Reported Alcohol Consumption and Cognitive Decline: The Northern Manhattan Study

Division of Stroke and Critical Care, Department of Neurology, College of Physicians and Surgeons of Columbia University, New York, NY 10032, USA.
Neuroepidemiology (Impact Factor: 2.56). 02/2006; 27(4):201-7. DOI: 10.1159/000096300
Source: PubMed


Moderate alcohol intake may slow cognitive decline, and both vascular and neurodegenerative mechanisms have been implicated.
We examined reported alcohol intake and cognitive decline in a community-based cohort of Hispanic, black and white individuals (n = 1,428). The role of the apolipoprotein E epsilon4 (APOE4) allele as a modifier was also studied.
Reported drinking was as follows: 300 participants (21%) were 'never' drinkers, 622 (44%) 'past' drinkers, 145 (10%) reported taking less than 1 drink weekly, 330 (23%) 1 drink weekly up to 2 daily and 31 (2%) more than 2 drinks daily. A positive relationship was seen between reported alcohol intake and cognition. Drinking less than 1 drink a week (p = 0.09), between 1 drink weekly up to 2 drinks daily (p = 0.001) and more than 2 drinks daily (p = 0.003) were associated with less cognitive decline on the modified Telephone Interview for Cognitive Status compared to never drinkers. This dose-response relationship was not modified by the presence of an APOE4 allele in a subsample.

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Available from: Clinton B Wright, Nov 07, 2014
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    • "Light to moderate alcohol consumption is hypothesized to be associated with better cognitive function and lower risk of dementia,2–9 but less is known about the impact of alcohol on cognitive aging trajectories because much of the evidence comes from studies conducted in elderly populations10–17 in which health-related changes in alcohol consumption are likely to influence results.2 Because alcohol consumption declines with age,18 the heavy drinking category is either small12,13,15,17 or not represented at all10,11,14,16 in these studies. Besides notable exceptions,19,20 few studies have examined the impact of alcohol consumption on cognitive aging trajectories before old age. "
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    ABSTRACT: To examine the association between alcohol consumption in midlife and subsequent cognitive decline. Data are from 5,054 men and 2,099 women from the Whitehall II cohort study with a mean age of 56 years (range 44-69 years) at first cognitive assessment. Alcohol consumption was assessed 3 times in the 10 years preceding the first cognitive assessment (1997-1999). Cognitive tests were repeated in 2002-2004 and 2007-2009. The cognitive test battery included 4 tests assessing memory and executive function; a global cognitive score summarized performances across these tests. Linear mixed models were used to assess the association between alcohol consumption and cognitive decline, expressed as z scores (mean = 0, SD = 1). In men, there were no differences in cognitive decline among alcohol abstainers, quitters, and light or moderate alcohol drinkers (<20 g/d). However, alcohol consumption ≥36 g/d was associated with faster decline in all cognitive domains compared with consumption between 0.1 and 19.9 g/d: mean difference (95% confidence interval) in 10-year decline in the global cognitive score = -0.10 (-0.16, -0.04), executive function = -0.06 (-0.12, 0.00), and memory = -0.16 (-0.26, -0.05). In women, compared with those drinking 0.1 to 9.9 g/d of alcohol, 10-year abstainers showed faster decline in the global cognitive score (-0.21 [-0.37, -0.04]) and executive function (-0.17 [-0.32, -0.01]). Excessive alcohol consumption in men (≥36 g/d) was associated with faster cognitive decline compared with light to moderate alcohol consumption.
    Neurology 01/2014; 82(4). DOI:10.1212/WNL.0000000000000063 · 8.29 Impact Factor
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    • "Although each domain can be characterized as a conceptually distinct unit, their functions are highly interrelated (Moscovitch, 1992). Many studies use global or aggregated composite measures of cognition (Bond et al., 2005; Cervilla et al., 2000; den Heijer et al., 2004; Elwood et al., 1999; Espeland et al., 2005; Flicker et al., 2005; Galanis et al., 2000; Lang et al., 2007; Launer et al., 1996; Leroi et al., 2002; McGuire et al., 2007; Wright et al., 2006). Such measures of global mental status or tests of general intelligence show good reliability and encompass a variety of cognitive constructs but are not as sensitive to domainspecific measures of cognition (Leroi, Sheppard, & Lyketsos, 2002; Lyketsos, Chen, & Anthony, 1999). "
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    ABSTRACT: The association of alcohol consumption with performance in different cognitive domains has not been well studied. The Johns Hopkins Precursors Study was used to examine associations between prospectively collected information about alcohol consumption ascertained on multiple occasions starting at age 55 years on average with domain-specific cognition at age 72 years. Cognitive variables measured phonemic and semantic fluency, attention, verbal memory, and global cognition. Controlling for age, hypertension, smoking status, sex, and other cognitive variables, higher average weekly quantity and frequency of alcohol consumed in midlife were associated with lower phonemic fluency. There were no associations with four other measures of cognitive function. With respect to frequency of alcohol intake, phonemic fluency was significantly better among those who drank three to four alcoholic beverages per week as compared with daily or almost daily drinkers. A measure of global cognition was not associated with alcohol intake at any point over the follow-up. Results suggest that higher alcohol consumption in midlife may impair some components of executive function in late life.
    The Journals of Gerontology Series B Psychological Sciences and Social Sciences 10/2010; 66(1):39-47. DOI:10.1093/geronb/gbq062 · 3.21 Impact Factor
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    ABSTRACT: A substantial literature exists that demonstrates associations between putative risk factors and cognitive decline in late life. However, there is a need to integrate this broad literature within a framework that incorporates the interaction of behavioral and ecological influences with cognitive development. Such a framework is required for developing a range of personal and environmental interventions to optimize cognitive development in the population, and to reduce the risk of cognitive impairment in late life. This review aims to identify the key considerations for developing a life course model of the various factors that influence cognitive development and cognitive decline. A contextualized, dynamic approach to life course epidemiology is proposed. A theoretical evaluation of key methodological and interpretational issues relating to how risk factors influence cognitive development and cognitive impairment was conducted. This focused on the example of alcohol consumption as a risk factor for cognitive decline and dementia. This review identified dimensions that need to be accounted for in life course theories of cognitive development and cognitive impairment. These include: (a) intergenerational influences; (b) methodological and interpretational issues; (c) individual differences (personal factors); (d) contextual factors (environmental or ecological factors), and (e) cognitive ability as determinant. The methodological and interpretational factors included measurement of exposure and outcome variables; the important distinction between level of ability versus change over time; nonlinear relationships among exposures and outcomes, and outcomes and age; the distinction between association and cause, and between short-term effects and long-term change. A contextualized, dynamic approach to life course epidemiology accounts for the complex range of influences over the life course that interact to determine normal and pathological cognitive ageing. This approach provides a framework for the development of interventions to maximize cognitive gains in early life, and minimize cognitive loss in late life.
    Gerontology 02/2008; 54(5):283-91. DOI:10.1159/000161735 · 3.06 Impact Factor
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