Midlife Alcohol Consumption and Risk of Dementia Over 43 Years of Follow-Up: A Population-Based Study From the Swedish Twin Registry

Handing, Elizabeth P.; Andel, Ross; Kadlecová, Pavla; Gatz, Margaret; Pedersen, Nancy L.

doi:10.1093/gerona/glv038

Cited by 55 publications

(46 citation statements)

References 36 publications

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“…In a study based on the Swedish Twin Registry with 43 years of follow-up, where dementia was assessed through electronic health records, a quadratic association was found whereby both no alcohol consumption and high alcohol consumption were associated with an increased risk of dementia, although the excess risk in abstainers did not reach statistical significance and the excess risk of high consumption began at 12 g/day (corresponding to around 10.5 units/week). 37 The study also found, as in our investigation, a reduced risk of dementia for moderate wine consumption and a linear increased risk of dementia in those consuming spirits. Furthermore, a recent study based on a nationwide dataset of patients admitted to hospital in France between 2008 and 2013 reported that those with a hospital admission record for alcohol use disorders had a 3.3-times higher risk of dementia in multivariate analysis, 12 providing further support for our findings.…”

Section: Discussionsupporting

confidence: 89%

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

Sabia

Fayossé

Dumurgier

et al. 2018

BMJ

191

156

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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.

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Section: Discussionsupporting

confidence: 89%

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

Sabia

Fayossé

Dumurgier

et al. 2018

BMJ

191

156

View full text Add to dashboard Cite

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“…Several other previous studies have suggested that heavy alcohol consumption could increase the risk of cognitive impairment and dementia, in contrast to the present findings. This might be due to the following reasons.…”

Section: Discussioncontrasting

confidence: 99%

“…This might indicate that moderate lifestyles, in general, which can vary across cultural environments, could protect against cognitive deterioration. 20 Several other previous studies have suggested that heavy alcohol consumption could increase the risk of cognitive impairment and dementia, 21,22 in contrast to the present findings. This might be due to the following reasons.…”

Section: Discussioncontrasting

confidence: 99%

Alcohol consumption and incident dementia in older Japanese adults: The Okayama Study

Liu

Mitsuhashi

Yamakawa

et al. 2019

Geriatrics Gerontology Int

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Aim To evaluate the association between the amount and frequency of alcohol consumption and incident dementia in older Japanese adults using large sample size data over a long follow‐up period. Methods This was a retrospective cohort study carried out in Japan. A total of 53 311 older adults were followed from 2008 to 2014. A health checkup questionnaire was used to assess the amount and frequency of alcohol consumption. The Dementia Scale of long‐term care insurance was used as a measure of incident dementia. Cox proportional hazards models were used to calculate adjusted hazard ratios, with their 95% confidence intervals, for the incidence of dementia across the categories of alcohol consumption by sex. Results During a 7‐year follow‐up period, 14 479 participants were regarded as having incident dementia. Compared with non‐drinkers, the multivariate adjusted hazard ratios for participants with alcohol consumption ≤2 units per day, occasionally (0.88, 95% CI 0.81–0.96 in men and 0.84, 95% 0.79–0.90 in women) and daily (0.79, 95% 0.73–0.85 in men and 0.87, 95% 0.78–0.97 in women) were statistically significant, and the difference between occasional and daily consumption was only statistically significant in men; however, for participants with alcohol consumption >2 units per day, occasionally (0.91, 95% 0.71–1.16 in men and 1.09, 95% 0.72–1.67 in women) and daily (0.89, 95% 0.81–1.00 in men and 1.16, 95% 0.84–1.81 in women) were not significant. Conclusions Alcohol consumption of ≤2 units per day, occasionally or daily, could reduce the risk of incident dementia, with greater benefit for men with such daily consumption. Geriatr Gerontol Int 2019; 19: 740–746.

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“…The Swedish Twin Registry study, with 12,326 participants, showed that each additional gram of alcohol over 1.16 g per day from wine was associated with a 2% decreased risk of dementia, yet the highest amount of alcohol intake from wine was associated with an increased dementia risk by 1% [ 66 ]. A cross-sectional study, used high-resolution structural MRI on 589 multi-ethnic community-dwelling elderly to assess the effect of alcohol intake and on imaging markers of brain structure.…”

Section: Resultsmentioning

confidence: 99%

Wine: An Aspiring Agent in Promoting Longevity and Preventing Chronic Diseases

et al. 2018

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Introduction: Moderate wine consumption is a characteristic of the Mediterranean diet. Studies around the world have shown a beneficial effect of moderate alcohol intake, especially wine, on health. This review aims to critically summarise the most recent studies that investigate the beneficial effects of moderate wine intake on human health. Methods: The PubMed database was comprehensively searched to identify trials published from 2013 to 2018 that investigated the association between moderate wine consumption and health. Results: The most recent studies confirm the valuable role of moderate wine consumption, especially red wine, in the prevention and treatment of chronic diseases such as cardiovascular disease, metabolic syndrome, cognitive decline, depression, and cancer. In the meantime, recent studies also highlight the beneficial role of red wine against oxidative stress and in favour of desirable gut bacteria. The beneficial role of red wine has been attributed to its phytochemical compounds, as highlighted by clinical trials, where the effect of red wine has been compared to white wine, non-alcoholic wine, other alcoholic drinks, and water. Conclusions: Moderate wine intake, at 1–2 glasses per day as part of the Mediterranean diet, has been positively associated with human health promotion, disease prevention, and disease prognosis.

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Midlife Alcohol Consumption and Risk of Dementia Over 43 Years of Follow-Up: A Population-Based Study From the Swedish Twin Registry

Cited by 55 publications

References 36 publications

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

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

Alcohol consumption and incident dementia in older Japanese adults: The Okayama Study

Wine: An Aspiring Agent in Promoting Longevity and Preventing Chronic Diseases

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