{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T16:11:05Z","timestamp":1790784665883,"version":"4.1.0"},"reference-count":48,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T00:00:00Z","timestamp":1790640000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"Central Government Guides Local Science and Technology Development Special Projects of Hubei Province","award":["2022BGE243"],"award-info":[{"award-number":["2022BGE243"]}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82372337"],"award-info":[{"award-number":["82372337"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Alzheimer\u2019s Disease"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Early-life tobacco smoke exposure, including maternal smoking during gestation and smoking during childhood or adolescence, may have long-term health consequences, but its association with dementia remains uncertain.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To examine the associations of prenatal tobacco smoke exposure and childhood\/adolescence smoking with incident dementia and to explore whether biological-age acceleration represents a potential intermediate component of these associations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a prospective cohort study of 285,009 dementia-free participants from the UK Biobank. Biological aging was assessed using Klemera\u2013Doubal method biological age acceleration (KDM-BA) and phenotypic age acceleration (PhenoAge). Cox proportional hazards models estimated hazard ratios (HRs) for incident dementia, and exploratory mediation analyses evaluated model-based indirect components through biological-age acceleration.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>During a mean follow-up of 13.67 years, 4621 incident dementia cases were documented. Prenatal tobacco smoke exposure (HR\u2009=\u20091.094, 95% CI 1.025\u20131.168) and childhood\/adolescence smoking (HR\u2009=\u20091.187, 95% CI 1.106\u20131.275) were associated with higher dementia hazards. The corresponding standardized 10-year absolute risk differences were 0.063 and 0.124 percentage points. For childhood\/adolescence smoking, the combined indirect effect through KDM-BA and PhenoAge acceleration was small (HR\u2009=\u20091.0062, 95% CI 1.0002\u20131.0125), with an estimated mediated proportion of 3.63% (95% CI 0.11%\u20138.77%).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Early-life tobacco smoke exposure was associated with modestly higher hazards of incident dementia. Exploratory mediation analyses identified a small estimated indirect component through biological-age acceleration for childhood\/adolescence smoking.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/13872877261492699","type":"journal-article","created":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T11:45:01Z","timestamp":1790682301000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Accelerated biological aging in the association between early-life tobacco smoke exposure and dementia risk: An exploratory mediation analysis"],"prefix":"10.1177","author":[{"given":"Linling","family":"Yu","sequence":"first","affiliation":[{"name":"Department of Laboratory Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China"},{"name":"Department of Public Health, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huaxin","family":"Deng","sequence":"additional","affiliation":[{"name":"Department of Occupational Health and Radiation Health, Chongqing Center for Disease Control and Prevention, Chongqing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meng","family":"Yang","sequence":"additional","affiliation":[{"name":"Institute of Maternal and Child Health, Wuhan Children's Hospital (Wuhan Maternal and Child Health Care Hospital), Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ding-Sheng","family":"Jiang","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China"},{"name":"Key Laboratory of Organ Transplantation, Ministry of Education; NHC Key Laboratory of Organ Transplantation, Chinese Academy of Medical Sciences, Wuhan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chenqi","family":"Liao","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Danyang","family":"Sun","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiahao","family":"Song","sequence":"additional","affiliation":[{"name":"Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hongbin","family":"Luo","sequence":"additional","affiliation":[{"name":"HuBei Minzu University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9830-9916","authenticated-orcid":false,"given":"Wei","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Public Health, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China"},{"name":"Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4588-1898","authenticated-orcid":false,"given":"Xiong","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,9,29]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(24)00038-3"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1002\/alz.12655"},{"key":"e_1_3_3_4_2","unstructured":"Estimation of the global prevalence of dementia in 2019 and forecasted prevalence in 2050: an analysis for the Global Burden of Disease Study 2019. 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