Oh y demencia

October 17, 2019

Relation Between Alcohol Use and Cognitive Impairment

Thomas L. Schwenk, MD reviewing Koch M et al. JAMA Netw Open2019 Sep 27

Among people in their 70s and 80s, associations between alcohol consumption and incident dementia depended on the baseline presence of mild cognitive impairment.

Researchers explored previous conflicting findings about a relation between alcohol intake and development of dementia by performing secondary analyses of a prior large prospective dementia clinical trial (JAMA 2008; 300:2253). Alcohol consumption patterns and baseline cognition of 3021 participants (median age, 78; mostly white) were assessed at baseline. Cognitive function was assessed every 6 months during a median follow-up of 6 years.

Analyses were adjusted for a wide range of clinical and demographic factors. The association of alcohol intake with incident dementia depended on baseline cognition, as follows:

• For patients without baseline mild cognitive impairment (MCI), no level of alcohol consumption was associated with any excess risk for incident dementia.

• For patients with baseline MCI, alcohol intake of >14 drinks weekly, compared with ≤1 drink weekly, was associated with slightly higher risk for developing dementia (hazard ratio, 1.72; P=0.13) and a significantly greater decrease in the Modified Mini-Mental State Examination score (P=0.02).

• Dementia risk with any alcohol consumption was not associated with the presence or absence of the apolipoprotein E e4 allele (a genetic risk factor for Alzheimer disease).

COMMENT

This study suggests that, in older patients with MCI, consuming 14 or more alcoholic drinks weekly probably promotes further cognitive decline — and eventually might hasten progression to dementia. Clinicians should not overlook detailed alcohol-consumption assessment in such patients.

EDITOR DISCLOSURES AT TIME OF PUBLICATION

Disclosures for Thomas L. Schwenk, MD at time of publication

Editorial boards

UpToDate

CITATION(S):

Koch M et al. Alcohol consumption and risk of dementia and cognitive decline among older adults with or without mild cognitive impairment. JAMA Netw Open 2019 Sep 27; 2:e1910319. (https://doi.org/10.1001/jamanetworkopen.2019.10319)

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Skin Care Physicians of Costa Rica

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