Alcohol Use Linked to Dementia Onset

Michael Schwarzinger, MD, PhD, Translational Health Economics Network

Michael Schwarzinger, MD, PhD

Alcohol use disorders are a major risk factor for all types of dementia, including early-onset dementia, according to recently published findings.

Michaël Schwarzinger, MD, PhD, and colleagues from France and Canada analyzed adult patients admitted to hospitals between 2008 and 2013 in order to evaluate the link between alcohol use and dementia risk.

The study authors wrote that while some literature suggests a beneficial effect of light to moderate drinking on cognitive health, moderate drinking is consistently associated with damage to the brain.

Between 2008 and 2013, there were 31.6 million adults aged 20 years or older who were discharged from French metropolitan hospitals. The researchers learned that 1.1 million of those patients were diagnosed with dementia and therefore included in the analysis.

Of those patients, there were about 57,000 cases of early-onset dementia. Most of those, nearly 40%, were alcohol-related or had an additional diagnosis or alcohol use disorders, the researchers determined and was equally true for both men and women. However, the researchers did add that alcohol use was not included in the recent dementia review published by the Lancet Commission examining dementia prevention, intervention and care.

Notably, they wrote, when patients were under the age of 65 years, the most common cases of dementia were alcohol-related or the patients otherwise qualified for a diagnosis of alcohol use disorders.

“Alcohol-related dementia should be recognized as one of the main causes of early-onset dementia,” they wrote. “Additionally, clinicians should be better aware of the role of alcohol use disorders in dementia onset over the lifetime, which seems to be a risk factor often omitted.”

The study authors offered a variety of reasons for their findings. Among them, heavy drinking can lead to permanent structural and functional brain damage because of the ethanol. Plus, heavy drinking can lead to other conditions which damage the brain, such as epilepsy, head injury and vascular diseases. Heavy drinking can also be linked to smoking, depression and low education, they wrote. These factors have led to formulating a specific diagnosis for alcohol-related dementia.

In a related editorial, Clive Ballard and Iain Lang from the United Kingdom called the association between alcohol consumption and dementia a J-shaped relationship.

In their commentary, they wrote that the study authors “modeled the importance of alcohol use disorders and suggested their effect might be greater than that of recognized risk factors such as smoking, depression and hypertension. Their study is immensely important and highlights the potential of alcohol use disorders, and possibly alcohol consumption, as modifiable risk factors for dementia prevention.”

Finally, they commented that physicians may want to reconsider the extent to which the growing prevalence of dementia worldwide might be stalled by reductions in major alcohol consumption.

The study, titled “Contribution of alcohol use disorders to the burden of dementia in France 2008—13: a nationwide retrospective cohort study,” was published in The Lancet Public Health.

The commentary, titled “Alcohol and dementia: a complex relationship with potential for dementia prevention,” can be found here.

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