Moderate, Regular Alcohol Consumption is Associated with Higher Cognitive Function in Older Community-Dwelling Adults

Abstract

Background: Evidence suggests that moderate alcohol consumption may protect against cognitive decline and dementia. However, uncertainty remains over the patterns of drinking that are most beneficial.

Objective: To examine associations between amount and frequency of alcohol consumption with multiple domains of cognitive function in a well-characterized cohort of older community-dwelling adults in southern California.

Design: Observational, cross-sectional cohort study.

Setting: A research visit between 1988-1992 in Rancho Bernardo, California.

Participants: 1624 participants of the Rancho Bernardo Study (mean age ± SD = 73.2 ± 9.3 years). Measurements: Participants completed a neuropsychological test battery, self-administered questionnaires on alcohol consumption and lifestyle, and a clinical health evaluation. We classified participants according to average amount of alcohol intake into never, former, moderate, heavy and excessive drinkers, and according to frequency of alcohol intake, into non-drinkers, rare, infrequent, frequent and daily drinkers. We examined the association between alcohol intake and cognitive function, controlling for age, sex, education, exercise, smoking, waist-hip ratio, hypertension and self-assessed health.

Results: Amount and frequency of alcohol intake were significantly associated with cognitive function, even after controlling for potentially related health and lifestyle variables. Global and executive function showed positive linear associations with amount and frequency of alcohol intake, whereas visual memory showed an inverted U-shaped association with alcohol intake, with better performance for moderate and infrequent drinkers than for non-drinkers, excessive drinkers or daily drinkers.

Conclusions: In several cognitive domains, moderate, regular alcohol intake was associated with better cognitive function relative to not drinking or drinking less frequently. This suggests that beneficial cognitive effects of alcohol intake may be achieved with low levels of drinking that are unlikely to be associated with adverse effects in an aging population.

Keywords: Cognitive aging; drinking frequency; drinking quantity; executive function; visual memory.

Figure 1

Multivariable adjusted means on each neuropsychological test are shown for each alcohol consumption group. Trails B scores are plotted with an inverted scale because lower scores indicate better performance. Scores differed significantly by amount of alcohol intake on the MMSE (A), Trails B (B) and immediate visual recall (C) tests. There were no significant effects of alcohol on category fluency (D), delayed visual recall (E) or Selective Reminding (F) scores. (p’s < 0.05, adjusted for age, sex, education, exercise, smoking, waist-hip ratio, hypertension and health.) Error bars represent the standard error of the mean.

Figure 2

Multivariable adjusted means on each neuropsychological test are plotted according to average frequency of alcohol consumption. Trails B scores are plotted with an inverted scale because lower scores indicate better performance. MMSE (A), Trails B (B), immediate (C) and delayed visual recall (E) scores significantly differed by frequency of alcohol consumption. There were no significant differences by drinking frequency on category fluency (D) or Selective Reminding (F) scores. (p’s < 0.05, adjusted for age, sex, education, exercise, smoking, waist-hip ratio, hypertension and health.) Error bars represent the standard error of the mean.