Dose-Related Impact of Alcohol Consumption on Cognitive Function in Advanced Age: Results of a Multicenter Survey

Zuccal??, Giuseppe; Onder, Graziano; Cesari, Matteo; Landi, Francesco; Bernabei, Roberto; Cocchi, A

doi:10.1097/00000374-200112000-00009

Cited by 33 publications

(44 citation statements)

References 32 publications

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“…Other studies also detected sex differences [106,107,111]. Light to moderate alcohol consumption was also found beneficial based on findings of other cohort and cross-sectional studies with a U- or J-shaped pattern observed [108-110,113,114,116,117,119-121,124-127]. However, in other studies, a linear dose–response relationship between alcohol use and improved cognition was noted, though the authors cautioned that these should not encourage increased alcohol consumption without an upper bound to this consumption [114,115,122,131].…”

Section: Resultsmentioning

confidence: 88%

“…9 of the 12 cross-sectional studies (75%) found an association in the hypothesized direction for the entire study population and for most outcomes of interest [106,109,110,119,121,123,126-128]. The remaining 3 studies either found this U-shaped or J-shaped association in a sub-group [107], and either failed to detect any association [112] or detected one that was not in line with the hypothesis, whereby alcohol use was generally found to result in poor cognitive outcomes [130].…”

Section: Resultsmentioning

confidence: 99%

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Epidemiologic studies of modifiable factors associated with cognition and dementia: systematic review and meta-analysis

et al. 2014

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BackgroundCognitive impairment, including dementia, is a major health concern with the increasing aging population. Preventive measures to delay cognitive decline are of utmost importance. Alzheimer’s disease (AD) is the most frequent cause of dementia, increasing in prevalence from <1% below the age of 60 years to >40% above 85 years of age.MethodsWe systematically reviewed selected modifiable factors such as education, smoking, alcohol, physical activity, caffeine, antioxidants, homocysteine (Hcy), n-3 fatty acids that were studied in relation to various cognitive health outcomes, including incident AD. We searched MEDLINE for published literature (January 1990 through October 2012), including cross-sectional and cohort studies (sample sizes > 300). Analyses compared study finding consistency across factors, study designs and study-level characteristics. Selecting studies of incident AD, our meta-analysis estimated pooled risk ratios (RR), population attributable risk percent (PAR%) and assessed publication bias.ResultsIn total, 247 studies were retrieved for systematic review. Consistency analysis for each risk factor suggested positive findings ranging from ~38.9% for caffeine to ~89% for physical activity. Education also had a significantly higher propensity for “a positive finding” compared to caffeine, smoking and antioxidant-related studies. Meta-analysis of 31 studies with incident AD yielded pooled RR for low education (RR = 1.99; 95% CI: 1.30-3.04), high Hcy (RR = 1.93; 95% CI: 1.50-2.49), and current/ever smoking status (RR = 1.37; 95% CI: 1.23-1.52) while indicating protective effects of higher physical activity and n-3 fatty acids. Estimated PAR% were particularly high for physical activity (PAR% = 31.9; 95% CI: 22.7-41.2) and smoking (PAR%=31.09%; 95% CI: 17.9-44.3). Overall, no significant publication bias was found.ConclusionsHigher Hcy levels, lower educational attainment, and decreased physical activity were particularly strong predictors of incident AD. Further studies are needed to support other potential modifiable protective factors, such as caffeine.

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Section: Resultsmentioning

confidence: 88%

Section: Resultsmentioning

confidence: 99%

Epidemiologic studies of modifiable factors associated with cognition and dementia: systematic review and meta-analysis

et al. 2014

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“…Age or disease-related changes in major organs (12) can decrease alcohol tolerance, metabolism, distribution, and elimination leading to adverse alcohol-related consequences at lower levels of consumption (13). Common alcohol-related consequences among older adults include falls, memory problems, and adverse alcohol–prescription drug interactions requiring emergency medical attention and/or hospitalization (10,12,14). Interactions between alcohol and prescription drugs, especially those prescribed for diabetes, hypertension, anxiety, and depression, can alter medication effectiveness, lead to misdiagnosis, and result in life-threatening medical complications (10,12).…”

Section: Introductionmentioning

confidence: 99%

“…Interactions between alcohol and prescription drugs, especially those prescribed for diabetes, hypertension, anxiety, and depression, can alter medication effectiveness, lead to misdiagnosis, and result in life-threatening medical complications (10,12). Risky drinking among older adults may contribute to declines in cognition, slowed reaction times, and changes in spatial perception and balance—all posing dangers for older adults who drive or live alone (14). …”

Section: Introductionmentioning

confidence: 99%

Comparing behavioral health models for reducing risky drinking among older male veterans

Wooten

Tavakoli

Al-Barwani

et al. 2017

The American Journal of Drug and Alcohol Abuse

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Background Screening older veterans in Veterans Affairs Medical Center (VAMC) primary care clinics for risky drinking facilitates early identification and referral to treatment. Objective This study compared two behavioral health models, integrated care (a standardized brief alcohol intervention co-located in primary care clinics) and enhanced referral care (referral to specialty mental health or substance abuse clinics), for reducing risky drinking among older male VAMC primary care patients. VAMC variation was also examined. Method A secondary analysis of longitudinal data from the Primary Care Research in Substance Abuse and Mental Health for Elderly (PRISM-E) study, a multisite randomized controlled trial, was conducted with a sample of older male veterans (n = 438) who screened positive for risky drinking and were randomly assigned to integrated or enhanced referral care at five VAMCs. Results Generalized estimating equations revealed no differences in either behavioral health model for reducing risky drinking at a 6-month follow-up (AOR: 1.46; 95% CI: 0.42–5.07). Older veterans seen at a VAMC providing geriatric primary care and geriatric evaluation and management teams had lower odds of risky drinking (AOR: 0.24; 95% CI: 0.07–0.81) than those seen at a VAMC without geriatric primary care services. Conclusions Both integrated and enhanced referral care reduced risky drinking among older male veterans. However, VAMCs providing integrated behavioral health and geriatric specialty care may be more effective in reducing risky drinking than those without these services. Integrating behavioral health into geriatric primary care may be an effective public health approach for reducing risky drinking among older veterans.

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“…Some reasons for the differences among studies include length of follow-up, how alcohol use is defined, which cognitive measures are used, sociodemographics and under- or over-adjustment for confounders. Some studies have shown that alcohol use is associated with either increased cognitive impairment 21 or decreased cognitive impairment 22 . Other studies have shown that current alcohol users have better cognitive performance than former alcohol users or those who have never used alcohol 23–28 .…”

Section: Introductionmentioning

confidence: 99%

Lifetime alcohol use and cognitive performance in older adults

Kalapatapu

Ventura

Barnes

2016

Journal of Addictive Diseases

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Background Substance use is an important clinical issue in the older adult population. As older adults are susceptible to cognitive disorders, the intersection of the fields of substance use and cognitive neuroscience is an active area of research. Prior studies of alcohol use and cognitive performance are mixed, and inconsistencies may be due to under- or over-adjustment for confounders. Aim This manuscript adds to this literature by conducting a secondary analysis of self-reported lifetime history of alcohol use and cognitive performance in older adults (n = 133). We hypothesized that current alcohol users would have poorer cognitive performance compared to never/minimal and former alcohol users. Methods Older adult participants were classified into never/minimal alcohol users, former alcohol users, and current alcohol users. A neurocognitive battery included a global cognitive measure and individual measures of attention, memory, fluency, and executive function. A directed acyclic graph (DAG)-based approach was used to select variables to be included in the multiple linear regression models. Results Though unadjusted analyses showed some significant associations between alcohol use and cognitive performance, all associations between alcohol use and cognitive performance were eliminated after adjusting for age, education, sex, race and smoking pack years. Alcohol drink years were not significantly associated with cognitive performance among current and former alcohol users. Discussion These results suggest that lifetime alcohol use is not significantly associated with cognitive performance in older adults after adjustment for key confounders. Inconsistencies in prior studies may be due to uncontrolled confounding and/or unnecessary adjustment of mediators and/or colliders.

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Dose-Related Impact of Alcohol Consumption on Cognitive Function in Advanced Age: Results of a Multicenter Survey

Cited by 33 publications

References 32 publications

Epidemiologic studies of modifiable factors associated with cognition and dementia: systematic review and meta-analysis

Epidemiologic studies of modifiable factors associated with cognition and dementia: systematic review and meta-analysis

Comparing behavioral health models for reducing risky drinking among older male veterans

Lifetime alcohol use and cognitive performance in older adults

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