12 January 2009

Relationship between alcohol consumption and cognitive decline

Alcohol and dementia
Dementia News (Alzheimer's Australia): 8 January 2008
Dr Ruth Peters and colleagues from London’s Imperial College undertook a systematic review and meta-analyses of 23 studies reporting on 25 different sets of results of relationships between cognitive decline and/or dementia and alcohol consumption. Dementia and cognitive decline have been linked to cardiovascular risk, and alcohol in small quantities may be protective for the cardiovascular system, which has raised the question of whether alcohol could be protective against cognitive decline.

For inclusion in the analysis, studies had to be longitudinal; compare alcohol intake against an outcome of dementia or cognitive decline; include only people aged 65 years or older; and be published in English between 1995 and March 2006.

Dr Peters and her colleagues noted considerable variability in the studies, including differing lengths of follow up from 1 to 25 years (although most had more than 5 years of follow-up); measurement of alcohol intake; inclusion of true abstainers; and assessment of potential confounders, such as whether study participants had cardiovascular disease. In addition, there was no close agreement across studies over what level of consumption is optimal, so if alcohol consumption is protective, it is not possible to say what level of intake would be protective. There was also wide variation with regard to what was considered light to moderate drinking.

Furthermore, the researchers noted that an association between light to moderate alcohol consumption and protection against dementia could be misleading and simply reflect that those who drink in moderation are more likely to act moderately in other areas of life and it may be this overall healthier lifestyle that is protective.

On the basis of their review and meta-analysis, Dr Peters and her colleagues concluded that there is no evidence that alcohol has a protective effect against vascular dementia or impaired cognitive function, but that small to moderate amounts of alcohol consumption earlier in life may be associated with a reduced incidence of dementia and Alzheimer’s disease in older people. But, because of the variation in the data and other limitations in the studies, Dr Peters and her colleagues recommend that these findings be interpreted with caution.

The paper, “Alcohol, dementia and cognitive decline in the elderly: a systematic review”, by Ruth Peters, Jean Peters, James Warner, Nigel Beckett, and Christopher Bulpitt, is published in Age and Ageing 2008; 37: 505-512.

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