Increased risk of dementia from any cause in people who abstain from alcohol

Increased risk of dementia from any cause in people who abstain from alcohol

In a current one Seeks Researchers in journals are conducting an in-depth analysis of the connection between alcohol and dementia and determining whether certain amounts of alcohol consumption increase the risk of dementia.

Study: The association between alcohol consumption and dementia in adults over 60 years of age: a combined analysis of prospective, individual participant data from 15 international studies. Image source: Ground Picture / Shutterstock

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Dementia generally affects elderly and geriatric patients. This condition is categorized by numerous symptoms, some of which include decreased cognition, memory, attention, communication, logical thinking, and visual perception. Dementia affects the patient's quality of life and causes severe physical, psychological, social and economic burdens.

The global prevalence of dementia has increased over the past two decades, with the number of dementia patients expected to reach 152 million by 2050. Although there remains a lack of effective treatments for dementia, certain behaviors have been shown to increase the risk of dementia development. In fact, according to the 2020 Lancet Commission for Dementia Prevention, Intervention, and Care, up to 40% of dementia cases could be prevented or delayed if 12 different risk factors were avoided.

For example, excessive alcohol consumption in midlife can have significant neurotoxic effects on the brain. Compared to other risk factors such as high blood pressure and diabetes, harmful alcohol consumption is one of the strongest risk factors for the development of dementia.

Population-based studies have reported conflicting results on the association between alcohol and dementia. For example, some reports suggest that light to moderate alcohol consumption may reduce the risk of dementia compared to people who have abstained from alcohol. In contrast, other studies report that alcohol consumption has no effect on dementia risk.

Despite these varying reports, reviews of population-based observational studies suggest that the association between alcohol and dementia is J-shaped. More specifically, low levels of alcohol consumption may provide some benefit in reducing the risk of dementia, whereas excessive alcohol consumption is likely to increase the risk of dementia in a dose-dependent manner.

About the study

The researchers' goal in the current review was to provide a more precise understanding of the connection between alcohol and dementia while addressing the limitations of previous studies. These limitations included a lack of standardization of alcohol consumption categorization and low representation of low- to middle-income countries.

In addition, researchers collected data from 15 prospective epidemiological cohort studies conducted on six continents to examine the association between alcohol and dementia. Most cohorts were located in high-income countries; However, cohorts from low- and middle-income countries were represented by cohorts from Brazil and the Republic of Congo.

People over 60 years old took part in the study. Individuals with a diagnosis of dementia at baseline, those without follow-up for dementia assessment, and those without alcohol consumption records were excluded.

For each study cohort, alcohol consumption was converted to average grams of pure ethanol per day (g/day) based on the type of alcoholic beverage reported. Using these values, the researchers categorized no, occasional, light to moderate, moderate, and heavy alcohol users as those who currently abstained from alcohol or consumed less than 1.3 g/day, 1.3-24.9 g/day, 25-44.9 g/day, and over 45 g/day, respectively.

Study results

A total of 24,478 people were included in the current study, with an average age of 71.8 years at the start of the study. Of these, 58.3% were women and 54.2% were current drinkers.

The risk of dementia was higher in alcohol abstainers than in occasional, light to moderate and moderate drinkers, and men. Notably, this result was consistent in female subjects when fully adjusted and competing risk models were used. However, no association between alcohol consumption and dementia was found in women in fully adjusted models and those adjusted for competition for mortality risk.

Neither lifelong abstainers nor former drinkers had a different risk of dementia, regardless of gender, demographic or clinical characteristics.

Moderate alcohol consumption was associated with a lower risk of dementia compared to lifelong abstainers. These results were consistent across men and women and in the adjusted models.

Dose-response analysis conducted among current drinkers found no significant differences in dementia risk based on the amount of alcohol consumed. Based on current alcohol consumption status, neither men nor women showed differences in susceptibility to dementia after adjusting for demographic and clinical characteristics.

Furthermore, the risk of dementia did not differ between daily drinkers and occasional drinkers. The same was true when comparing lifelong abstainers and current drinkers.

Continental analyzes of the association between alcohol consumption and dementia risk, including Europe, Oceania (Australia), North America, and Asia (Korea), revealed nonlinear relationships for Europe, North America, and Asia; However, these differences were not statistically significant. Meanwhile, results from Oceania showed a protective effect of alcohol consumption against dementia compared to lifelong abstainers.

Among current drinkers, light to moderate alcohol consumption was associated with a lower risk of dementia in Europeans compared to occasional drinkers. Alcohol consumption has no influence on dementia risk in Asia.

Conclusions

The study results suggest that avoiding alcohol may increase the risk of dementia from any cause. Furthermore, there was no evidence that the amount of alcohol consumed had an impact on the risk of dementia.

The researchers of the current study emphasize that their findings need to be compared with the existing literature reporting the association between moderate alcohol consumption and poor brain health, as well as other health conditions such as cancer. The current study results therefore do not aim to promote alcohol consumption, but rather question whether current guidelines for reducing alcohol consumption in people over 60 years of age are an effective approach to preventing the development of dementia.

Nevertheless, the present study has certain limitations that must be taken into account. For example, cohort participants self-reported their daily alcohol consumption, which may have been under-reported. Furthermore, the type of alcoholic beverage was not assessed consistently across each cohort. Finally, the presence of healthy survivor bias may also limit the applicability of the study results, particularly given the older age of the cohorts.

Reference:

• Mewton, L., Visontay, R., Hoy, N., et al. (2022). Der Zusammenhang zwischen Alkoholkonsum und Demenz bei Erwachsenen über 60 Jahren: eine kombinierte Analyse prospektiver, individueller Teilnehmerdaten aus 15 internationalen Studien. Sucht. https://doi.org/10.1111/add.16035, https://onlinelibrary.wiley.com/doi/full/10.1111/add.16035