Alcohol consumption and risk of dementia and cognitive decline among older adults with or without mild cognitive impairment 

A study investigated whether alcohol consumption is associated with the risk of dementia and cognitive decline in older adults with or without mild cognitive impairment. The research also assessed the roles of mild cognitive impairment (MCI) and apolipoprotein E ε4 (APOE E4) genotype in modifying this association.
The study used data from the Ginkgo Evaluation of Memory Study, conducted from 2000 to 2008 among US community-dwelling participants. 3021 participants aged 72 years and older who were free of dementia were included in the study. The median age was 78 (76-80) years; 46.2% were female.
During an average follow-up of 6.0 years, 512 cases of dementia occurred. For 7.1 to 14.0 drinks per week compared with less than 1.0 drink per week, the hazard ratios for dementia were 0.63 (95% CI, 0.38-1.06) among 2,548 participants without MCI and 0.93 (95% CI, 0.47-1.84) among 473 participants with MCI. Among participants with MCI, the hazard ratio for dementia was 1.72 (95% CI, 0.87-3.40) for more than 14.0 drinks per week compared with less than 1.0 drink per week.
The association of alcohol intake with dementia differed for participants with and without baseline MCI (P for interaction = .03). Among participants without MCI, daily low-quantity drinking was associated with lower dementia risk than infrequent higher-quantity drinking (hazard ratio, 0.45; 95% CI, 0.23-0.89; P = .02). Findings were consistent when stratified by sex, age, and APOE E4 genotype.
Complete abstention (in participants without MCI) and the consumption of more than 14.0 US drinks of 14g per week or 28g per day (in participants with MCI) were associated with lower Modified Mini-Mental State Examination.
In this study, complete abstention and consuming more than 14.0 drinks per week (compared with drinking <1.0 drink per week) were associated with lower cognitive scores among participants aged 72 years and older. These findings suggest that physicians caring for older adults need to carefully assess the full dimensions of drinking behavior and cognition when providing guidance to patients about their alcohol consumption.
Source: Alcohol consumption and risk of dementia and cognitive decline among older adults with or without mild cognitive impairment. Manja Koch, PhD et al. JAMA Netw Open. 2019;2(9):e1910319.