American Journal of Epidemiology Advance Access originally published online on January 4, 2007
American Journal of Epidemiology 2007 165(6):677-683; doi:10.1093/aje/kwk056
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ORIGINAL CONTRIBUTIONS |
Areca Nut Chewing and Mortality in an Elderly Cohort Study
1 Division of Gerontology Research, National Health Research Institutes, Taipei, Taiwan
2 Division of Child and Adolescent Health, Bureau of Health Promotion, Department of Health, Taichung, Taiwan
3 Center for Population and Health Survey Research, Bureau of Health Promotion, Department of Health, Taichung, Taiwan
4 Department of Public Health, Chung Shan Medical University, Taichung, Taiwan
Correspondence to Dr. Tzuo-Yun Lan, Division of Gerontology Research, National Health Research Institutes, Room 4110, 4F, No. 161, Ming-Chuan East Road, Sec. 6, Taipei 114, Taiwan (e-mail: tylan{at}nhri.org.tw).
Received for publication May 3, 2006. Accepted for publication August 26, 2006.
Compared with the well-documented association with betel-related cancer, little is known about the long-term effect of areca nut chewing on other fatal diseases. The authors' analyses were based on a population-based cohort study in Taiwan, including 4,049 participants aged 60 years or older enrolled in 1989 and 2,462 participants aged 50–66 years enrolled in 1996. Information regarding betel quid chewing and covariates was collected at baseline and was updated at subsequent interviews. Proportional hazards analysis was performed to determine the effect of chewing on all-cause and cause-specific deaths. During a mean follow-up of 9.5 years, 2,309 deaths occurred. Ever chewers were at higher risk of only total (hazard ratio = 1.19, 95% confidence interval: 1.05, 1.35) and cerebrovascular (hazard ratio = 1.66, 95% confidence interval: 1.19, 2.30) deaths. Furthermore, increased chewing-years or quid-years appeared to be associated with increased mortality risk (linear trend: p = 0.02 for total mortality and p = 0.001 for cerebrovascular mortality). The authors found that, although betel quid chewing resulted in a statistically significant increase in the risk of total and cerebrovascular deaths in the elderly population, the associations were weak and should be interpreted with caution. Further studies are needed to confirm these findings and to better understand the possible mechanisms of death.
aged; areca; cohort studies; mortality
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