Cognitive decline and alcohol consumption in the aging population-A longitudinal analysis of the Survey of Health, Ageing and Retirement in Europe

Abstract

Background: Prevalence of cognitive decline and dementia is rising globally, with more than 10 million new cases every year. These conditions cause a significant burden for individuals, their caregivers, and health care systems. As no causal treatment for dementia exists, prevention of cognitive decline is of utmost importance. Notably, alcohol is among the most significant modifiable risk factors for cognitive decline.

Methods: Longitudinal data across 15 years on 6,967 individuals of the Survey of Health, Ageing and Retirement in Europe were used to analyze the effect of alcohol consumption and further modifiable (i.e., smoking, depression, and educational obtainment) and non-modifiable risk factors (sex and age) on cognitive functioning (i.e., memory and verbal fluency). For this, a generalized estimating equation linear model was estimated for every cognitive test domain assessed.

Results: Consistent results were revealed in all three regression models: A nonlinear association between alcohol consumption and cognitive decline was found-moderate alcohol intake was associated with overall better global cognitive function than low or elevated alcohol consumption or complete abstinence. Furthermore, female sex and higher educational obtainment were associated with better cognitive function, whereas higher age and depression were associated with a decline in cognitive functioning. No significant association was found for smoking.

Conclusion: Our data indicate that alcohol use is a relevant risk factor for cognitive decline in older adults. Furthermore, evidence-based therapeutic concepts to reduce alcohol consumption exist and should be of primary interest in prevention measures considering the aging European population.

Keywords: Aged; alcohol use disorder; dementia; epidemiology; mild cognitive impairment.

Figure 1.

Results of the GEE model illustrating the effect of the analyzed risk factors on the cognitive dimension verbal fluency. For the set reference levels, see the section “Statistical analysis.” AD, consumption of alcoholic drinks; Euro-D, Euro-Depression-Scale-Score; education, years of education; age, age at baseline in groups of 10 years; timepoint, number of follow-up interview in reference to the baseline interview.

Figure 2.

Results of the GEE model illustrating the effect of the analyzed risk factors on the cognitive dimension verbal memory (short term). For the set reference levels, see the section “Statistical analysis.” AD, consumption of alcoholic drinks; Euro-D, Euro-Depression-Scale-Score; education, years of education; age, age at baseline in groups of 10 years; timepoint, number of follow-up interview in reference to the baseline interview.

Figure 3.

Results of the GEE model illustrating the effect of the analyzed risk factors on the cognitive dimension of delayed verbal memory. For the set reference levels, see the section “Statistical analysis.” AD, consumption of alcoholic drinks; Euro-D, Euro-Depression-Scale-Score; education, years of education; age, age at baseline in groups of 10 years; timepoint, number of follow-up interview in reference to the baseline interview.