Increased risk for all-cause dementia in people who abstain from alcohol

In a recent Addiction journal paper researchers perform an in-depth analysis of the alcohol-dementia relationship and determine whether certain levels of alcohol consumption increases the risk of dementia.

Study: The relationship between alcohol use and dementia in adults aged more than 60 years: a combined analysis of prospective, individual-participant data from 15 international studies. Image Credit: Ground Picture / ShutterstockStudy: The relationship between alcohol use and dementia in adults aged more than 60 years: a combined analysis of prospective, individual-participant data from 15 international studies. Image Credit: Ground Picture / Shutterstock

Background

Dementia generally affects the elderly and geriatric patients. This condition is categorized by numerous symptoms, some of which include diminished cognition, memory, attention, communication, reasoning, and visual perception. Dementia impairs the patient's quality of life and imposes severe physical, psychological, social, and economic burdens.

The global prevalence of dementia has been rising over the last two decades, with the number of dementia patients expected to reach 152 million by 2050. Although there remains a lack of effective treatments for dementia, certain behaviors have been shown to increase the risk of its development. In fact, according to the 2020 Lancet Commission for Dementia Prevention, Intervention, and Care, up to 40% of dementia cases could be prevented or delayed if 12 distinct risk factors were avoided.

Excessive alcohol consumption in mid-life, for example, can cause significant neurotoxic effects on the brain. As compared to other risk factors, such as high blood pressure and diabetes, harmful alcohol use is one of the strongest risk factors for the development of dementia.

Population-based studies have reported conflicting results on the alcohol-dementia relationship. For example, some reports suggest that light-to-moderate alcohol use can reduce dementia risk as compared to those who have abstained from alcohol. In contrast, other studies report that alcohol use does not impact the risk of dementia.

Despite these different reports, reviews of population-based observational studies indicate that the alcohol-dementia relationship is J-shaped. More specifically, low levels of alcohol use may provide some benefit in reducing the risk of dementia, whereas excessive alcohol consumption likely increases the risk of dementia in a dose-dependent manner.

About the study

The researchers in the current review aimed to provide a more concise understanding of the alcohol-dementia relationship while addressing the limitations of previous studies. Some of these limitations included a lack of standardization regarding how alcohol use was categorized and the scarcity of representation from low- to middle-income countries.

Moreover, the researchers collected data from 15 prospective epidemiological cohort studies conducted across six continents to examine the relationship between alcohol and dementia. Most of the cohorts were based in high-income countries; however, representation from low- and middle-income countries was provided by cohorts from Brazil and the Republic of Congo.

The study included individuals above 60 years of age. Individuals with dementia diagnosis at baseline, those without follow-up after dementia assessment, and those with no alcohol use records were excluded. 

For each study cohort, alcohol use was converted into average grams of pure ethanol daily (g/day) based on the type of alcoholic beverage reported. From these values, the researchers categorized none, occasional, light-moderate, moderate-heavy, and heavy alcohol users as individuals who were currently abstaining from alcohol or consumed less than 1.3 g/day, 1.3-24.9 g/day, 25-44.9 g/day, and over 45 g/day, respectively.

Study findings

A total of 24,478 individuals were included in the current study, with a mean age of 71.8 years at baseline. Among these, 58.3% were females, and 54.2% were current drinkers. 

The risk of dementia was greater among alcohol abstainers than occasional, light-moderate-, and moderate-heavy drinkers, as well as among men. Notably, this result was consistent among female subjects when fully adjusted and competing risk models were employed. However, in fully adjusted models and those adjusted for competing for risk of death, no association was found between alcohol use and dementia among females.

Neither lifetime abstainers nor previous drinkers had a different dementia risk, regardless of their sex, demographic, or clinical characteristics.

Moderate drinkers were associated with a reduced risk of dementia compared to lifetime abstainers. These findings were consistent among men and women and in the adjusted models.

The dose-response analysis conducted among current drinkers did not show any significant variation in dementia risk based on the amount of alcohol consumed. Furthermore, based on current alcohol intake status, neither men nor women showed any variation in dementia susceptibility after adjusting for demographic and clinical characteristics.

Furthermore, dementia risk did not differ between daily drinkers and occasional drinkers. The same was true in comparison between lifetime abstainers and current drinkers.

Continent-wise analyses for the association between alcohol use and dementia risk, including Europe, Oceania (Australia), North America, and Asia (Korea), revealed non-linear relationships for Europe, North America, and Asia; however, these differences were not statistically significant. Meanwhile, results from Oceania depicted a protective effect of alcohol use against dementia compared to lifetime abstainers.

Among current drinkers, light-moderate alcohol consumption was associated with a reduced risk of dementia among Europeans compared to occasional drinkers. Alcohol consumption does not impact the risk of dementia in Asia.

Conclusions

The study findings suggest that abstaining from alcohol may increase the risk for all-cause dementia. Furthermore, there was no evidence to suggest that the amount of alcohol consumed impacts the dementia risk.

The current study's researchers emphasize that their findings must be balanced against existing literature reporting the association between moderate alcohol use and poor brain health, as well as other health conditions like cancer. Thus, the current study findings are not meant to encourage alcohol consumption and instead question whether current guidelines on reducing alcohol consumption in individuals over the age of 60 is an effective approach to preventing the development of dementia.

Nevertheless, the current study is associated with certain limitations that must be considered. The cohort participants, for example, self-reported their daily alcohol intake, which may be under-reported. Furthermore, the type of alcoholic drink was not consistently assessed in each cohort. Finally, the presence of healthy survivor bias may also limit the applicability of the study findings, particularly considering the older age of the cohorts. 

Journal reference:
Nidhi Saha

Written by

Nidhi Saha

I am a medical content writer and editor. My interests lie in public health awareness and medical communication. I have worked as a clinical dentist and as a consultant research writer in an Indian medical publishing house. It is my constant endeavor is to update knowledge on newer treatment modalities relating to various medical fields. I have also aided in proofreading and publication of manuscripts in accredited medical journals. I like to sketch, read and listen to music in my leisure time.

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Comments

  1. Nathan Lemmon Nathan Lemmon United States says:

    Maybe people who abstain from alcohol learn to relax in different ways. They may prefer to watch television, eat ice cream with potato chips, smoke cigarettes and rely on sleeping pills.

  2. Sarah Peak Sarah Peak United States says:

    You need to look up what that word means.

  3. Lizfree Lizfree United States says:

    That is so ridiculous I don’t believe one word about this study, this is only one more thing that doctors(scientists are failing) Is the opposite actually, people who drink and drinkers are highly risk to get problems with memory loss later on in life because damage the neurological cells brain’s, it toast your brain…I believe what you didn’t take a very good study nor investigate it; if the people in this study may have gut problems, people with bad digestion and deficiency in vitamins get dementia..your stomach is connect it to your brain ;the Alcohol has nothing to do to help to not get dementia! Wow what a great recommendation here with this article , .. and if has something to do like I said It is the opposite. Please stop encouraging people and given them the excuse to add Alcohol in their diet, that is ok..they are fine drinking, especially to young people, this is a evil and tread for people that like to drink. Maybe is just an article for business to promote the market’s to buy crap another lie to public. How many times you will lie us with studies that just put people in risk and the wrong direction!!..

    • Rudolph Rassendyll Rudolph Rassendyll United States says:

      Then too, causality is very complex for the less learned?

    • Karl Schwinbarger Karl Schwinbarger United States says:

      I'm 72 and have always drunk some, at home, these days a cocktail before lunch and before dinner. But always only one. And I'm learning German, for years now, reading Dickens, and bicycling 40 miles a week at least. My dad died at 59 from a heart attack. He drank too much as a young man and smoked too much. My brother died the same way at 54. He did a lot of drugs when young. I think so much depends on the psyche of the people involved. By itself alcohol like caffeine is not a boogeyman. But some people, many, turn it into one, For nerdy folks who don't I can see how it might help with a lot earthy problems, what I did get hooked on was anti-depressants for 25 years. Off now, but probably needed them while working.

  4. Spike Doe Spike Doe United States says:

    Didn't help Biden.

  5. Cali House Cali House United States says:

    Nidhi, while some of your information was very interesting, it was impossible to actually get into your article because there are countless editing mistakes. As while as sentences that were worded improperly, sometimes confusing because of inconsistency. If you edit your own work, you might want some else to proofread. If someone else edits your work for you, fire them. Just some constructive criticism. But overall Your article was full of valuable information. As being a person that has close family with dementia. I truly appreciate the knowledge I gained from reading this segment. Best Wishes

  6. Karen Runnels Karen Runnels United States says:

    Any chance that the alcoholic beverage industry financed the study or studies showing that lower consumption of alcohol helps to protect against dementia?

  7. Anjan Dutta Anjan Dutta United States says:

    Can you share who funded this study? Also, what were the actual differences between those who abstained and those who consumed?

  8. Fred Scuttle Fred Scuttle United States says:

    "..some reports suggest that light-to-moderate alcohol use can reduce alcohol risk among abstainers."

  9. Christopher Mixon Christopher Mixon United States says:

    The first sentence says that abstinence (not using alcohol) results in increased risk of dementia?
    Please clarify.

  10. Scott Pratt Scott Pratt United States says:

    I'm guessing that the word abstinence in the first sentence isn't supposed to be there?

  11. Robert Baron Robert Baron United States says:

    You're right. Live your life in total fear and wait to die.

  12. T Neilson T Neilson United States says:

    This study is misleading. First you are saying that low dosage alchohol use prevents dementia more than non drinkers. At the end if the article you state that there is no difference between "abstainers" and occasional/low dose alchohol consumers. This study is partially why there are so many alcoholics in treatment currently. Making alchohol consumption sound like it benefits people seems extremely reckless.

    • George Williams George Williams New Zealand says:

      I cant find anywhere in the article or the actual study article that says that "there is no difference between "abstainers" and occasional/low dose alchohol consumers " It is actually very consistent across all demographics in all cohorts that alcohol consumption has a protective effect against dementia...

  13. Bigg Brother Bigg Brother United States says:

    Sounds like the study was done by drinkers who like to drink.

    Any excuse to consume poison. Lol. Figure it out already.

  14. S Taj S Taj United States says:

    Please do not publish incomplete information, especially on internet, I am a certified doctor in the US . Alcohol in any form and concentration is harmful and has established itself as a cause for heart disease( no 1 killer in the world), liver failure, stroke, dementia, delirium, seizures , fall and especially in the elderly. If we care for our loved ones , we must make sure we weigh the impact of our journalism in spreading beneficial information and not something that could mislead and put our loved ones in more danger. Friendly advice. Elderly population is highly sensitive to even lesser concentrations of alcohol enough to make them deleirius , aspirate , cause fall and end up in critical states. Please don't try to imply it is protective to dementia. What I see practically everyday is the reality. Dementia is of varying types. Common man may not be able to identify these intricacies.

    • George Williams George Williams New Zealand says:

      I think a review of many meta analysis with over 47000 subjects is probably more scientific and more likely to be true than your opinions and the stories you tell youself, even if you are a doctor and clearly smarter than the "common man". By the waybthis study was done by far more educatedxand learned people than you...

  15. Bob Scoggin Bob Scoggin United States says:

    These people always act like alcoholism doesn't exist and anyone can be a moderate drinker. wow

  16. John Vance John Vance United States says:

    In your report on the study, you say: "Moderate drinking – alcohol intake of up to 40 g/day was associated with lower dementia risk relative to lifetime abstinence."  Seeking more info, I went to the actual study, and read "For each cohort, alcohol use was converted into average grams of pure ethanol per day (g/day)".  However reading further in your report on the study I read: "Among current users, minimal drinking – up to 0.3 mg per day, posed a lower dementia risk among Europeans".  It seems to me the scale is off as we are talking about a decimal of a mg vs 40 grams.  I am just trying to calculate what is a realistic volume to consume, if one wanted to achieve a benefit.  Would you clarify for me, please?

  17. Edward Rodriguez Edward Rodriguez United States says:

    To find moderate drinkers you have to look in Europe specifically around the Mediterranean where alcohol wine in particular is part of a fine meal enjoyed seated at a table around friends and family and never in a hurry. Can you find that in the US and Canada? Maybe that is the reason we are so sick and drinking is a way to get drunk.

  18. Humbert Suarez Humbert Suarez United States says:

    In this study, half of people that abstain from alcohol have a history of alcohol dependency in their past, or a history of smoking. These people have higher mortality. This can explain that in the study above they had higher risk of dementia.

    journals.plos.org/.../journal.pmed.1003819

    HS

  19. D B D B United States says:

    Really? Are we to assume you know better than most on this subject? I would think by anyone who has families who endure an Alcoholic would know better. The devastation alcoholism brings from young to old speaks for itself. Shame on you for such irresponsible reporting and using information so twisted in truth! Alcohol most certainly does not help prevent Dementia and you and the Makers producing these products know it as well. It makes me wonder if you were paid by these to falsely write this report in their favor! Everyone has the choice to drink alcohol, but for you to encourage them to consume alcoholic beverages to counter Dementia is criminal in my view. You may want to stick to filling cavities.

  20. Washoewillie Washoewillie United States says:

    My father never drank, my mother had an alcoholic drink or two maybe 4 times a year. They never developed dementia. I am 66 and have not had an alcoholic drink since was 18. You can probably guess what I think of this study.

  21. Alvin Ginsburg Alvin Ginsburg United States says:

    This article really says that abstainers live longer and therefore more likely to get dementia. Notice the paragraph that says that when adjusted for mortality the difference disappears.

  22. F. J F. J United States says:

    There are lies, damned lies, and statistics. 24,000 may sound a lot, but not true given the wide genomic diversity. Add to it self-reporting variation, any claim of so-called "adjustment for such and such factors" is what we normally call "fudge factors". Given known biochemical mechanisms how alcohol affects the brain, take this with a grain of salt. Just like similar studies claiming alcohol enhances the risk of dementia. The existence of both contradictory claims simply shows that the effect of alcohol on dementia is not definitive. One might have protective genes and another might not.

  23. John Freeman John Freeman United States says:

    ... is self-serving and thoughtless. You can always find a positive in bad decisions.

    Alcohol is deceptive and ensnares the most studious and intelligent. Alcohol is so deceptive that intelligent parents encourage or facilitate their children and grandchildren to drink "as long as it's in moderation." I've seen horrible things from alcohol because people thought it was okay "as long as it's done in moderation."

    The Bible does not promote alcohol. It says to not drink grape juice (wine meant 'fruit of the vine') when it has started to or might have started to ferment, since there were no refrigerators and since grape juice was a very special, desirable, delicious, and healthy beverage, mainly delicious.

  24. Chase Fraley Chase Fraley United States says:

    Throughout this article one will find a consistent display of contradiction and imprecise, confusing articulation, yielding bewilderment and frustration.

  25. Greg Maxim Greg Maxim United States says:

    How can you even make that connection?  You actually can't.  You have no proof only coincidences.  Alcohol is a toxin not meant for consumption.  How can you say a toxin helps with dementia, that makes zero rational sense.  What's next the medical community is going to say smoking cigarettes is healthy again.  These people like fauci are paid to say all this bs.  It's not real data.

The opinions expressed here are the views of the writer and do not necessarily reflect the views and opinions of News Medical.
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