Alcohol consumption and risk of dementia: 23 year follow-up of Whitehall II cohort study

Abstract

ObjectiveTo examine the association between alcohol consumption and risk of dementia.DesignProspective cohort study.SettingCivil service departments in London (Whitehall II study).Participants9087 participants aged 35-55 years at study inception (1985/88).Main outcome measuresIncident dementia, identified through linkage to hospital, mental health services, and mortality registers until 2017. Measures of alcohol consumption were the mean from three assessments between 1985/88 and 1991/93 (midlife), categorised as abstinence, 1-14 units/week, and >14 units/week; 17 year trajectories of alcohol consumption based on five assessments of alcohol consumption between 1985/88 and 2002/04; CAGE questionnaire for alcohol dependence assessed in 1991/93; and hospital admission for alcohol related chronic diseases between 1991 and 2017.Results397 cases of dementia were recorded over a mean follow-up of 23 years. Abstinence in midlife was associated with a higher risk of dementia (hazard ratio 1.47, 95% confidence interval 1.15 to 1.89) compared with consumption of 1-14 units/week. Among those drinking >14 units/week, a 7 unit increase in alcohol consumption was associated with a 17% (95% confidence interval 4% to 32%) increase in risk of dementia. CAGE score >2 (hazard ratio 2.19, 1.29 to 3.71) and alcohol related hospital admission (4.28, 2.72 to 6.73) were also associated with an increased risk of dementia. Alcohol consumption trajectories from midlife to early old age showed long term abstinence (1.74, 1.31 to 2.30), decrease in consumption (1.55, 1.08 to 2.22), and long term consumption >14 units/week (1.40, 1.02 to 1.93) to be associated with a higher risk of dementia compared with long term consumption of 1-14 units/week. Analysis using multistate models suggested that the excess risk of dementia associated with abstinence in midlife was partly explained by cardiometabolic disease over the follow-up as the hazard ratio of dementia in abstainers without cardiometabolic disease was 1.33 (0.88 to 2.02) compared with 1.47 (1.15 to 1.89) in the entire population.ConclusionThe risk of dementia was increased in people who abstained from alcohol in midlife or consumed >14 units/week. In several countries, guidelines define thresholds for harmful alcohol consumption much higher than 14 units/week. The present findings encourage the downward revision of such guidelines to promote cognitive health at older ages.

Factores asociados al deterioro cognitivo en personas mayores en Chile

“…Por este motivo, es importante poder corroborar si los factores de riesgo para sospecha de deterioro cognitivo reportados en otras poblaciones en el mundo son similares a los observados en Chile. cual podría estar explicado por el tamaño muestral de nuestro estudio, pero también por la falta de datos que permitan clasificar el tipo de alcohol consumido 3,5,19 . Otros factores que han mostrado asociación con deterior cognitivo es la presencia de factores de riesgo cardiovascular, como diabetes e hipertensión arterial, sin embargo, nuestro estudio no pudo replicar estas asociaciones, que en parte podrían ser explicadas por el efecto de mediación del IMC, ya que nuestros modelos fueron ajustado por este marcador de obesidad, el cual podría estar mediando la asociación entre deterioro cognitivo y factores de riesgo cardiovascular 3,5,12 .…”

Role of Alcohol Drinking in Alzheimer’s Disease, Parkinson’s Disease, and Amyotrophic Lateral Sclerosis

“…It seems that the effect of alcohol on AD is related to the amount, pattern and frequency of drinking, the type of alcohol, the nutritional state of individuals and the human genotype. Sabia et al [49] reported the Whitehall II cohort study that examined the link between alcohol consumption and the risk of dementia in a 23-years-long follow-up study, specifically, with a focus on the amount of alcohol intake per week. They concluded that the risk of dementia was increased in people who abstained from alcohol in midlife or consumed >14 units/week.…”

Association between alcohol consumption and Alzheimer’s disease: A Mendelian randomization Study

“…where excessive alcohol consumption (in reference to light-moderate consumption) defined as more than 14 drinks/week increases the risk of dementia in a linear fashion [39]. However, alcohol dependence is also associated with a higher risk of somatic diseases (e.g.…”