Moderate alcohol use is associated with decreased brain volume in early middle age in both sexes

Abstract

the aim was to examine cross-sectional association between moderate alcohol consumption and total brain volume in a cohort of participants in early middle-age, unconfounded by age-related neuronal change. 353 participants aged 39 to 45 years reported on their alcohol consumption using the AUDit-c measure. participants with alcohol abuse were excluded. Brain MRi was analyzed using a fully automated method. Brain volumes were adjusted by intracranial volume expressed as adjusted total brain volume (aTBV). AUDIT-C mean of 3.92 (SD 2.04) indicated moderate consumption. In a linear regression model, alcohol consumption was associated with smaller atBV (B = − 0.258, p < .001). When sex and current smoking status were added to the model, the association remained significant. Stratified by sex, the association was seen in both males (B = − 0.258, p = 0.003) and females (B = − 0.214, p = 0.011). Adjusted for current smoking, the association remained in males (B = − 0.268, p = 0.003), but not in females. When alcohol consumption increased, total brain volume decreased by 0.2% per one AUDIT-C unit already at 39-45 years of age. Moderate alcohol use is associated with neuronal changes in both males and females suggesting health risks that should not be overlooked. Alcohol abuse is harmful to the brain, but the effects of moderate consumption, and the earliest age when the harmful effects appear, are less known. Volume changes of small parts of the brain, e.g. hippocampus 1 and the ventricles 2,3 , have been associated with moderate consumption, but the relationship of alcohol consumption and total brain volume is contradictory. Methodological differences in imaging technology and in estimating alcohol consumption may make the results difficult to compare and interpret. In addition, most previous studies of global brain values have included participants in late middle-age or old age. However, the rate of age-related brain volume does not occur in a linear fashion, but the decrease accelerates towards old age making the effect of age difficult to control in statistical analysis. Studying younger participants and groups with less age heterogeneity would be helpful. We found ten studies 4-13 which used volumetry, voxel-based morphometry or brain age estimates for analyzing the association of large brain structures and alcohol consumption in moderate drinkers (Table 1). Two of these studies included middle-aged participants in their forties to sixties 4,5 , two mainly over 65-year-olds 6,7 , and six report on participants of a wide age range 8-13. Findings in the middle-aged were conflicting. Decreased 4 and increased 5 volume of white matter, and increased volume of gray matter and ventricular size were associated with moderate drinking in males, but no associations were found in females. Studies of participants over 65 years found either larger 6 or smaller 7 whole brain volumes associated with drinking. Studies of a wider age range have found decreased volumes 8-10 or no association 11,12 with consumption. The most recent stud...

Multimodal brain imaging study of 36,678 participants reveals adverse effects of moderate drinking

“…We find negative associations between alcohol intake and the global IDPs for both sexes and weak evidence for interactive effects between alcohol intake and sex on the brain. These findings are similar to a recent study of early middle-aged adult moderate drinkers that showed smaller brain volumes associated with moderate alcohol consumption in both men and women 46 . The weak sex-by-alcohol interactions also comport with the findings of an earlier longitudinal study in individuals with AUD 38 ; however, other cross-sectional studies have reported greater volume deficits in women than men 48,49 .…”

“…We report a multimodal brain imaging study of 36 The negative associations between alcohol intake and total GMV and WMV are consistent with prior studies of early middle-aged 46 and older adults 28,47 . Because men consume more alcohol units per day and had larger global GMV and WMV, we further examine the effect of sex in detail.…”

Associations between alcohol consumption and gray and white matter volumes in the UK Biobank

“…The negative associations between alcohol intake and total GMV and WMV are consistent with prior studies of early middle-aged 46 and older adults 28 , 47 . Based on Figs.…”

Lifetime perspective on alcohol and brain health

“…Although alcohol use disorders are relatively rare in older adults, many older people frequently consume low to moderate amounts of alcohol 12. Recently, even moderate drinking was shown to be associated with small but significant loss of brain volume in midlife,13 supporting previous research indicating an association between low risk drinking and brain damage in older adults 2. However, it is currently unclear whether these structural changes translate into functional cognitive impairment.…”