals for the risks of Alzheimer's disease and cancer. Results: Over a mean follow-up of 10 years, 221 cases of probable Alzheimer's disease were diagnosed. Cancer survivors had a lower risk of probable Alzheimer's disease (hazard ratio 0.67, 95% confidence interval 0.47 to 0.97), adjusted for age, sex, and smoking. The risk was lower among survivors of smoking related cancers (0.26, 0.08 to 0.82) than among survivors of non-smoking related cancers (0.82, 0.57 to 1.19). In contrast with their decreased risk of Alzheimer's disease, survivors of smoking related cancer had a substantially increased risk of stroke (2.18, 1.29 to 3.68). In the nested case-control analysis, participants with probable Alzheimer's disease had a lower risk of subsequent cancer (0.39, 0.26 to 0.58) than reference participants, as did participants with any Alzheimer's disease (0.38) and any dementia (0.44). Conclusions: Cancer survivors had a lower risk of Alzheimer's disease than those without cancer, and patients with Alzheimer's disease had a lower risk of incident cancer. The risk of Alzheimer's disease was lowest in survivors of smoking related cancers, and was not primarily explained by survival bias. This pattern for cancer is similar to that seen in Parkinson's disease and suggests an inverse association between cancer and neurodegeneration.

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