Drinking and dementia. Alcohol in moderation reduces risk of demential

The relationship between drinking and dementia, as well as Alzheimer’s, is an important matter. It effects millions of people, their loved ones, and governments.

Overview

I. Study Summaries (24)

II. Related Studies (3)

III. Should Older People Drink Less Alcohol?

IV. Resources

Medical research has shown that moderate drinking reduces the risk of dementia. This includes Alzheimer’s disease. The alcohol can be beer, wine or spirits. However, abstaining from alcohol increases the risk of cognitive decline. So does abusing alcohol.

Reducing the risk of dementia would help contain health care costs. It would reduce the emotional burden of care giving. And it would promote enhanced quality of later life.

I. Study Summaries: Research on Drinking and Dementia

Large Studies

• Moderate drinking protects older persons from the development of cognitive impairment. That’s the conclusion of researchers who studied 15,807 Italians 65 years of age and older. Among the drinkers, only 19% showed signs of mental impairment. That’ compared to 29% of the abstainers.¹

• Other investigators studied 12,480 older women over time. Drinkers were about 20% less likely than abstainers to have poor memory as they aged. The same was true for thinking abilities. The positive effects of different alcoholic beverages were all the same.²

• Two large studies in Australia tested people age 20 to 64. They found that moderate drinkers did better than abstainers on all measures of cognitive ability.³

Long Studies

• A long-term study of over 6,000 Britons began in 1967. Drinkers did much better on tests of cognitive functioning than teetotalers. For example, abstainers were twice as likely as occasional drinkers to receive the lowest test scores. The beneficial mental effects of alcohol occur when a person drinks up to about 30 drinks per week. It increased with consumption. Researchers did not test higher levels of drinking.⁴

• A study followed 1,018 men and women age 65-79 for an average of 23 years. The subject was drinking and dementia. “[D]rinking no alcohol, or too much, increases risk of cognitive impairment.”⁵

• This study followed 1,309 women age 65 or older for twenty years. Scientists assessed alcohol consumption was periodically for 16 years. At the end of 20 years, they measured cognitive impairment, including dementia.

Important Fact

Some women cut their drinking by one-half drink or more per week. They increased their risk of cognitive impairment or dementia by 34.5%. Adjusting for age, education, diabetes, smoking, weigh, and physical activity had little impact on the results.⁶

• Researchers studied Japanese-American men for 18 years. They found “a positive association between moderate alcohol intake among middle-aged men and subsequent cognitive performance in later life.” Moderate drinkers scored much higher on the Cognitive Abilities Screening Instrument (CASI). It includes tests of attention, concentration, orientation, memory, and language.

Significant

Both non-drinkers and heavy drinkers had the lowest CASI scores.⁷

• Scientists followed over 9,000 women aged 70 to 79 for 14 years. Moderate drinking led to better mental function among older women compared to abstainers. Seven tests measured mental function. Drinkers did much better on five of seven tests. They also did much better on a score combining all seven tests.⁸

• Researchers studied over a thousand persons age 65 and older. They did so over a period of seven years. The study adjusted for such factors as age, sex, education, depression, smoking, general mental status. There was a clear relationship between drinking and dementia risk. Overall, light and moderate drinkers had less mental decline than did non-drinkers.⁹

• A study examined 5,033 stroke-free men and women who participated in a longitudinal population-based study in Tromsø, Norway. Researchers followed them for seven years. Among both men and women, moderate wine drinkers had better performance on all cognitive tests.¹⁰

• Researchers studied 7,983 people aged 55 of age or older over an average period of six years. Those who had one to three drinks per day had a much lower risk of dementia than abstainers. That included Alzheimer’s disease.¹¹

• A study of people at least 75 years old tracked them for six years. There was a strong connection between drinking and dementia. Drinkers were only half as likely to develop dementia as abstainers. That also included Alzheimer’s.¹²

Specifically Alzheimer’s

• Researchers used data from a large study. They found that people who drank regularly had a significantly lower risk of Alzheimer’s disease than non-drinkers. This included those who drank in excess of U.S. recommended levels.¹³

• Researchers made a case-control study of alcohol and smoking as risk factors for Alzheimer’s disease. They collected data on both factors before the onset of the disease. They did the same for their age-matched controls.

The analysis adjusted for gender, age, residence and education. Also for economic situation, employment, and history of dementia in close relatives.

Tobacco use had no effect on risk of developing Alzheimer’s disease. However, those who consumed alcohol had almost half the risk of Alzheimer’s than did lifetime abstainers from alcohol. Those who drank alcohol but never smoked had even lower risk of Alzheimer’s disease.¹⁴

Progression of Dementia

• Neurology published a study on drinking and dementia. People with mild cognitive impairment who were light drinkers developed dementia at an 85 percent slower rate than non-drinkers.¹⁵

• A study in France followed drinkers and abstainers for three years. Moderate drinkers were much less likely than non-drinkers to develop either dementia or Alzheimer’s disease.¹⁶

• Researchers looked at about 6,000 people age 65 and older. Moderate drinkers had a 54% lower chance of developing dementia than abstainers.¹⁷

• A study of 3,069 people aged 75 and older found that daily drinking reduced the risk of dementia. It did so by 37%. Researchers examined the participants every six months for up to six years. They identified any changes in their memory or thinking abilities. The analysis controlled for other possible explanations for the findings.¹⁸

Other

• Researchers studied older women. Those who had up to two drinks per day performed better on memory tests than abstainers. In all cases, the group who drank scored better than those who did not drink.¹⁹

• Researchers studied 7,469 women age 65 and older. They looked at drinking and dementia. Those who had up to three drinks per day had much better cognition better than non-drinkers. This included such things as concentration, memory, abstract reasoning, and language.²⁰

• Another study in France examined drinkers and abstainers. Moderate drinkers were 2.5 times more likely to receive the highest cognitive ability scores than were non-drinkers.²¹

• Researchers made a community-based cross-sectional study of 1,145 elderly Brazilians. Moderate drinkers had much lower cognitive impairment and dementia compared to non-drinkers.²²

• A cross-sectional study of older Chinese in Hong Kong examined alcohol consumption and cognitive impairment. Their mean age was 79,9 years.

Light or moderate drinkers had a greatly reduced risk of cognitive impairment compared with both heavy drinkers and non-drinkers. This applied to both men and women.²³

• Other researchers studied 1,624 older adults living in a suburban community. Their mean age was 73.2 years.

The researchers assessed the association between drinking and dementia. In doing so, they adjusted for age, sex, education, exercise, smoking, waist-hip ratio, hypertension and self-assessed health.

Both the quantity and frequency of drinking improved cognitive ability. And they did so in a positive linear pattern. That is, as the amount and frequency increased, so did thinking ability. However, it declined with excessive drinking.²⁴

II. Related Studies

• Scientists studied 2,258 elderly persons for an average of four years. Those who closely followed the Mediterranean diet reduced their risk of Alzheimer’s risk by about 40%.

The Mediterranean diet is heart-healthy. It includes drinking wine. Things that are good for the heart are also good for the brain.²⁵

• A New Zealand study suggests that moderate alcohol consumption may also help improve short-term memory. The study was on rats. However, it has potential for developing new treatments for memory disorders.²⁶

• A study looked at drinking and the risk of brain atrophy. It used MRI to identify brain atrophy. Subjects were 589 residents of New York City. They averaged 80 years of age.

Light to moderate drinking greatly reduced risk of brain atrophy compared to abstainers. This is consistent with other research findings.²⁷

III. Should Older People Drink Less Alcohol?

Some writers urge that older people drink less alcohol. They think it would “protect their bodies and minds.” But Dr. Erik Skovenborg disagrees. He says people don’t develop low alcohol tolerance when they turn 65. That idea is “a myth based on plain ignorance, ageism prejudice and political correctness, mixed with a minuscule amount of facts.”²⁸

Fat doesn’t absorb alcohol. Older bodies tend to have a lower proportion of water to fat as they age. Thus, the same amount of alcohol would lead to a higher BAC. So some people say older people should drink less.

But from age 20-29 to 70-79, men’s total body water drops only 3.2%. The drop for women is even less. The increase in BAC would not be measurable on a Breathalyzer.

Some say older bodies don’t break down alcohol as well as younger bodies. However, medical research does not support that belief.

The health and longevity benefits of moderate drinking become greater for older people. It may be more important for older people to drink.

Seniors Don’t Drink Enough

drinking and dementia — Eric Skovenborg, M.D.

Dr. Skovenborg’s suggestion may actually be too conservative. The amount of alcohol most older people drink in the U.S. isn’t enough to get its health benefits.

A government survey proves this. Only 55% of people aged 50 had even a single alcoholic drink in the previous month. And the proportion declined with increasing age. It dropped to half among those age 60-64. Then to only 40% among those 65 and older.

Not drinking enough by older people might lead to unnecessary suffering for them. And to higher medical costs to society. It might be better to encourage older people to drink more for their personal welfare and that of society.

Perhaps the advice should be “older people drink more alcohol.” It certainly shouldn’t be to drink less. That’s a health risk.

IV. Resources: Drinking and Dementia

Medical research shows a clear connection between drinking and dementia. Drinking in moderation reduces the risk of cognitive decline. The form of alcohol (beer, wine or spirits) makes no difference.

Video

Amen, D. Preventing Alzheimers. DVD video. Newport Beach, CA : Mindworks, 2004.

Scientific Readings

Funk-White, M. et al. Alcohol use and cognitive performance. Age Ment Health, 2021.

Shen, Y. et al. Association of Low to Moderate Alcohol Drinking With Cognitive Functions. JAMA Network Open. 2020, 3(6), 7922.

Zhang, Y. et al. Association between alcohol consumption in midlife and cognitive function in old age. Nut Meta Cardio Dis, 2021, 31(11), 3044-3053.

References

1 Zuccala, G., et al. Dose-related impact of alcohol consumption on cognitive function in advanced age. Alco Clin Exper Res, 2001, 25, 1743-1748.

2 Stampfer, M., et al. Effects of moderate alcohol consumption on cognitive function in women. New Eng J Med, 2005, 352, 245-253.

3 Rodgers, B., et al. Non-linear relationships between cognitive function and alcohol consumption in young, middle-aged and older adults. Addict., 2005, 100(9), 1280-1290. Anstey, K., et al. Lower cognitive test scores and demographic, personality, and biological factors. Addict., 2005, 100(9), 1291-1301.

4 Matthews, R. Alcohol sharpens your brain, say researchers. Telegraph, Aug 1, 2004.

5 Antilla, T., et al. Alcohol drinking in middle age and subsequent risk of mild cognitive impairment. Brit Med J, 2004, 329, 538-539.

6 Hoang, T., et al. Alcohol consumption and cognitive impairment in older women. Am J Geri Psychi., 2014, 22, 1663-1667.

7 Galanis, D., et al. A study of drinking and cognitive performance. Am J Pub Health, 2000, 90, 1254-1259.

8 Harrison, P. Moderate Drinking Helps Preserve Women’s Brains. Reuters Health, June 15, 2001.

9 Ganguli, M., et al. Alcohol consumption and cognitive function in late life. Neurol, 2005, 65, 1210-1217.

10 Arntzen, K., et al. Moderate wine consumption and better cognitive test results. Acta Neurol Scandin, 2010, 122, 23-29.

11 Ruitenberg, A., et al. Alcohol consumption and risk of dementia. Lancet, 2002, 359(9303), 281-286.

12 Huang, W., et al. Alcohol consumption and incidence of dementia. J Clin Epid. 2002, 55(10), 959-64.

13 Cupples, L. Effects of smoking, alcohol and APOE genotype on Alzheimer disease. Alzheimer Report, 2000, 3, 105-114.

14 García, A., et al. Effects of tobacco and alcohol consumption on risk of Alzheimer’s disease. J Alzheim Dis, 2010, 20(2), 577-586.

15 Solfrizzi, V., et al. Alcohol consumption, mild cognitive impairment, and progression to dementia. Neurol, 2007, 68(2).

16 Cupples, ibid.

17 Mulkamal, K., et al. Study of alcohol consumption and risk of dementia in older adults. JAMA, 2003, 289, 1405-1413.

18 Sink, K., et al. Moderate Alcohol Intake and Lower Risk of Dementia. Presented at Alzheimer’s Assn Int Conf Alzheimer’s Dis. Vienna, July, 2009.

19 McDougall, G. Older Women’s Cognitive and Affective Response to Moderate Drinking. Paper. Nat Cong State Sci Nurs Res. Washington, D.C., Oct 7-8, 2004. U. Texas. Moderate drinking in older adult women has positive influence on memory. Report, Oct 3, 2004.

20 Espeland, M., et al. Association between alcohol intake and domain-specific cognitive function in older women. Neuroepi, 2006, 1(27), 1-12.

21 Dufouil, C., et al. Sex Differences in the Association between Alcohol Consumption and Cognitive Performance. Am J Epid, 2007, 146(5), 405-412.

22 Lopes, M., et al. Prevalence of Alcohol-Related Problems in an Elderly Population. Alco Clin Exper Res, 2010. PMID 20102571.

23 Chan, K., et al. Alcohol consumption and cognitive impairment. Int J Ger Psychi, 2010, 25(120), 1272-1279.

24 Reas, E., et al. Moderate, regular alcohol consumption and higher cognitive function in older adults. J Prev Alz Dis, 2016, 3(2), 105-113.

25 Scarmeas, N., et al. Mediterranean diet and risk for Alzheimer’s disease. Ann Neurol, 2006, 59(6), 912-21.

26 Kalev-Zylinska, M. and During, M. Facilitatory effect of low-dose alcohol consumption on memory mediated by NMDA receptors. J Neurosci, 2007, 27, 10456-10467.

27 Gu, Y., et al. Alcohol intake and brain structure. Clin Nut., 2014, 33, 662-7.

28 Skovenborg, E. Nature’s medicine? AIM Digest, 2015, 40(3), 3-5.

Note

Mediterranean Diet Pyramid courtesy of Oldways.

Drinking and Dementia, Alzheimer’s, & Memory Loss