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Am J Epidemiol 2003; 158:395.
Copyright © 2003 by Johns Hopkins Bloomberg School of Public Health

LETTERS TO THE EDITOR

THE AUTHORS REPLY

Iracema Leroi, Jeannie-Marie Sheppard and Constantine G. Lyketsos

Neuropsychiatry and Memory Group, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD 21205

We thank Drs. Kritz-Silverstein and Barrett-Connor for their observations (1). Edelstein et al. (2) reported that smoking is a confounding factor in the association between alcohol drinking and cognitive function. In our analysis (3), we used age, race, and education as covariates to adjust for the effect of variables other than alcohol use that might be associated with cognitive decline. We deliberately omitted drug use and cigarette smoking from the analysis because of previous reports, based on the Epidemiologic Catchment Area data set, of a lack of association between these factors and cognitive decline as measured by the Mini-Mental State Examination (4; K. Mehta, University of California, San Francisco, unpublished data). The use of the Mini-Mental State Examination may itself be a limiting factor in finding an association between smoking and cognitive decline using Epidemiologic Catchment Area data.

REFERENCES

  1. Kritz-Silverstein D, Barrett-Connor E. Re: "Cognitive function after 11.5 years of alcohol use: relation to alcohol use." (Letter). Am J Epidemiol 2003;158:394–5.[Free Full Text]
  2. Edelstein SL, Kritz-Silverstein D, Barrett-Connor E. Prospective association of smoking and alcohol use with cognitive function in an elderly cohort. J Womens Health 1988;7:1271–81.
  3. Leroi I, Sheppard JM, Lyketsos CG. Cognitive function after 11.5 years of alcohol use: relation to alcohol use. Am J Epidemiol 2002;156:747–52.[Abstract/Free Full Text]
  4. Lyketsos CG, Garrett E, Liang KY, et al. Cannabis use and cognitive decline in persons under 65 years of age. Am J Epidemiol 1999;149:794–800.[Abstract/Free Full Text]

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This Article
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