Link between alcohol intake, cognition in older adults is complex

  • Koch M & al.
  • JAMA Netw Open
  • 4 Sep 2019

  • International Clinical Digest
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Takeaway

  • Lighter drinking appeared to protect against dementia among older adults who did not have mild cognitive impairment (MCI), while heavier drinking appeared detrimental among older adults who had MCI.

Why this matters

Key results

  • Dementia incidence during median 6.0-year follow-up: 16.9%.
  • Compared with
  • Without MCI: HR, 0.63 (95% CI, 0.38-1.06).
  • With MCI: HR, 0.93 (95% CI, 0.47-1.84).
  • Older adults with MCI had trend toward higher risk with >14.0 drinks/week (HR, 1.72; 95% CI, 0.87-3.40).
  • Association of intake with dementia differed by MCI status (P for interaction=.03).
  • Among group without MCI, compared with infrequent higher-quantity drinking, daily low-quantity drinking appeared protective (HR, 0.45; P=.02).
  • Findings similar in subgroups stratified by sex, age, APOE E4 genotype.
  • Modified Mini-Mental State Examination scores lower with:
    • Complete abstention among those without MCI.
    • Intake >14.0 drinks/week among those with MCI.
  • Study design

    • Retrospective cohort study: 3021 community-dwelling adults aged ≥72 years free of dementia (15.7% had MCI).
    • Main outcome: dementia.
    • Funding: National Center for Complementary and Alternative Medicine; National Institute of Neurological Disorders and Stroke; others.

    Limitations

    • Alcohol intake was self-reported.
    • Unknown generalisability to younger age-groups.
    • Possibility of inverse association.