Does Alcohol Cause Dementia?

Does Alcohol Cause Dementia
Alcohol and dementia Excessive alcohol consumption over a lengthy time period can lead to brain damage, and may increase your risk of developing dementia. However, drinking alcohol in moderation has not been conclusively linked to an increased dementia risk, nor has it been shown to offer significant protection against developing dementia.

As such, people who do not currently drink alcohol should not be encouraged to start as a way to reduce dementia risk.
Conversely, those who drink alcohol within the recommended guidelines are not advised to stop on the grounds of reducing the risk of dementia, although cutting back on alcohol consumption may bring other health benefits.

Two reviews of the available evidence conducted by and the scrutinised multiple research studies of alcohol consumption and the development of dementia. Both reviews used a systematic approach, that is one in which researchers evaluate the conclusions made in multiple previously published research studies.

While this may sound like a re-run of old data, it is a powerful approach that allows us to make stronger conclusions on a given topic. If multiple studies using varied methods and studying different groups of people come up with the same conclusion, then we can be more certain of the conclusion for the whole population.

These reviews found that individuals who drank heavily or engaged in binge drinking – where a person consumes a large quantity of alcohol in a short time period – were more likely to develop Alzheimer’s disease or any other form of dementia than those who engaged in moderate alcohol consumption (see below for definition).

How much does alcohol increase dementia risk?

Figure. Adjusted Hazard Ratios (HRs) and 95% CIs for the Association of Change in Alcohol Consumption Amount With Risk of Dementia HRs (squares) were adjusted for age, sex, smoking status, regular exercise, area of residence, income, comorbidities (hypertension, diabetes, and dyslipidemia), systolic blood pressure, and laboratory results (fasting glucose levels, total cholesterol, and serum creatinine). Table 2. HRs and 95% CIs for the Association of Change in Alcohol Consumption Amount With Risk of Dementia, With Nondrinkers as the Reference Table 3. HR and 95% CIs for the Association of Change in Alcohol Consumption Amount With Risk of Dementia, With Sustained Drinking at the Same Level as a Reference Original Investigation Neurology February 6, 2023 JAMA Netw Open.2023;6(2):e2254771. doi:10.1001/jamanetworkopen.2022.54771 Key Points Question Is a change in alcohol consumption associated with the incidence of dementia? Findings In this cohort study of 3 933 382 individuals in Korea, maintaining mild to moderate alcohol consumption was associated with a decreased risk of dementia compared with sustained nondrinking, whereas sustained heavy drinking of alcohol was associated with an increased risk of dementia. Reduction of drinking from a heavy to a moderate level and initiation of mild drinking were associated with a decreased risk of dementia compared with a sustained level of drinking. Meaning These findings suggest that the threshold of alcohol consumption for dementia risk reduction is low. Importance The impact of serial changes in alcohol consumption on dementia risk has rarely been investigated to date. Objective To investigate the association of comprehensive patterns of changes in alcohol consumption with the incidence of all-cause dementia, Alzheimer disease (AD), and vascular dementia (VaD). Design, Setting, and Participants This is a retrospective cohort study. Data were obtained from the Korean National Health Insurance Service database. Adults aged 40 years and older underwent 2 health examinations in 2009 and 2011. The cohort was assessed until December 31, 2018, and statistical analysis was performed in December 2021. Exposures Alcohol consumption level was categorized into none (0 g per day), mild (<15 g per day), moderate (15-29.9 g per day), and heavy (≥30 g per day) drinking. On the basis of changes in alcohol consumption level from 2009 to 2011, participants were categorized into the following groups: nondrinker, quitter, reducer, sustainer, and increaser. Main Outcomes and Measures The primary outcome was newly diagnosed AD, VaD, or other dementia. Results Among 3 933 382 participants (mean age, 55.0 years; 2 037 948 men ), during a mean (SD) follow-up of 6.3 (0.7) years, there were 100 282 cases of all-cause dementia, 79 982 cases of AD, and 11 085 cases of VaD. Compared with sustained nondrinking, sustained mild (adjusted hazard ratio, 0.79; 95% CI, 0.77-0.81) and moderate (aHR, 0.83; 95% CI, 0.79-0.88) drinking were associated with a decreased risk of all-cause dementia, whereas sustained heavy drinking was associated with an increased risk of all-cause dementia (aHR, 1.08; 95% CI, 1.03-1.12). Compared with sustained levels of drinking, reducing alcohol consumption from a heavy to a moderate level (aHR, 0.92; 95% CI, 0.86-0.99) and the initiation of mild alcohol consumption (aHR, 0.93; 95% CI, 0.90-0.96) were associated with a decreased risk of all-cause dementia. Increasers and quitters exhibited an increased risk of all-cause dementia compared with sustainers. The trends in AD and VaD remained consistent. Conclusions and Relevance In this cohort study of a Korean population, decreased risk of dementia was associated with maintaining mild to moderate alcohol consumption, reducing alcohol consumption from a heavy to a moderate level, and the initiation of mild alcohol consumption, suggesting that the threshold of alcohol consumption for dementia risk reduction is low. Currently, more than 57 million people live with dementia worldwide, and this number is expected to increase to more than 152 million by 2050.1 Alcohol consumption is generally considered as a potential modifiable risk factor for dementia, but the results in the literature are not completely consistent.2 Several longitudinal studies 3 - 6 reported an association of mild to moderate alcohol consumption with a reduced risk of dementia, whereas others showed no association.7 - 10 Notably, most studies assessed alcohol consumption only once at baseline. Only a few studies considered a change of alcohol consumption during the study period and its association with the incidence of dementia (eTable 1 in Supplement 1 ). Sabia et al 4 examined the link between 17-year trajectories of alcohol consumption and the risk of dementia in the UK. The authors concluded that the risk of dementia was increased in those with long-term abstinence, decreased alcohol consumption, and long-term consumption greater than 14 units per week compared with participants with long-term consumption of 1 to 14 units per week.4 However, that study did not conduct stratified analyses considering the initial amount of alcohol consumption level (eg, mild, moderate, or heavy). Mukamal et al 5 examined alcohol consumption in 2 separate assessments. In that study, however, the participants were simply categorized according to the average level of alcohol consumption between 2 measurements (eg, <1 drinks per week) without reflecting changes in the pattern (eg, decreased or increased) of alcohol consumption between the measurements.5 In addition, that study used only the abstainers, but not the sustainers, as a reference, making it difficult to accurately reflect the effect of changes in the pattern of alcohol consumption on the risk of dementia. In the present study, we evaluated the association between comprehensive patterns of changes in alcohol consumption and the risk of dementia stratified by the initial amount of alcohol consumption using a large sample of a representative Korean population. Notably, to our knowledge, our study is the first to use the sustainers at the same level of alcohol consumption, in addition to the abstainers, as a reference group within each baseline alcohol consumption level, which enables more comprehensive understanding on the association between changes in the pattern of alcohol consumption and risk of dementia. Data Source and Study Setting The Korean National Health Insurance Service (NHIS) is a single insurer administered by the Korean government. The NHIS provides a free biennial cardiovascular health examination to all insured individuals aged 40 years and older. The health examination consists of a standard questionnaire regarding medical history and lifestyle habits (eg, drinking, smoking, and exercise), anthropometric measurements, and laboratory tests.11 The NHIS also retains qualification data regarding demographics and diagnosis codes for diagnoses and utilization of inpatient and outpatient medical services for insurance claims. This study was approved by the institutional review board of the Samsung Medical Center, which waived the need for informed consent because the data were publicly available and anonymized under confidentiality guidelines. This study was designed and conducted according to the Strengthening the Reporting of Observational Studies in Epidemiology ( STROBE ) reporting guideline. From the NHIS database of the entire Korean population, we collected data of participants aged 40 years and older who had undergone 2 national health examinations in 2009 (first examination) and 2011 (second examination). Among 4 961 817 participants, those who had a previous diagnosis of dementia (11 337 participants), cancer (142 259 participants), or cardiovascular disease (402 191 participants) before their second examination were excluded. In addition, participants who received a diagnosis of dementia (6378 participants), cancer (45 372 participants), or cardiovascular disease (47 187 participants) and those who died (5373 participants) within 1 year after their second examination (called the 1-year lag period) were excluded to minimize possible reverse causality. Finally, those whose records were missing any information on alcohol consumption or other key variables (368 338 participants) were excluded. We also established a subgroup of people who participated in 3 consecutive health examinations to assess the impact of further changes in drinking level at a third examination in 2013. A total of 2 977 137 individuals were included in this subgroup analysis (eFigure 1 in Supplement 1 ). Information on alcohol consumption was obtained from self-reported questionnaires regarding the frequency (the number of days per week) and quantity (the number of standard drinks on each occasion) of alcohol consumption in the past 12 months. The number of standard drinks was converted to measurements of pure alcohol in grams, which is approximately 8 g for a typical volume of beer, wine, soju (Korean traditional alcohol), or whisky.12 The weekly frequency and pure alcohol amount per occasion were multiplied to calculate the total amount of alcohol consumption per week, which was then converted to the daily amount of alcohol intake. The participants were classified into 4 groups: none (0 g per day), mild (<15 g per day), moderate (15-29.9 g per day), or heavy (≥30 g per day), according to the Dietary Guidelines for Americans.13 The participants were then assigned to 1 of 5 groups according to change in alcohol consumption from 2009 to 2011: (1) sustained nondrinkers, (2) quitters (those who stopped drinking), (3) reducers (those who reduced their level of consumption but did not stop drinking), (4) sustainers (those who maintained the same level of consumption), and (5) increasers (those who increased their level of consumption). Information on covariates is described in the eMethods in Supplement 1, Study Outcomes and Follow-up The end points of the study were newly diagnosed dementia, which was identified by new claims with the International Statistical Classification of Diseases and Related Health Problems, Tenth Revision (ICD-10) codes for AD ( ICD-10 codes F00 or G30), VaD ( ICD-10 code F01), or other dementia ( ICD-10 codes F02, F03, G23.1, or G31) combined with the prescription of antidementia drugs at least twice. To file expense claims for the prescription of acetylcholinesterase inhibitors (donepezil hydrochloride, rivastigmine, and galantamine) or the N-methyl-D-aspartate receptor antagonist (memantine) for dementia treatment, physicians need to document evidence of cognitive dysfunction according to National Health Insurance Reimbursement criteria: a Mini-Mental State Examination score of 26 or less and either a Clinical Dementia Rating of 1 or higher or a Global Deterioration Scale score of 3 or higher.14 - 16 The cohort was assessed from 1 year after the second health examination to the date of incident dementia or death, or until the end of the study period (December 31, 2018), whichever came first. Continuous variables were presented as mean (SD), and categorical variables were presented as number and percentage. Cox proportional hazard regression analyses were conducted to estimate hazard ratios (HRs) and 95% CIs for the association of change in alcohol consumption with incidence of dementia. To determine which covariates to include in multivariable-adjusted proportional hazards models, we used a directed acyclic diagram 17 (eFigure 2 in Supplement 1 ). Model 1 was adjusted for age, sex, smoking status, regular exercise, area of residence, and income. Model 2 was additionally adjusted for comorbidities (hypertension, diabetes, and dyslipidemia), body mass index (calculated as weight in kilograms divided by height in meters squared), systolic blood pressure, and laboratory results (fasting glucose levels, total cholesterol, and serum creatinine). Comparisons were done using 2 different reference groups: (1) sustained nondrinkers as a reference group to compare the association across all categories and (2) sustainers as a reference group within each baseline category. Sensitivity analysis with competing risk analysis was performed with the Fine and Gray method to assess the subdistribution HR for dementia incidence considering death from any cause as a competing event. Stratified analyses were performed by age (65 years old), sex, and smoking status. Statistical analyses were performed using SAS statistical software version 9.4 (SAS Institute), and 2-sided P < .05 was considered statistically significant. Statistical analysis was performed in December 2021. After exclusions, a total of 3 933 382 participants (mean age, 55.0 years; 2 037 948 men ) were included in our analyses. At the first examination, 2 157 126 participants (54.8%) were nondrinkers, 1 048 578 (26.7%) were mild drinkers, 431 203 (11.0%) were moderate drinkers, and 296 475 (7.5%) were heavy drinkers (eTable 2 in Supplement 1 ). From 2009 to 2011, 253 643 mild drinkers (24.2%), 36 329 moderate drinkers (8.4%), and 22 604 heavy drinkers (7.6%) became quitters, whereas 299 206 nondrinkers (13.9%), 169 212 mild drinkers (16.1%), and 75 124 moderate drinkers (17.4%) increased their drinking level (eTable 3 in Supplement 1 ). Table 1 (total study population) and eTable 4 in Supplement 1 (divided by sex) show the baseline characteristics according to changes in alcohol consumption. Sustained nondrinkers had the oldest mean age and the highest proportion of female participants (1 380 847 participants ) among the 5 categories and were mostly nonsmokers (1 572 583 participants ). Compared with sustainers, quitters tended to be older, female, nonsmokers, be more engaged in regular exercise, and have lower incomes. Alcohol Consumption and Dementia During a mean (SD) follow-up of 6.3 (0.7) years after a 1-year lag period, there were 100 282 cases (2.5%) of all-cause dementia, 79 982 cases (2.0%) of AD, and 11 085 cases (0.3%) of VaD. Compared with sustained nondrinkers, those who sustained mild or moderate alcohol consumption had a significantly lower risk of all-cause dementia (21% lower for mild to mild, adjusted HR, 0.79; 95% CI, 0.77-0.81; 17% lower for moderate to moderate, aHR, 0.83; 95% CI, 0.79-0.88), whereas sustained heavy drinkers had an 8% higher risk of all-cause dementia (aHR, 1.08; 95% CI, 1.03-1.12) ( Table 2 ). Similar patterns were also observed in both AD and VaD. The association was smaller for VaD than AD possibly because the smaller number of cases of VaD (11 085 participants) compared with cases of AD (79 982 participants). Alcohol Consumption Change and Dementia When sustainers at the same level of alcohol consumption were used as the reference group, nondrinkers who initiated drinking to a mild level were at lower risk for all-cause dementia (aHR, 0.93; 95% CI, 0.90-0.96) and AD (aHR, 0.92; 95% CI, 0.89-0.95) ( Table 3 and Figure ). We also found that those who reduced their drinking from heavy to moderate levels had a lower risk of all-cause dementia (8% decreased risk; aHR, 0.92; 95% CI, 0.86-0.99) and AD (12% decreased risk; aHR, 0.88; 95% CI, 0.81-0.95). In contrast, increasers exhibited increased risk of all-cause dementia (mild to moderate, aHR, 1.09; 95% CI, 1.03-1.15; mild to heavy, aHR, 1.37; 95% CI, 1.27-1.47; and moderate to heavy, aHR, 1.16; 95% CI 1.07-1.25). Quitters from any level of alcohol consumption showed higher risk of all-cause dementia compared with those who sustained the same level of drinking. The results of the competing analysis (eTable 5 in Supplement 1 ) and analyses stratified by age, sex, and smoking status (eTables 6, 7, 8, and 9 in Supplement 1 ) were consistent with those of the main analyses. Subgroup Analysis: Subsequent Changes in Alcohol Consumption and Risk of Dementia When we extended the analysis using additional data on alcohol consumption in the subgroup who underwent a health examination in 2013, the results demonstrated similar patterns (eTables 10 in Supplement 1 ). Those who sustained a mild-moderate level of drinking through the third examination (aHR, 0.75; 95% CI, 0.72-0.77) and those who initiated a mild-moderate level of drinking at the 2011 screening and maintained a mild-moderate level (aHR, 0.82; 95% CI, 0.77-0.88) were found to have a lower risk of all-cause dementia compared with sustained nondrinkers. Among those who reduced their alcohol intake from a heavy level in 2009 to a mild-moderate level in 2011 and mild-moderate level in 2013, there was a decreased aHR for all-cause dementia (aHR, 0.92, 95% CI, 0.83-1.03), although the difference was not significant. In contrast, those who quit at the 2011 screening and sustained quitting were at a higher risk of all-cause dementia and AD. In this nationwide cohort study, we found that sustained mild drinkers had a 21% decreased risk of all-cause dementia, and sustained moderate drinkers had a 17% decreased risk of all-cause dementia compared with sustained nondrinkers, whereas sustained heavy drinkers had an 8% increased risk. Compared with those who sustained the same level of drinking, heavy drinkers who reduced intake to a moderate level and nondrinkers who initiated drinking to a mild level exhibited a decreased risk of all-cause dementia and AD, whereas those who increased alcohol consumption from a mild or a moderate level to a heavy level exhibited an increased risk of all-cause dementia and AD. Subgroup analysis using information from a third examination showed consistent findings regarding a subsequent change in drinking level, supporting the robustness of our results. We observed a J-shaped or U-shaped association between alcohol consumption and risk of all-cause dementia, which is consistent with the majority of previous studies.18 We also found a similar pattern of associations between alcohol consumption and risk of AD and VaD. Consistent with our findings, in a recent systematic review of meta-analyses, 19 mild to moderate alcohol consumption was found to be protective for all-cause dementia, AD, and VaD. The protective effect of mild to moderate alcohol consumption may be attributed to various mechanisms. In AD, for example, previous studies 20 proposed that the protective effect of mild to moderate alcohol consumption involves the promotion of prosurvival pathways and decrease of neuroinflammation. Regarding VaD, previous studies 21, 22 proposed that mild to moderate alcohol consumption may be beneficial to the vascular system, with beneficial effects on platelet function and increased serum concentration of high-density lipoprotein. However, excessive alcohol consumption also has various harmful effects through direct mechanisms, such as the proven neurotoxic effect of alcohol and nutritional deficiency.23 Additionally, excessive alcohol consumption is thought to exacerbate the pathology of AD through enhanced tau accumulation 24 and the destruction of cholinergic neurons accompanied by decreased acetylcholine release.25 Our study showed that initiation of mild alcohol consumption was associated with a decreased risk of all-cause dementia and AD, which, to our knowledge, has never been reported in previous studies. Although mild to moderate alcohol consumption has been reported to confer beneficial effects on cardiovascular disease, 26, 27 debate persists with respect to numerous other outcomes.28 None of the existing health guidelines recommends starting alcohol drinking. The 2015 to 2020 Dietary Guidelines for Americans does not recommend that individuals begin drinking or drink more for any reason.13 Moreover, personal metabolic characteristics (sex, body weight, and acetaldehyde dehydrogenase type 29 ) and susceptibility to alcohol vary individually, thereby making it difficult to find the optimal level of alcohol for each individual. Furthermore, alcohol consumption is a marker for several lifestyle factors, and a mild to moderate level of drinking is considered an important component of social activities. Several studies suggest that more frequent social contact decreases the risk of dementia.30 It is difficult to draw conclusions from our results without fully understanding the socioeconomic reasons underlying the changes in drinking patterns. Given the ethical limitations of a randomized clinical trial able to sufficiently establish causality, additional studies that further support our conclusion are required before clinical application of these findings. Our results showed that quitting from any level of alcohol consumption was associated with a higher risk of all-cause dementia, AD, and VaD, which is in line with a previous report.4, 5 The results observed in the quitters are suspected to be primarily attributed to the sick quitter effect, which is defined as a person quitting (or reducing) a certain hazardous activity because of health issues.31 Sabia et al 4 found the excess risk of dementia associated with abstinence was partly explained by cardiometabolic disease (stroke, coronary heart disease, atrial fibrillation, heart failure, and diabetes). Uncaptured medical comorbidities or health consequences leading to quitting may exist in our study. To minimize possible reverse causality, we conducted a subgroup analysis with 3 assessments and applied a 1-year lag time, but the sick quitter effect remains a source of potential bias. In our study, nondrinkers seemed to have other risk factors, including being older and lower income. Although existing evidence points to a downward trend in alcohol consumption as people age, 32, 33 in our age-stratified analyses, the association between change in alcohol consumption with risk of dementia was similar between the younger than 65 years age group and the 65 years and older age group. Regarding the association of socioeconomic status with alcohol consumption, people in higher socioeconomic status groups seem to drink more often and drink smaller amounts more frequently, whereas lower socioeconomic status groups have a higher proportion of abstainers, but otherwise drink more often in problematic ways.34 Although we adjusted for several socioeconomic characteristics in our analyses, we admit that the measures did not fully address the social capital aspect of socioeconomic status and health problems. Thus, the exact nature of these complex relationships warrants further investigation. Interestingly, reducing alcohol consumption from a heavy (≥30 g per day) to a moderate level (15-29.9 g per day) was associated with an 8% decreased risk of all-cause dementia and a 12% decreased risk of AD in our study. In subgroup analysis of participants who underwent 3 health examinations, in which mild and moderate drinking levels were merged into a single mild-moderate level because of the small number of cases, among those who reduced their alcohol intake from a heavy level in 2009 to mild-moderate level in 2011 and mild-moderate level in 2013, there was a decreased aHR for all-cause dementia (aHR, 0.92; 95% CI, 0.83-1.03). A possible interpretation of this result is that sustaining heavy alcohol drinking is detrimental to dementia, which may be conceptually in line with a recent indication that excessive alcohol consumption (drinking >21 units of alcohol per week = 24 g per day) has been recognized as a new modifiable risk factor for dementia in the 2020 dementia prevention guidelines published by the Lancet Commission.30 This study has several limitations. First, alcohol consumption was self-reported in our study, which tends to underestimate the actual level of alcohol consumption.35 Second, the type of alcoholic beverage was not considered in our study.36, 37 Third, our study participants were limited to health screening participants, who might be healthier and more engaged in a healthy lifestyle than the general population.38 Fourth, although our models were adjusted for various potential confounders, unmeasured confounders, including genetic ones (eg, APOE ), 5, 9 might still distort the results. Fifth, caution is required when applying our results to ethnic groups other than Korean individuals, because the genetic background for alcohol metabolism 39 and drinking culture vary depending on ethnicity. In conclusion, our analyses indicate that maintaining mild to moderate alcohol consumption is associated with a decreased risk of dementia, whereas maintaining heavy drinking is associated with an increased risk of dementia. Notably, our analyses stratified by the initial amount of alcohol consumption indicate that reduction of drinking from a heavy to a moderate level and initiation of mild drinking were associated with a decreased risk of all-cause dementia and AD. Accepted for Publication: December 19, 2022. Published: February 6, 2023. doi: 10.1001/jamanetworkopen.2022.54771 Open Access: This is an open access article distributed under the terms of the CC-BY License, © 2023 Jeon KH et al. JAMA Network Open, Corresponding Authors: Dong Wook Shin, MD, DrPH, MBA, Department of Family Medicine/Supportive Care Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-Ro, Gangnam-gu, Seoul 06351, Republic of Korea ( [email protected] ); Kyungdo Han, PhD, Department of Statistics and Actuarial Science, Soongsil University, 369 Sangdo-ro, Dongjak-gu, Seoul, 06978, Republic of Korea ( [email protected] ). Author Contributions: Dr Shin had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. Concept and design: Jeon, Han, Kim, Shin. Acquisition, analysis, or interpretation of data: Jeon, Jeong, Park, J.E. Yoo, J. Yoo, Lee, Kim, Shin. Drafting of the manuscript: Jeon, Han, Shin. Critical revision of the manuscript for important intellectual content: Jeon, Jeong, Park, J.E. Yoo, J. Yoo, Lee, Kim, Shin. Statistical analysis: Jeon, Han, J. Yoo. Obtained funding: Shin. Administrative, technical, or material support: Park, J.E. Yoo, Shin. Supervision: Kim, Shin. Conflict of Interest Disclosures: None reported. Data Sharing Statement: See Supplement 2,8. Handing EP, Andel R, Kadlecova P, Gatz M, Pedersen NL. Midlife alcohol consumption and risk of dementia over 43 years of follow-up: a population-based study from the Swedish Twin Registry. J Gerontol A Biol Sci Med Sci,2015;70(10):1248-1254. doi: 10.1093/gerona/glv038 PubMed Google Scholar Crossref 14. Yoo JE, Han K, Kim B, et al. Changes in physical activity and the risk of dementia in patients with new-onset type 2 diabetes: a nationwide cohort study. Diabetes Care,2022;45(5):1091-1098. doi: 10.2337/dc21-1597 PubMed Google Scholar Crossref 19. Anstey KJ, Ee N, Eramudugolla R, Jagger C, Peters R. A systematic review of meta-analyses that evaluate risk factors for dementia to evaluate the quantity, quality, and global representativeness of evidence. J Alzheimers Dis,2019;70(s1):S165-S186. doi: 10.3233/JAD-190181 PubMed Google Scholar Crossref 20. Collins MA, Neafsey EJ, Wang K, Achille NJ, Mitchell RM, Sivaswamy S. Moderate ethanol preconditioning of rat brain cultures engenders neuroprotection against dementia-inducing neuroinflammatory proteins: possible signaling mechanisms. Mol Neurobiol,2010;41(2-3):420-425. doi: 10.1007/s12035-010-8138-0 PubMed Google Scholar Crossref 21. Piano MR. Alcohol’s effects on the cardiovascular system. Alcohol Res,2017;38(2):219-241. PubMed Google Scholar 22. Brien SE, Ronksley PE, Turner BJ, Mukamal KJ, Ghali WA. Effect of alcohol consumption on biological markers associated with risk of coronary heart disease: systematic review and meta-analysis of interventional studies. BMJ,2011;342:d636. doi: 10.1136/bmj.d636 PubMed Google Scholar Crossref 25. Tyas SL. Alcohol use and the risk of developing Alzheimer’s disease. Alcohol Res Health,2001;25(4):299-306. PubMed Google Scholar 26. Bell S, Daskalopoulou M, Rapsomaniki E, et al. Association between clinically recorded alcohol consumption and initial presentation of 12 cardiovascular diseases: population based cohort study using linked health records. BMJ,2017;356:j909. doi: 10.1136/bmj.j909 PubMed Google Scholar Crossref 28. World Health Organization. Global Status Report on Alcohol and Health 2018, World Health Organization; 2018.34. Collins SE. Associations between socioeconomic factors and alcohol outcomes. Alcohol Res,2016;38(1):83-94. PubMed Google Scholar 36. Schaefer SM, Kaiser A, Behrendt I, Eichner G, Fasshauer M. Association of alcohol types, coffee, and tea intake with risk of dementia: prospective cohort study of UK Biobank participants. Brain Sci,2022;12(3):360. doi: 10.3390/brainsci12030360 PubMed Google Scholar Crossref 39. Chen J, Huang W, Cheng CH, Zhou L, Jiang GB, Hu YY. Association between Aldehyde dehydrogenase-2 polymorphisms and risk of Alzheimer’s disease and Parkinson’s disease: a meta-analysis based on 5,315 individuals. Front Neurol,2019;10:290. doi: 10.3389/fneur.2019.00290 PubMed Google Scholar Crossref

What age does alcohol induced dementia start?

Increased risk of head injuries – If a person regularly drinks too much alcohol, they also have a higher risk of repeated head injuries. While under the effects of alcohol they may fall and hit their head, or receive blows to the head in fights or as victims of violence.

Both can cause lasting damage to the brain.
A person with ARBD may experience all of these types of damage.
The different types of damage are linked to different types of ARBD.
For example, Wernicke–Korsakoff syndrome is most closely linked with low levels of thiamine (vitamin B1).
Usually a person is diagnosed with a specific type of ARBD.

Depending on their symptoms, they may have one of several conditions, including: The two main types of ARBD that can cause symptoms of dementia are alcohol-related ‘dementia’ and Wernicke–Korsakoff syndrome. Neither of these are actual types of dementia, because you cannot get better from dementia, and there is some chance of recovery in both of these conditions.

A person who has ARBD won’t only have problems caused by damage to their brain. They will usually also be addicted to alcohol. This means that they have become dependent on it. Addiction can make it much more difficult to treat a person with ARBD. This is because professionals need to treat the person’s alcohol addiction together with their symptoms related to memory and thinking.

About one in 10 people with dementia have some form of ARBD. In people with (who are younger than 65 years old) ARBD affects about one in eight people. It is likely – for a wide range of reasons – that the condition is under-diagnosed. This means that the number of people living with ARBD is probably higher.

People who are diagnosed with ARBD are usually aged between about 40 and 50. This is younger than the age when people usually develop the more common types of dementia, such as Alzheimer’s disease. It is not clear why some people who drink too much alcohol develop ARBD, while others do not. ARBD affects men much more often than women.

However, women who have ARBD tend to get it at a younger age than men, and after fewer years of alcohol misuse. This is because women are at a greater risk of the damaging effects of alcohol. What kind of information would you like to read? Use the button below to choose between help, advice and real stories.

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We will remember your selection for future visits; you can change your choices at any time : Alcohol-related brain damage (ARBD): what is it and who gets it?

Does 3 glasses of wine a day prevent dementia?

– Source: CNN ” data-fave-thumbnails=”, “small”: }” data-vr-video=”” data-show-html=”” data-check-event-based-preview=”” data-network-id=”” data-details=””> VIDEO: These are the questions doctors ask to figure out if you have dementia 02:53 – Source: CNN CNN — Keeping alcohol consumption to one or two drinks a day lessened the odds of developing dementia, according to a study of nearly 4 million South Koreans. However, drinking more than two drinks a day increased that risk, according to the study published Monday in the journal JAMA Network Open. “We found that maintaining mild to moderate alcohol consumption as well as reducing alcohol consumption from a heavy to moderate level were associated with a decreased risk of dementia,” said first author Dr. Keun Hye Jeon, an assistant professor at CHA Gumi Medical Center, CHA University in Gumi, South Korea, in an email. But don’t rush to the liquor store, experts say. “This study was well done and is extremely robust with 4 million subjects, but we should be cautious not to over interpret the findings,” said Alzheimer’s researcher Dr. Richard Isaacson, a preventive neurologist at the Institute for Neurodegenerative Diseases of Florida. He was not involved in the new study. Alcohol use can be a risk factor for breast and other cancers, and consuming too much can contribute to digestive problems, heart and liver disease, hypertension, stroke, and a weak immune system over time, according to the US Centers for Disease Control and Prevention. There are red flags for Alzheimer’s as well. For example, if a person has one or two copies of the APOE4 gene variant, which raises your risk of developing the mind-wasting disease, drinking is not a good choice, Isaacson said. “Alcohol has been shown to be harmful for brain outcomes in people with that risk gene — and about 25% of the US population carries one copy of APOE4,” he said. The new study examined the medical records of people covered by the Korean National Health Insurance Service (NHIS), which provides a free health exam twice a year to insured South Koreans who are 40 and older. In addition to doing various tests, examiners asked about each person’s drinking, smoking and exercise habits. The study looked at the data collected in 2009 and 2011 and categorized people by their self-reported drinking levels. If a person said they drank less than 15 grams (approximately 0.5 ounces) of alcohol a day, they were considered “mild” drinkers. In the United States, a standard drink contains 14 grams of alcohol, which is roughly the same as 12 ounces of regular beer, 5 ounces of wine or 1.5 ounces of distilled spirits. If study participants told doctors they drank 15 to 29.9 grams a day — the equivalent of two standards drinks in the US — the researchers categorized them as “moderate” drinkers. And if people said they drank over 30 grams, or three or more drinks a day, researchers considered them “heavy” drinkers. Researchers also looked at whether people sustained or changed the amount they drank between 2009 and 2011, Jeon said. “By measuring alcohol consumption at two time points, we were able to study the relationship between reducing, ceasing, maintaining and increasing alcohol consumption and incident dementia,” he said. The team then compared that data to medical records in 2018 — seven or eight years later — to see if anyone studied had been diagnosed with dementia. After adjusting for age, sex, smoking, exercise level and other demographic factors, researchers found people who said they drank at a mild level over time — about a drink a day — were 21% less likely to develop dementia than people who never drank. People who said they continued to drink at moderate level, or about two drinks a day, were 17% less likely to develop dementia, the study found. “One has to be cautious when interpreting studies using medical records. They can be fraught with challenges in how diseases are coded and studied,” Isaacson said. “Any anytime you ask people to recall their behaviors, such as drinking, it leaves room for memory errors.” The positive pattern did not continue as drinking increased. People who drank heavily — three or more drinks a day — were 8% more likely to be diagnosed with dementia, the study found. If heavy drinkers reduced their drinking over time to a moderate level, their risk of being diagnosed with Alzheimer’s fell by 12%, and the risk of all-cause dementia fell by 8%. However, people aren’t very good at judging how much alcohol they are drinking, Isaacson said. “People don’t really monitor their pours of wine, for example,” Isaacson said. “They may think they are drinking a standard-sized glass of wine, but it’s really a glass and a half every time. Drink two of those pours and they’ve had three glasses of wine. That’s no longer mild or moderate consumption.” In addition, too many people who think they are moderate drinkers do all of their drinking on weekends. Binge drinking is on the rise worldwide, even among adults, studies show, “If someone downs five drinks on Saturday and Sunday that’s 10 drinks a week so that would qualify as a moderate alcohol intake,” Isaacson said. “To me, that is not that is not the same as having a glass of wine five days a week with a meal, which slows consumption.” The new study also found that starting to drink at a mild level was associated with a decreased risk of all-cause dementia and Alzheimer’s, “which, to our knowledge, has never been reported in previous studies,” the authors wrote. However, “none of the existing health guidelines recommends starting alcohol drinking,” Jeon said, adding that since the study was observational, no cause and effect can be determined. “Our findings regarding a initiation of mild alcohol consumption cannot be directly translated into clinical recommendations, thereby warranting additional studies to confirm these associations further,” Jeon said. A study published in March 2022 found that just one pint of beer or glass of wine a day can shrink the overall volume of the brain, with the damage increasing as the number of daily drinks rises. On average, people between 40 and 69 who drank a pint of beer or 6-ounce glass of wine per day for a month had brains that appeared two years older than those who only drank half of a beer, according to that previous study. “I’ve never personally suggested someone to start drinking moderate amounts of alcohol if they were abstinent,” Isaacson said. “But there’s really not a one-size-fits-all approach towards counseling a patient on alcohol consumption.”

Is three glasses of wine a night too much?

What Are Healthy Amounts Of Wine To Drink? – Men and women have different wine drinking limits, as both genders are affected by alcohol differently. Women are more likely to get tipsy or intoxicated faster than men, as their body has higher amounts of water.

Less alcohol is metabolized in their body, going into their bloodstream, creating a sensitivity to alcohol.
Experts say a a good maximum amount of wine for women would be a 5 oz glass of wine, and for men two 5 oz glasses of wine, no more than several times a week.
Experts strongly advise women against having more than 3 drinks of wine per day, and for men, 4 drinks of wine per day.

People may be tempted to drink more wine as a serving of wine, which averages 12.5% alcohol, has lower amounts of alcohol compared to hard liquor, however, drinking greater volumes of wine negates this difference. Exercising moderation in drinking wine can help individuals avoid the risk of binge drinking.

Men who drink 5 or more drinks in a 2-hour time frame and Women who drink 4 or more drinks in a 2-hour time frame

How long can you live with alcohol dementia?

Understanding Wernicke-Korsakoff Syndrome – So, what—exactly—is a “wet brain?” According to the National Organization for Rare Disorders, Wernicke-Korsakoff syndrome is really two different disorders. Wernicke’s is a neurological disease characterized by “confusion, the inability to coordinate voluntary movement and eye (ocular) abnormalities,” while Korsakoff’s is a mental disorder characterized by disproportionate memory loss.

Because the ability to form new memories is almost nonexistent, a person with Wernick-Korsakoff syndrome might be too confused to find their way out of a room or remember what’s been said just 20 minutes before, consistently repeating questions or comments during a conversation.
As summarized by healthline.com, “Wernicke’s disease affects the nervous system and causes visual impairments, a lack of muscle coordination, and mental decline.

If Wernicke’s disease is left untreated, it can lead to Korsakoff syndrome. Korsakoff syndrome permanently impairs memory functions in the brain.” How does wet brain kill you? Without thiamine, the tissue of the brain begins to deteriorate. Korsakoff’s syndrome dementia affects not just the brain, but also the cardiovascular and central nervous system.

Once a person has been diagnosed with end stage alcoholism, life expectancy can be as limited as six months. In many ways, a person struggling with alcohol addiction and showing symptoms of second-phase wet brain acts much like someone with Alzheimer’s disease. Based on statistics from the National Institute on Alcohol Abuse and Alcoholism, 90 percent of alcoholics suffering from stage 1 symptoms go on to develop stage 2, with some overlap between the stages and symptoms.

Symptoms: Stage 1

Drowsiness and paralysis of eye movements Rapid, tremor-like eye movements Visual and auditory hallucinations Ataxia (unsteady gait caused by weakness in limbs or lack of muscle coordination) Affected sense of smell Delirium Tremens (the shakes) Confusion, agitation or inattentiveness

Symptoms: Stage 2

Alcohol-related memory loss (from mild to severe) Disorientation with regard to time and place Distorted or misinterpreted memories Made up or invented information to compensate for poor memory Mental disturbances Dementia Hallucinations Impaired ability to learn new tasks Coma (advanced stages)

About 1-2 percent of the population is affected by wet brain, according to research by the National Organization for Rare Disorders. Men suffering from alcohol abuse, between 30-70 years, are slightly more affected than women of the same age. Of those who develop Wernicke-Korsakoff syndrome, about 25 percent require long-term treatment in a hospital setting.

There’s no single test for the syndrome, but a good indication, particularly when disorientation and confusion are apparent, is testing vitamin B1 levels in the blood. Research conducted by the Alzheimer’s Association estimates that when caught early enough, approximately 25 percent of people will recover, 50 percent will improve and 25 percent will stay the same.

However, once the syndrome has progressed to the point of no return—no new memories or experiences, no reversing the symptoms—the disease is generally fatal. The grim reality of chronic alcohol abuse is that the body can only handle so much; and Wernicke-Korsakoff syndrome is a tragic, heartbreaking consequence of the abusive nature of alcoholism.

Does lack of alcohol cause dementia?

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.

Why do I not remember when I drink?

What Are Blackouts? – Alcohol-related blackouts are gaps in a person’s memory for events that occurred while they were intoxicated. These gaps happen when a person drinks enough alcohol to temporarily block the transfer of memories from short-term to long-term storage—known as memory consolidation—in a brain area called the hippocampus.

Is drinking a bottle of wine every day an alcoholic?

Difference Between Alcohol Abuse And Drinking In Moderation – Moderate drinking, means following the guidelines of a national institute like the NHS to drink within the recommended limit. The current dietary guidelines recommend that men and women must not consume more than 14 units of alcohol within a single week.

Will my memory get better if I stop drinking wine?

Health panel: How can I improve my memory? I overdosed last year, and because my brain lacked oxygen before I was discovered, I’ve been left with terrible memory problems – I can’t even remember the events leading up to the overdose. I don’t want to tell anyone about my past, but my poor memory is affecting my life in all sorts of ways, including the type of jobs I can apply for (anything with lots of computer work is a no-no) and also my relationships, as people get very irritated at having to repeat themselves.

I’ve also totally lost my sense of direction – I find getting from A to B, even if it’s only minutes away, very difficult. I have managed to kick heroin but I remain an alcoholic, drinking typically around nine pints a night. My doctor says my memory is now as good as it’s going to get. I’m depressed and anxious as I’m only 37, and feel I’m living a half life.

Do wine drinkers have better memory health?

Introduction – The consumption of alcohol and tobacco are considered unhealthy habits, harmful to health, and are related to the development of pathologies such as cardiovascular diseases (CVD), digestive system diseases, hypertension, diabetes mellitus, or cognitive deterioration among others, representing a serious problem for public health ( 1 – 3 ).

Indeed, alcohol consumption increases the risk of dementia, especially early-onset dementia ( 4 – 10 ), indicating a negative impact of alcohol consumption on different areas of familial, social, and cultural wellbeing ( 11 – 13 ). The alcohol consumption recommendations established by the WHO are 30 g for men and 20 g for women, 3 standard drinking units (SBUs), and 2 SBUs, respectively, as 1 SBU corresponds to 10 g of pure alcohol ( 14 ).

It has been suggested that low-to-moderate alcohol consumption could be beneficial to the health of middle-aged ( 15 ) and older subjects ( 16 – 18 ), leading to a J-shaped or inverse U-shaped association between alcohol and cognitive function, heart disease ( 19, 20 ) and all-cause mortality ( 21 ).

Furthermore, and according to previous systematic reviews, moderate alcohol consumption appears to be associated with a lower risk of cognitive impairment, dementia, Alzheimer’s disease, and better cognition ( 9, 22 ), which may be linked to its effects on cardiovascular disease ( 22 ).
These effects of alcohol consumption are not observed for vascular dementia ( 9 ), neither for heavy, chronic, and irregular alcohol consumption which are associated with an increased risk of cognitive impairment or dementia ( 13 ).

Further analysis of the data indicates that the effect of alcohol depends on the type of alcoholic beverage analyzed ( 20 ), distinguishing between beer, white wine, red wine, fortified wine, and spirits ( 23 ). Although wine consumption has been associated with a reduced risk of cerebrovascular disease and Alzheimer’s disease ( 24 ), there is controversy as to whether these benefits are also reported for beer and other spirits ( 4, 25 ).

The specific characteristics of wine could be the reason for its benefits. Wine is produced from the fermentation of grapes, and yeast is added, causing the sugars present in the grapes to be converted into ethanol, endowing wine with different nutritional properties. It has been reported that some components of wine, such as resveratrol, phenolic acids, and flavonoids, may exert positive health effects ( 26 ).

Previous research has shown that these components reduce free cholesterol ( 27 ), have a cardioprotective effect ( 28 ), induce endothelial relaxation ( 29 ), activate NO synthase ( 30 ), inhibit platelet aggregation, and ( 31 ) prevent oxidation of low-density lipoproteins (LDL) cholesterol ( 32 ).

Is it OK to drink wine every evening?

Are There Potential Downsides To Drinking Wine Every Night? – Alcohol intake at excessive amounts can be harmful. Binge drinking or consuming large amounts of alcohol is associated with negative health results. Heavy alcohol intake can lead to several health problems, such as pancreatic and liver diseases, heart disease, diabetes, cancers, and unintentional injuries.

It can also lead to weight gain, decreased immune function, and mental health issues,
Drinking wine in moderation delivers health benefits, while heavy drinking can negatively impact one’s health.
It is recommended that certain individuals abstain from consuming alcohol or quit drinking entirely, including pregnant women, minors, and those on specific medications,

Drinking a bottle of wine or having more than a few drinks daily can affect liver health, resulting in liver damage or liver disease,

Does alcohol contribute to dementia guardian?

Binge drinking ‘increases risk’ of dementia The following correction was printed in the Observer’s For the record column, Sunday 24 May 2009. Below we quoted Dr Jane Marshall of London’s Maudsley Hospital as saying alcohol is more likely to help induce dementia in women than men because “women have more body water and less body fat” than men.

It is the other way round; the ratio of water to fat is lower in the female than the male. Ethanol (alcohol) is distributed in water so for a given body weight its concentration in water (thus the blood stream) tends to be higher in the female than the male. Heavy drinking may be to blame for one in four cases of dementia.

Doctors have linked alcohol intake to the development of the brain-wasting condition in between 10 and 24% of the estimated 700,000 people in the UK with the disease. They warn that binge drinking and increased consumption are likely to produce an epidemic of alcohol-related brain damage in the future, which could see drinkers starting to experience serious memory problems in their 40s.

Women who drink a lot are at much greater risk than men of suffering problems with their cognitive functions, because they are physiologically less well able to cope with alcohol’s effects. Drink is known to kill brain cells, but the estimate of its impact on neurological health, contained in the journal and Alcoholism, indicates that the problem may be much more widespread than previously thought.

The rise in the amounts that people drink means “it is therefore likely that prevalence rates of alcohol-related brain damage are currently underestimated and may rise in future generations”, say the authors. Dr Jane Marshall, one of the co-authors and consultant psychiatrist at the Maudsley Hospital in south London, said: “People think that dementia is something that happens to people over 65.

But a lot of those under 65 have got cognitive problems and a large proportion of the problems in that group are related to alcohol. Alcohol-related brain damage may account for 10-24% of all cases of all forms of dementia. We know that alcohol is associated with serious cognitive impairment. It reduces memory and general cognition,” she added.

These findings follow research in America last year indicating that consuming more than two drinks a day can bring forward the onset of Alzheimer’s by as much as 4.8 years. Two thirds of all the 700,000 people in the UK with dementia have Alzheimer’s.

Drink is more likely to help induce dementia in women than men because women have more body water and less body fat, which means that they metabolise alcohol differently and so are more vulnerable,” said Marshall. Women who drink the same as men have a higher risk of cognitive impairment for that reason, in the same way that they are at higher risk of getting alcohol-related liver disease.

However, a heavy drinker of either sex who abstains from alcohol can expect to see brain cells regenerate and improvements in key areas of brain activity. Gayle Willis of the Alzheimer’s Society said: “We know that the prolonged use of alcohol can lead to memory deficiencies.

Only one third of the people with Alzheimer’s are diagnosed, but the problem of under-diagnosis of people with alcohol-related memory impairment could be even greater.” But the society believes that only a handful of all cases of dementia, perhaps as few as 3%, are directly attributable to alcohol.
Marshall and her colleagues examined Korsakoff’s syndrome, a little-known form of dementia linked to alcohol intake, characterised by short-term memory loss, changes in behaviour and confusion.

It is increasingly common in Scotland and the Netherlands, especially among poorer people with poor diets. One study of sufferers found that half were under 50. Professor Ian Gilmore, president of the Royal College of Physicians, said: “It is really concerning that awareness among clinical staff of this important link between alcohol and dementia remains poor, yet detection of early signs often gives a real chance of successfully heading off the condition.

It is vital that we improve understanding among doctors and nurses about the links between heavy drinkers and neurological damage.
Equally important is that people understand that alcohol-related brain damage can strike at any time of life.” Other research has shown that moderate drinking, of up to two drinks a day, can help protect against the onset of dementia.

Dr Allan Thomson, the guest editor of Alcohol and Alcoholism and spokesman for the Medical Council on Alcohol, has written to Dawn Primarolo, the public health minister, warning that the NHS must give alcohol-related brain damage the same priority it has put into liver problems linked to heavy drinking.