Consumption of more than 14 drinks per week increases dementia risk in elderly with MCI: JAMA

USA: Consumption of more than 14 drinks per week increases dementia risk in people aged 72 and older with mild cognitive impairment (MCI) compared to those who drank less than one drink a week, according to a recent study published in the journal JAMA. The study further found that in people without MCI, alcohol consumption did not increase dementia risk.

Alcohol is associated with a number of familiar cognitive changes, including loss of inhibitions, confused or abnormal thinking, and poor decision-making. An increasing number of cognitively impaired patients have been observed to be drinking alcohol regularly. According to the National Institute on Alcohol Abuse and Alcoholism, most heavy long-term alcohol users will experience a mild to moderate impairment of intellectual functioning as well as diminished brain size. The most common impairments relate to the ability to think abstractly as well as the ability to perceive and remember the location of objects in two- and three-dimensional space

The findings of the present study suggest the need for careful assessment of the full dimensions of drinking behaviour and cognition when providing guidance to older patients about their alcohol consumption by the physicians.

There is no precise and certain data on the association between alcohol consumption and dementia. Manja Koch, Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, and colleagues assessed the association between alcohol consumption and dementia and the roles of MCI and apolipoprotein E ε4 (APOE E4) genotype in modifying this association.

The study analyzed 3,021 adults (72 and older) who were free of dementia (2,548 were without MCI and 473 with MCI). During about six years of follow-up, there were 512 cases of dementia, including 348 cases of Alzheimer disease.

Key findings of the study include:

• For 7.1 to 14.0 drinks per week compared with less than 1.0 drink per week, the hazard ratios for dementia were 0.63 among 2548 participants without MCI and 0.93 among 473 participants with MCI.


• Among participants with MCI, the hazard ratio for dementia was 1.72 for more than 14.0 drinks per week compared with less than 1.0 drink per week.


• The association of alcohol intake with dementia differed for participants with and without baseline MCI.


• Among participants without MCI, daily low-quantity drinking was associated with lower dementia risk than infrequent higher-quantity drinking (hazard ratio, 0.45).


• Findings were consistent when stratified by sex, age, and APOE E4 genotype.


• Compared with drinking less than 1.0 drink per week, complete abstention (in participants without MCI) and the consumption of more than 14.0 drinks per week (in participants with MCI) were associated with lower Modified Mini-Mental State Examination scores.

"In this study, complete abstention and consuming more than 14.0 drinks per week (compared with drinking <1.0 drink per week) were associated with lower cognitive scores among participants aged 72 years and older. Particular caution is needed among individuals with MCI who continue to drink alcohol," concluded the authors.

More Information: "Alcohol Consumption and Risk of Dementia and Cognitive Decline Among Older Adults With or Without Mild Cognitive Impairment" published in the JAMA journal.