Review

. 2023 Mar;118(3):412-424.

doi: 10.1111/add.16035. Epub 2022 Sep 4.

The relationship between alcohol use and dementia in adults aged more than 60 years: a combined analysis of prospective, individual-participant data from 15 international studies

Louise Mewton¹, Rachel Visontay¹, Nicholas Hoy¹, Darren M Lipnicki¹, Matthew Sunderland², Richard B Lipton^{3

4

5}, Maëlenn Guerchet⁶, Karen Ritchie^{7

8

9}, Jenna Najar^{10

11}, Nikolaos Scarmeas^{12

13}, Ki-Woong Kim^{14

15

16}, Steffi Riedel Heller¹⁷, Martin van Boxtel¹⁸, Erin Jacobsen¹⁹, Henry Brodaty¹, Kaarin J Anstey^{20

21

22}, Mary Haan²³, Marcia Scazufca²⁴, Elena Lobo^{25

26

27}, Perminder S Sachdev^{1

28}; Collaborators from the Cohort Studies of Memory in an International Consortium (COSMIC)

Affiliations

¹ Centre for Healthy Brain Ageing, University of New South Wales, Sydney, Australia.
² Neuropsychiatric Institute, The Prince of Wales Hospital, Sydney, Australia.
³ The Matilda Centre for Mental Health and Substance Use, University of Sydney, Sydney, Australia.
⁴ Saul R. Korey, Department of Neurology, Albert Einstein College of Medicine, Yeshiva University, New York, NY, USA.
⁵ Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Yeshiva University, New York, NY, USA.
⁶ Department of Psychiatry and Behavioral Medicine, Albert Einstein College of Medicine, Yeshiva University, New York, NY, USA.
⁷ Limoges University, CHU Limoges, EpiMaCT, Institute of Epidemiology and Tropical Neurology, OmegaHealth, Limoges, France.
⁸ Neuropsychiatry, Epidemiological and Clinical Research, La Colombière Hospital, Montpellier, France.
⁹ Université de Montpellier, Montpellier, France.
¹⁰ Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK.
¹¹ Neuropsychiatric Epidemiology Unit, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Centre for Ageing and Health (AGECAP) at the University of Gothenburg, Mölndal, Sweden.
¹² Region Västra Götaland, Sahlgrenska University Hospital, Psychiatry, Cognition and Old Age Psychiatry Clinic, Gothenburg, Sweden.
¹³ Department of Neurology, Aiginition Hospital, National and Kapodistrian University of Athens, Athens, Greece.
¹⁴ Department of Neurology, Columbia University, New York, NY, USA.
¹⁵ Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, South Korea.
¹⁶ Department of Psychiatry, College of Medicine, Seoul National University, Seoul, South Korea.
¹⁷ Department of Brain and Cognitive Sciences, Seoul National University, Seoul, South Korea.
¹⁸ Institute of Social Medicine, Occupational Health and Public Health (ISAP), Medical Faculty, University of Leipzig, Leipzig, Germany.
¹⁹ School for Mental Health and Neuroscience/Alzheimer Centrum Limburg, Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, the Netherlands.
²⁰ Department of Psychiatry, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA.
²¹ School of Psychology, University of New South Wales, Sydney, Australia.
²² Neuroscience Research Australia, University of New South Wales, Sydney, Australia.
²³ Centre for Research on Ageing, Health and Wellbeing, Australian National University, Canberra, Australia.
²⁴ Department of Epidemiology and Biostatistics, School of Medicine, University of California, San Francisco, CA, USA.
²⁵ LIM-23, Hospital das Clinicas (HCFMUSP), Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil.
²⁶ Department of Preventive Medicine and Public Health, Universidad de Zaragoza, Zaragoza, Spain.
²⁷ Instituto de Investigacion Sanitaria Aragon, Zaragoza, Spain.
²⁸ Centro de Investigacion Biomedica en Red de Salud Mental (CIBERSAM), Ministry of Science and Innovation, Madrid, Spain.

PMID: 35993434
PMCID: PMC9898084
DOI: 10.1111/add.16035

Review

The relationship between alcohol use and dementia in adults aged more than 60 years: a combined analysis of prospective, individual-participant data from 15 international studies

Louise Mewton et al. Addiction. 2023 Mar.

. 2023 Mar;118(3):412-424.

doi: 10.1111/add.16035. Epub 2022 Sep 4.

Authors

Affiliations

¹ Centre for Healthy Brain Ageing, University of New South Wales, Sydney, Australia.
² Neuropsychiatric Institute, The Prince of Wales Hospital, Sydney, Australia.
³ The Matilda Centre for Mental Health and Substance Use, University of Sydney, Sydney, Australia.
⁴ Saul R. Korey, Department of Neurology, Albert Einstein College of Medicine, Yeshiva University, New York, NY, USA.
⁵ Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Yeshiva University, New York, NY, USA.
⁶ Department of Psychiatry and Behavioral Medicine, Albert Einstein College of Medicine, Yeshiva University, New York, NY, USA.
⁷ Limoges University, CHU Limoges, EpiMaCT, Institute of Epidemiology and Tropical Neurology, OmegaHealth, Limoges, France.
⁸ Neuropsychiatry, Epidemiological and Clinical Research, La Colombière Hospital, Montpellier, France.
⁹ Université de Montpellier, Montpellier, France.
¹⁰ Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK.
¹¹ Neuropsychiatric Epidemiology Unit, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Centre for Ageing and Health (AGECAP) at the University of Gothenburg, Mölndal, Sweden.
¹² Region Västra Götaland, Sahlgrenska University Hospital, Psychiatry, Cognition and Old Age Psychiatry Clinic, Gothenburg, Sweden.
¹³ Department of Neurology, Aiginition Hospital, National and Kapodistrian University of Athens, Athens, Greece.
¹⁴ Department of Neurology, Columbia University, New York, NY, USA.
¹⁵ Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, South Korea.
¹⁶ Department of Psychiatry, College of Medicine, Seoul National University, Seoul, South Korea.
¹⁷ Department of Brain and Cognitive Sciences, Seoul National University, Seoul, South Korea.
¹⁸ Institute of Social Medicine, Occupational Health and Public Health (ISAP), Medical Faculty, University of Leipzig, Leipzig, Germany.
¹⁹ School for Mental Health and Neuroscience/Alzheimer Centrum Limburg, Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, the Netherlands.
²⁰ Department of Psychiatry, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA.
²¹ School of Psychology, University of New South Wales, Sydney, Australia.
²² Neuroscience Research Australia, University of New South Wales, Sydney, Australia.
²³ Centre for Research on Ageing, Health and Wellbeing, Australian National University, Canberra, Australia.
²⁴ Department of Epidemiology and Biostatistics, School of Medicine, University of California, San Francisco, CA, USA.
²⁵ LIM-23, Hospital das Clinicas (HCFMUSP), Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil.
²⁶ Department of Preventive Medicine and Public Health, Universidad de Zaragoza, Zaragoza, Spain.
²⁷ Instituto de Investigacion Sanitaria Aragon, Zaragoza, Spain.
²⁸ Centro de Investigacion Biomedica en Red de Salud Mental (CIBERSAM), Ministry of Science and Innovation, Madrid, Spain.

PMID: 35993434
PMCID: PMC9898084
DOI: 10.1111/add.16035

Erratum in

Correction to 'The relationship between alcohol use and dementia in adults aged more than 60 years: a combined analysis of prospective, individual-participant data from 15 international studies'.
[No authors listed] [No authors listed] Addiction. 2024 Oct;119(10):1848. doi: 10.1111/add.16512. Epub 2024 Apr 18. Addiction. 2024. PMID: 38637890 Free PMC article. No abstract available.

Abstract

Aim: To synthesize international findings on the alcohol-dementia relationship, including representation from low- and middle-income countries.

Methods: Individual participant data meta-analysis of 15 prospective epidemiological cohort studies from countries situated in six continents. Cox regression investigated the dementia risk associated with alcohol use in older adults aged over 60 years. Additional analyses assessed the alcohol-dementia relationship in the sample stratified by sex and by continent. Participants included 24 478 community dwelling individuals without a history of dementia at baseline and at least one follow-up dementia assessment. The main outcome measure was all-cause dementia as determined by clinical interview.

Results: At baseline, the mean age across studies was 71.8 (standard deviation = 7.5, range = 60-102 years), 14 260 (58.3%) were female and 13 269 (54.2%) were current drinkers. During 151 636 person-years of follow-up, there were 2124 incident cases of dementia (14.0 per 1000 person-years). When compared with abstainers, the risk for dementia was lower in occasional [hazard ratio (HR) = 0.78; 95% confidence interval (CI) = 0.68-0.89], light-moderate (HR = 0.78; 95% CI = 0.70-0.87) and moderate-heavy drinkers (HR = 0.62; 95% CI = 0.51-0.77). There was no evidence of differences between life-time abstainers and former drinkers in terms of dementia risk (HR = 0.98; 95% CI = 0.81-1.18). In dose-response analyses, moderate drinking up to 40 g/day was associated with a lower risk of dementia when compared with lif-time abstaining. Among current drinkers, there was no consistent evidence for differences in terms of dementia risk. Results were similar when the sample was stratified by sex. When analysed at the continent level, there was considerable heterogeneity in the alcohol-dementia relationship.

Conclusions: Abstinence from alcohol appears to be associated with an increased risk for all-cause dementia. Among current drinkers, there appears to be no consistent evidence to suggest that the amount of alcohol consumed in later life is associated with dementia risk.

Keywords: Alcohol; cross-national comparison; dementia; epidemiology; individual participant data meta-analysis; older adults.

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Conflict of interest statement

None.

Figures

**FIGURE 1**
Dose–response relationship between alcohol use (g/day) and dementia including life‐time abstainers (reference group) and current drinkers

**FIGURE 2**
Dose–response relationship between alcohol use (g/day) and dementia among current drinkers

See this image and copyright information in PMC

References

1. Global Burden of Disease (GBD) Collaborators . Estimation of the global prevalence of dementia in 2019 and forecasted prevalence in 2050: an analysis for the Global Burden of Disease Study 2019. Lancet Public Health. 2022;7:e105–25. - PMC - PubMed
1. Patterson C. World Alzheimer’s Report. The State of the Art of Dementia Research: New Frontiers. An Analysis of Prevalence, Incidence, Cost and Trends. London, UK: Alzheimer’s Disease International; 2018.
1. Livingston G, Huntley J, Sommerlad A, Ames D, Ballard C, Banerjee S, et al. Dementia prevention, intervention, and care: 2020 report of the Lancet Commission. Lancet. 2020;396:413–46. - PMC - PubMed
1. Rao R, Topiwala A. Alcohol use disorders and the brain. Addiction. 2020;115:1580–9. - PubMed
1. Topiwala A, Ebmeier KP. Effects of drinking on late‐life brain and cognition. Evid Based Ment Health. 2018;21:12–5. - PMC - PubMed

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The relationship between alcohol use and dementia in adults aged more than 60 years: a combined analysis of prospective, individual-participant data from 15 international studies

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The relationship between alcohol use and dementia in adults aged more than 60 years: a combined analysis of prospective, individual-participant data from 15 international studies

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