Association between Alcohol Consumption and Risk of Dementia in Patients Aged 75 and Older

This population-based study in Germany evaluated the association between alcohol consumption, incident overall dementia, and Alzheimer dementia in a sample of 3202 primary-care patients aged ≥75 and free of dementia at baseline. Structured clinical interviews conducted at baseline, 1.5, and 3 years assessed for current quantity, frequency, and type of alcohol consumption and dementia diagnosis per DSM-IV criteria. For the 26% of patients not available for face-to-face follow-up at 3 years (including those who died over the study period), systematic assessments focusing particularly on dementia were obtained from primary-care physicians, relatives, or caregivers. Results were adjusted for sex, age, education, living situation, functional impairment, comorbid conditions, depression, apoE4 status, mild cognitive impairment, and smoking.

• Two-hundred seventeen patients (7%) met criteria for dementia during follow-up.

• Overall, patients who consumed alcohol had an approximately 30% lower risk for dementia (adjusted hazard ratio [HR], 0.71) and an approximately 40% lower risk for developing Alzheimer dementia (adjusted HR, 0.58) compared with nondrinkers.

• With regard to quantity of alcohol consumed (range, 1–40+ g per day), all HRs were lower than 1, although a statistically significant association was found only among patients who consumed light-to-moderate amounts (20–29 g) per day.

• No significant differences were seen based on type of alcoholic beverage consumed.

Comments:

Similar to results from younger subjects in previous studies, these results suggest moderate drinking is associated with less dementia, even among the very old. In this study, alcohol consumption was significantly associated with other factors protective for dementia (better education, not living alone, and absence of depression). However, even after controlling for these, the risk for dementia remained significantly lower among light-to-moderate alcohol consumers compared with nondrinkers. Part of the explanation may be that men and women who drink alcohol sensibly in old age have other lifestyle factors that promote physical and mental health.

R. Curtis Ellison, MD

Reference:

Weyerer S, Schäufele M, Wiese B, et al. Current alcohol consumption and its relationship to incident dementia: results from a 3-year follow-up study among primary care attenders aged 75 years and older. Age Ageing. March 2, 2011 (E-pub ahead of print), doi: 10.1093/ageing/afr007.