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Research Summary

Midlife Alcohol Consumption and Cognitive Decline

Some researchers suggest that lower-risk alcohol use may be associated with better cognitive function, but the impact of alcohol use on cognitive aging trajectories is not well known. This study examined the association between midlife alcohol use (assessed 3 times over a 10-year period) and cognitive decline (3 waves of cognitive assessment in the next 10-year period) in 5054 men and 2099 women (mean age=56), measuring global cognitive function, executive function, and memory.

  • Men with an average daily consumption of ≥36 g of alcohol showed a significantly faster decline on all cognitive measures compared with those with an average daily consumption of 0.1–19.9 g. The effect size was comparable to 2.4 extra years of decline for global cognitive function, 1.5 for executive function, and 5.7 for memory. There were no differences observed between 10-year abstainers, those who ceased alcohol use within the last 10 years, those with occasional alcohol use, those with an average daily consumption of 20–35.9 g, and those with an average daily consumption of 0.1–19.9 g.
  • In women, 10-year abstainers showed a faster decline in global cognitive function and executive function compared with those with an average daily consumption of 0.1–9.9 g. There were no other statistically significant differences between groups.

Note: Analyses were adjusted for age, ethnicity, education, occupation, marital status, smoking history, physical activity level, time since first cognitive evaluation, and interaction between each covariate and time.


In men, heavy alcohol use in midlife appears to be harmful to cognitive function, and no benefit was found for light to moderate use. Among women, abstainers showed a faster cognitive decline, but the number of abstainers was small and residual confounding is likely. No differences were observed among women with alcohol use, even though some results suggested that those with heavier use might experience a faster cognitive decline. Nicolas Bertholet, MD, MSc


Sabia S, Elbaz A, Britton A, et al. Alcohol consumption and cognitive decline in early old age. Neurology. 2014:28;82(4):332–339.