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Kilian C, Klinger S, Rehm J, Manthey J. Alcohol use, dementia risk, and sex: a systematic review and assessment of alcohol-attributable dementia cases in Europe. BMC Geriatr 2023; 23:246. [PMID: 37098501 PMCID: PMC10127029 DOI: 10.1186/s12877-023-03972-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Accepted: 04/13/2023] [Indexed: 04/27/2023] Open
Abstract
BACKGROUND High-risk alcohol use is an established modifiable risk factor for dementia. However, prior reviews have not addressed sex differences in alcohol-related dementia risk. In this systematic review, we take a sex-specific perspective towards the alcohol-dementia link, taking into account the age of dementia onset. METHODS We searched electronic databases for original cohort or case-control studies investigating the association between alcohol use and dementia. Two restrictions were considered: First, studies had to report results stratified by sex. Second, given the fact that the age at dementia onset seems to affect the alcohol-dementia link, studies were required to distinguish between early-onset and late-onset dementia (cut-off: 65 years). Additionally, the contribution of alcohol to dementia incidence was quantified for a set of 33 European countries for the year 2019. RESULTS We reviewed 3,157 reports, of which 7 publications were finally included and summarised narratively. A lower dementia risk when drinking alcohol infrequent or at moderate levels was found in men (three studies) and women (four studies). High-risk use and alcohol use disorders increased the risk of mild cognitive impairment and dementia, particularly early-onset dementia. Estimating the alcohol-attributable share of incident dementia cases revealed that 3.2% and 7.8% of incident dementia cases were estimated to be attributable to high-risk alcohol use (at least 24 g of pure alcohol per day) in 45-to-64-year-old women and men, respectively. CONCLUSIONS Research to date has paid little attention to the sex-specific link of alcohol and dementia. In the absence of sex-specific research, the established recommendations on high-risk alcohol use should be employed to communicate the alcohol-attributable dementia risk.
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Affiliation(s)
- Carolin Kilian
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany.
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health (CAMH), Toronto, ON, Canada.
| | - Sinja Klinger
- Centre for Interdisciplinary Addiction Research, Department of Psychiatry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Jürgen Rehm
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health (CAMH), Toronto, ON, Canada
- Centre for Interdisciplinary Addiction Research, Department of Psychiatry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Program On Substance Abuse, Public Health Agency of Catalonia, Barcelona, Spain
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
- Department of International Health Projects, Institute for Leadership and Health Management, I.M. Sechenov First Moscow State Medical University, Moscow, Russian Federation
| | - Jakob Manthey
- Centre for Interdisciplinary Addiction Research, Department of Psychiatry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Department of Psychiatry, Medical Faculty, University of Leipzig, Leipzig, Germany
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2
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Garduno AC, Laughlin GA, Bergstrom J, Tu XM, Cummins KM, Franz CE, Elman JA, Lyons MJ, Reynolds CA, Neale MC, Gillespie NA, Xian H, McKenzie RE, Toomey R, Kremen WS, Panizzon MS, McEvoy LK. Alcohol use and cognitive aging in middle-aged men: The Vietnam Era Twin Study of Aging. J Int Neuropsychol Soc 2023; 29:235-245. [PMID: 35465863 PMCID: PMC9592679 DOI: 10.1017/s1355617722000169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
OBJECTIVE To determine associations of alcohol use with cognitive aging among middle-aged men. METHOD 1,608 male twins (mean 57 years at baseline) participated in up to three visits over 12 years, from 2003-2007 to 2016-2019. Participants were classified into six groups based on current and past self-reported alcohol use: lifetime abstainers, former drinkers, very light (1-4 drinks in past 14 days), light (5-14 drinks), moderate (15-28 drinks), and at-risk drinkers (>28 drinks in past 14 days). Linear mixed-effects regressions modeled cognitive trajectories by alcohol group, with time-based models evaluating rate of decline as a function of baseline alcohol use, and age-based models evaluating age-related differences in performance by current alcohol use. Analyses used standardized cognitive domain factor scores and adjusted for sociodemographic and health-related factors. RESULTS Performance decreased over time in all domains. Relative to very light drinkers, former drinkers showed worse verbal fluency performance, by -0.21 SD (95% CI -0.35, -0.07), and at-risk drinkers showed faster working memory decline, by 0.14 SD (95% CI 0.02, -0.20) per decade. There was no evidence of protective associations of light/moderate drinking on rate of decline. In age-based models, light drinkers displayed better memory performance at advanced ages than very light drinkers (+0.14 SD; 95% CI 0.02, 0.20 per 10-years older age); likely attributable to residual confounding or reverse association. CONCLUSIONS Alcohol consumption showed minimal associations with cognitive aging among middle-aged men. Stronger associations of alcohol with cognitive aging may become apparent at older ages, when cognitive abilities decline more rapidly.
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Affiliation(s)
- Alexis C Garduno
- Division of Epidemiology and Biostatistics, School of Public Health, San Diego State University, San Diego, CA, USA
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, San Diego, CA, USA
| | - Gail A Laughlin
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, San Diego, CA, USA
| | - Jaclyn Bergstrom
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, San Diego, CA, USA
| | - Xin M Tu
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, San Diego, CA, USA
| | - Kevin M Cummins
- Department of Public Health, California State University, Fullerton, CA, USA
| | - Carol E Franz
- Department of Psychiatry, University of California San Diego, San Diego, CA, USA
- Center for Behavior Genetics of Aging, University of California San Diego, San Diego, CA, USA
| | - Jeremy A Elman
- Department of Psychiatry, University of California San Diego, San Diego, CA, USA
- Center for Behavior Genetics of Aging, University of California San Diego, San Diego, CA, USA
| | - Michael J Lyons
- Department of Psychological and Brain Sciences, Boston University, Boston, MA, USA
| | - Chandra A Reynolds
- Department of Psychology, University of California Riverside, Riverside, CA, USA
| | - Michael C Neale
- Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA, USA
| | - Nathan A Gillespie
- Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA, USA
| | - Hong Xian
- Department of Statistics, St Louis University, St Louis, MO, USA
- Research Service, VA St Louis Healthcare System, St Louis, MO, USA
| | - Ruth E McKenzie
- Department of Psychology, Boston University, Boston, MA, USA
- Department of Applied Human Development and Community Studies, Merrimack College, North Andover, MA, USA
| | - Rosemary Toomey
- Department of Psychological and Brain Sciences, Boston University, Boston, MA, USA
| | - William S Kremen
- Department of Psychiatry, University of California San Diego, San Diego, CA, USA
- Center for Behavior Genetics of Aging, University of California San Diego, San Diego, CA, USA
| | - Matthew S Panizzon
- Department of Psychiatry, University of California San Diego, San Diego, CA, USA
- Center for Behavior Genetics of Aging, University of California San Diego, San Diego, CA, USA
| | - Linda K McEvoy
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, San Diego, CA, USA
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Funk-White M, Moore AA, McEvoy LK, Bondi MW, Bergstrom J, Kaufmann CN. Alcohol use and cognitive performance: a comparison between Greece and the United States. Aging Ment Health 2022; 26:2440-2446. [PMID: 34842012 PMCID: PMC9161584 DOI: 10.1080/13607863.2021.1998355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2021] [Accepted: 10/17/2021] [Indexed: 02/01/2023]
Abstract
OBJECTIVES To examine associations between alcohol use and cognitive performance among older adults in Greece and the United States, and assess potential differences due to differing drinking practices in the two countries. METHODS Data came from Hellenic Longitudinal Investigation of Aging and Diet (HELIAD) and National Alzheimer's Coordinating Center Uniform Dataset (NACC). We examined those aged 65-90 years at baseline who had no cognitive impairment and complete data for cognitive and alcohol use variables (N = 1110 from HELIAD; N = 2455 from NACC). We examined associations between current alcohol use and frequency of such use with cognitive performance on various cognitive tasks stratified by gender. RESULTS In NACC, use of alcohol was associated with better cognitive performance. Men drinkers performed better than non-drinkers on Trail A (standardized mean 0.07 vs. -0.24, p<.001), Trail B (0.06 vs. -0.19, p=.001), and women drinkers performed better on Trail A (0.04 vs. -0.09, p=.016), Trail B (0.04 vs. -0.10, p=.005), verbal fluency (Animals: 0.05 vs. -0.13, p<.001; Vegetables: 0.04 vs. -0.09, p=.027), and MoCA (0.03 vs. -0.08, p=.039). In HELIAD, fewer differences were seen with only women drinkers exhibiting better performance than non-drinkers on the Boston Naming Task (0.11 vs. -0.05, p=.016). In general, more frequent drinkers performed better on cognitive tasks than less frequent drinkers, although this was only statistically significant in the NACC dataset. CONCLUSION While drinking alcohol may be associated with better cognitive performance across both the US and Greece, more research is needed to assess the cultural factors that may modify this association.
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Affiliation(s)
- Makaya Funk-White
- San Diego State University/University of California San Diego, San Diego, CA, USA
| | - Alison A. Moore
- Division of Geriatrics, Gerontology and Palliative Care, Department of Medicine, University of California San Diego, La Jolla, CA, USA
| | - Linda K McEvoy
- Department of Radiology, University of California San Diego, La Jolla, CA, USA
| | - Mark W. Bondi
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
- Veterans Affairs San Diego Healthcare System, San Diego, CA, USA
| | - Jaclyn Bergstrom
- Division of Geriatrics, Gerontology and Palliative Care, Department of Medicine, University of California San Diego, La Jolla, CA, USA
- Department of Radiology, University of California San Diego, La Jolla, CA, USA
| | - Christopher N. Kaufmann
- Division of Epidemiology and Data Science in Gerontology, Department of Aging and Geriatric Research, University of Florida College of Medicine, Gainesville, FL, USA
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Rao R, Creese B, Aarsland D, Kalafatis C, Khan Z, Corbett A, Ballard C. Risky drinking and cognitive impairment in community residents aged 50 and over. Aging Ment Health 2022; 26:2432-2439. [PMID: 34766529 DOI: 10.1080/13607863.2021.2000938] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
OBJECTIVES Alcohol misuse is known to be a risk factor for dementia. This study aimed to explore the association between risky drinking and cognitive impairment in a cohort study of middle aged and older people at risk of dementia. METHOD The sample comprised 15,582 people aged 50 and over drawn from the PROTECT study. Risky drinking was defined according to a score of 4 or above on the Alcohol Use Disorders Identification Test (AUDIT). Cognitive function was assessed on visual episodic memory, spatial working memory, verbal working memory and verbal reasoning. RESULTS Risky drinkers at baseline were more likely to be younger, male, white British, married, of higher educational status, current or past tobacco smokers and to have moderate to severe depression than non-risky drinkers. Risky drinkers were also more likely to be impaired on self-reported instrumental activities of daily living and subjective cognitive decline. At baseline, risky drinkers were less likely than non-risky drinkers to show impairment on verbal reasoning and spatial working memory but not on visual episodic memory or verbal working memory. Risky drinking at baseline predicted decline in cognitive function on visual episodic memory, verbal reasoning and spatial working memory at 2 year follow-up, but only verbal working memory and spatial working memory remained significant outcomes after controlling for possible confounders. CONCLUSION Although of small effect size, the association between risky drinking and impairment on measures of working memory and visuospatial function warrants further examination; particularly given the possibility of partial reversibility in alcohol related cognitive impairment.
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Affiliation(s)
- Rahul Rao
- Department of Old Age Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College, London, UK
| | - Byron Creese
- The University of Exeter Medical School, Exeter, UK
| | - Dag Aarsland
- Department of Old Age Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College, London, UK
| | - Chris Kalafatis
- Department of Old Age Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College, London, UK
| | - Zunera Khan
- Department of Old Age Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College, London, UK
| | - Anne Corbett
- The University of Exeter Medical School, Exeter, UK
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Tian YM, Zhang WS, Jiang CQ, Zhu F, Jin YL, Zhu T, Cheng KK, Xu L. Association of alcohol use with memory decline in middle-aged and older Chinese: a longitudinal cohort study. BMC Psychiatry 2022; 22:673. [PMID: 36320000 PMCID: PMC9623936 DOI: 10.1186/s12888-022-04298-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Accepted: 10/10/2022] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND Previous studies on associations of alcohol use with memory decline showed inconclusive results. We examined these associations using longitudinal data from the Guangzhou Biobank Cohort Study (GBCS) and explored whether these associations varied by sex and age group. METHODS Memory function was assessed by delayed 10-word recall test (DWRT) and immediate 10-word recall test (IWRT) at both baseline (2003-2008) and follow-up (2008-2012) examinations, expressed as the mean annual change and mean annual rate of change in scores. Memory cognitive impairment was defined by DWRT scores of less than 4. Multivariable linear regression models and restricted cubic spline were used for data analysis. RESULTS Of 14,827 participants without memory cognitive impairment at baseline, 90.2% were never or occasional drinkers, 5% moderate drinkers, 1.5% excessive drinkers, and 3.3% former drinkers. The mean (standard deviation) age was 60.6 (6.6) years old. During an average of 4.1 years follow-up, 1000 (6.7%) participants developed memory cognitive impairment. After adjusting for confounders, compared with never or occasional drinkers, moderate and excessive drinkers had significant decline in DWRT scores (β, 95% confidence interval (CI) = -0.04 (-0.08 to -0.01), and - 0.07 (-0.14 to 0.01), respectively), and IWRT scores (β, 95% CI = -0.10 (-0.19 to -0.01), and - 0.15 (-0.30 to 0.01), respectively) annually. With respect to the mean annual rate of change, moderate and excessive drinkers also showed greater decline in DWRT scores (β, 95% CI = -1.02% (-1.87% to -0.16%), and - 1.64% (-3.14% to -0.14%), respectively). The associations did not vary by sex and age group (all P values for interaction ≥ 0.10). CONCLUSION Compared to never or occasional alcohol use, moderate and excessive alcohol users had greater memory decline and the associations did not vary by sex and age group.
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Affiliation(s)
- Yu Meng Tian
- grid.12981.330000 0001 2360 039XSchool of Public Health, Sun Yat-sen University, 74 Zhongshan 2nd Road, Guangzhou, Guangdong Province China
| | - Wei Sen Zhang
- Guangzhou Twelfth People's Hospital, 510620, Guangzhou, China.
| | | | - Feng Zhu
- Guangzhou Twelfth People’s Hospital, 510620 Guangzhou, China
| | - Ya Li Jin
- Guangzhou Twelfth People’s Hospital, 510620 Guangzhou, China
| | - Tong Zhu
- Guangzhou Twelfth People’s Hospital, 510620 Guangzhou, China
| | - Kar Keung Cheng
- grid.6572.60000 0004 1936 7486Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Lin Xu
- School of Public Health, Sun Yat-sen University, 74 Zhongshan 2nd Road, Guangzhou, Guangdong Province, China. .,School of Public Health, the University of Hong Kong, Hong Kong, China. .,Institute of Applied Health Research, University of Birmingham, Birmingham, UK.
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Chosy EJ, Edland S, Launer L, White LR. Midlife alcohol consumption and later life cognitive impairment: Light drinking is not protective and APOE genotype does not change this relationship. PLoS One 2022; 17:e0264575. [PMID: 35275952 PMCID: PMC8916616 DOI: 10.1371/journal.pone.0264575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Accepted: 02/12/2022] [Indexed: 11/30/2022] Open
Abstract
INTRODUCTION Much debate exists about the role of light to moderate alcohol intake and subsequent cognitive function. The apolipoprotein E genotype may modify the relationship. METHODS Using data from the Honolulu-Asia Aging Study, a longitudinal population-based cohort (n = 2,416), Cox proportional hazards regression analyses were performed to measure midlife alcohol intake (average age = 52 years) and later life cognitive function (average age = 87 years) and to explore the role of apolipoprotein E genotype. RESULTS No protective effect of light drinking (>1 drink/month- 1 drink/day) or moderate drinking (>1-2 drinks/day) was observed in the cohort in adjusted models (HR = 1.013, CI:0.88-1.16; HR = 1.104, CI:0.91-1.34, respectively). Heavy drinking (>2-4 drinks/day) and very heavy drinking (>4 drinks/day) increased the risk for incident moderate cognitive impairment (HR = 1.355, CI:1.09-1.68; HR = 1.462, CI:1.04-2.05, respectively). When examining the relationship by apolipoprotein E ε4 carrier status, a similar dose-response pattern was observed in both groups with higher hazard ratios for those carrying at least one copy of the apolipoprotein E ℇ4 allele. As alcohol level increased, the age at incident moderate cognitive impairment decreased, especially among those with at least one apolipoprotein E ℇ4 allele. DISCUSSION We did not observe a significant protective effect for light to moderate drinking in midlife and subsequent cognitive impairment in this cohort. Heavy drinking increased the risk for moderate cognitive impairment and decreased the age at incidence, as did carrying at least one allele of the apolipoprotein E ℇ4 gene.
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Affiliation(s)
- E. Julia Chosy
- Pacific Health Research and Education Institute, Honolulu, Hawaii, United States of America
| | - Steven Edland
- University of California at San Diego, La Jolla, California, United States of America
| | - Lenore Launer
- National Institute on Aging, National Institutes of Health, Bethesda, Maryland, United States of America
| | - Lon R. White
- Pacific Health Research and Education Institute, Honolulu, Hawaii, United States of America
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Slayday RE, Gustavson DE, Elman JA, Beck A, McEvoy LK, Tu XM, Fang B, Hauger RL, Lyons MJ, McKenzie RE, Sanderson-Cimino ME, Xian H, Kremen WS, Franz CE. Interaction between Alcohol Consumption and Apolipoprotein E (ApoE) Genotype with Cognition in Middle-Aged Men. J Int Neuropsychol Soc 2021; 27:56-68. [PMID: 32662384 PMCID: PMC7856052 DOI: 10.1017/s1355617720000570] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Heavy alcohol consumption is associated with poorer cognitive function in older adults. Although understudied in middle-aged adults, the relationship between alcohol and cognition may also be influenced by genetics such as the apolipoprotein (ApoE) ε4 allele, a risk factor for Alzheimer's disease. We examined the relationship between alcohol consumption, ApoE genotype, and cognition in middle-aged adults and hypothesized that light and/or moderate drinkers (≤2 drinks per day) would show better cognitive performance than heavy drinkers or non-drinkers. Additionally, we hypothesized that the association between alcohol use and cognitive function would differ by ApoE genotype (ε4+ vs. ε4-). METHOD Participants were 1266 men from the Vietnam Era Twin Study of Aging (VETSA; M age = 56; range 51-60) who completed a neuropsychological battery assessing seven cognitive abilities: general cognitive ability (GCA), episodic memory, processing speed, executive function, abstract reasoning, verbal fluency, and visuospatial ability. Alcohol consumption was categorized into five groups: never, former, light, moderate, and heavy. RESULTS In fully adjusted models, there was no significant main effect of alcohol consumption on cognitive functions. However, there was a significant interaction between alcohol consumption and ApoE ε4 status for GCA and episodic memory, such that the relationship of alcohol consumption and cognition was stronger in ε4 carriers. The ε4+ heavy drinking subgroup had the poorest GCA and episodic memory. CONCLUSIONS Presence of the ε4 allele may increase vulnerability to the deleterious effects of heavy alcohol consumption. Beneficial effects of light or moderate alcohol consumption were not observed.
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Affiliation(s)
- Riki E. Slayday
- Department of Psychology, San Diego State University, San
Diego, CA, USA
| | - Daniel E. Gustavson
- Department of Psychiatry, University of California San
Diego, La Jolla CA, USA
| | - Jeremy A. Elman
- Department of Psychiatry, University of California San
Diego, La Jolla CA, USA
| | - Asad Beck
- University of Washington, Graduate Program in Neuroscience,
Seattle, WA, USA
| | - Linda K. McEvoy
- Department of Radiology, University of California San
Diego, La Jolla, CA, USA
| | - Xin M. Tu
- Department of Family Medicine, University of California San
Diego, La Jolla, CA, USA
| | - Bin Fang
- Department of Psychiatry, University of California San
Diego, La Jolla CA, USA
| | - Richard L. Hauger
- Department of Psychiatry, University of California San
Diego, La Jolla CA, USA
- Center of Excellence for Stress and Mental Health, VA San
Diego Healthcare System, San Diego, CA, USA
| | - Michael J. Lyons
- Department of Psychological and Brain Sciences, Boston
University, Boston, MA, USA
| | - Ruth E. McKenzie
- Department of Psychological and Brain Sciences, Boston
University, Boston, MA, USA
| | - Mark E. Sanderson-Cimino
- Department of Psychology, San Diego State University, San
Diego, CA, USA
- Department of Psychiatry, University of California San
Diego, La Jolla CA, USA
| | - Hong Xian
- Department of Biostatistics, St Louis University, St.
Louis, MO, USA
| | - William S. Kremen
- Department of Psychiatry, University of California San
Diego, La Jolla CA, USA
- Center of Excellence for Stress and Mental Health, VA San
Diego Healthcare System, San Diego, CA, USA
- Center for Behavior Genetics of Aging, University of
California San Diego, La Jolla CA, USA
| | - Carol E. Franz
- Department of Psychiatry, University of California San
Diego, La Jolla CA, USA
- Center for Behavior Genetics of Aging, University of
California San Diego, La Jolla CA, USA
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Fama R, Le Berre AP, Sullivan EV. Alcohol's Unique Effects on Cognition in Women: A 2020 (Re)view to Envision Future Research and Treatment. Alcohol Res 2020; 40:03. [PMID: 32923307 PMCID: PMC7473713 DOI: 10.35946/arcr.v40.2.03] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Alcohol use and misuse is increasing among women. Although the prevalence of drinking remains higher in men than women, the gender gap is narrowing. This narrative review focuses on the cognitive sequelae of alcohol consumption in women. Studies of acute alcohol effects on cognition indicate that women typically perform worse than men on tasks requiring divided attention, memory, and decision-making. Beneficial effects of moderate alcohol consumption on cognition have been reported; however, a number of studies have cautioned that other factors may be driving that association. Although chronic heavy drinking affects working memory, visuospatial abilities, balance, emotional processing, and social cognition in women and men, sex differences mark the severity and specific profile of functional deficits. The accelerated or compressed progression of alcohol-related problems and their consequences observed in women relative to men, referred to as "telescoping," highlights sex differences in the pharmacokinetics, pharmacodynamics, cognitive, and psychological consequences of alcohol. Brain volume deficits affecting multiple systems, including frontolimbic and frontocerebellar networks, contribute to impairment. Taken together, sex-related differences highlight the complexity of this chronic disease in women and underscore the relevance of examining the roles of age, drinking patterns, duration of abstinence, medical history, and psychiatric comorbidities in defining and understanding alcohol-related cognitive impairment.
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Affiliation(s)
- Rosemary Fama
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, California
- Neuroscience Program, SRI International, Menlo Park, California
| | - Anne-Pascale Le Berre
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, California
| | - Edith V Sullivan
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, California
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9
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Matloff WJ, Zhao L, Ning K, Conti DV, Toga AW. Interaction effect of alcohol consumption and Alzheimer disease polygenic risk score on the brain cortical thickness of cognitively normal subjects. Alcohol 2020; 85:1-12. [PMID: 31734309 PMCID: PMC7220836 DOI: 10.1016/j.alcohol.2019.11.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Revised: 10/31/2019] [Accepted: 11/11/2019] [Indexed: 01/01/2023]
Abstract
Alcohol consumption and genetic risk for Alzheimer disease (AD) are among many factors known to be associated with brain structure in cognitively healthy adults. It is unclear, however, whether the effect of alcohol consumption on brain structure varies depending on a person's level of genetic risk for AD. We hypothesized that there is an interaction effect of alcohol consumption and a 33-SNP AD polygenic risk score (PRS) on the cortical thickness of brain regions known to be affected early in the course of AD. Studying 6,213 cognitively healthy subjects from the UK Biobank, we found a significant interaction effect of the 33-SNP AD PRS and alcohol consumption on this AD Cortical Thickness Signature. Stratified, among those who consume 12-24 g/day of alcohol, the 33-SNP AD PRS had a significant, positive association with AD Cortical Thickness Signature, with high-risk subjects having the greatest AD Cortical Thickness Signature. There were no significant associations of the 33-SNP AD PRS with AD Cortical Thickness Signature among the nondrinker or <1, 1-6, 6-12, 24-48, or >48 g/day groups. It is unclear whether this interaction is due to a detrimental or beneficial effect of moderate alcohol consumption in those with the highest genetic risk for AD.
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Affiliation(s)
- William J Matloff
- Laboratory of Neuro Imaging, USC Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Los Angeles, CA, 90033, United States
| | - Lu Zhao
- Laboratory of Neuro Imaging, USC Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Los Angeles, CA, 90033, United States
| | - Kaida Ning
- Laboratory of Neuro Imaging, USC Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Los Angeles, CA, 90033, United States
| | - David V Conti
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, 90032, United States
| | - Arthur W Toga
- Laboratory of Neuro Imaging, USC Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Los Angeles, CA, 90033, United States.
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10
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Nixon SJ, Lewis B. Clarifying the neurobehavioral sequelae of moderate drinking lifestyles and acute alcohol effects with aging. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2019; 148:39-78. [PMID: 31733667 DOI: 10.1016/bs.irn.2019.10.016] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Epidemiological estimates indicate not only an increase in the proportion of older adults, but also an increase in those who continue moderate alcohol consumption. Substantial literatures have attempted to characterize health benefits/risks of moderate drinking lifestyles. Not uncommonly, reports address outcomes in a single outcome, such as cardiovascular function or cognitive decline, rather than providing a broader overview of systems. In this narrative review, retaining focus on neurobiological considerations, we summarize key findings regarding moderate drinking and three health domains, cardiovascular health, Type 2 diabetes (T2D), and cognition. Interestingly, few investigators have studied bouts of low/moderate doses of alcohol consumption, a pattern consistent with moderate drinking lifestyles. Here, we address both moderate drinking as a lifestyle and as an acute event. Review of health-related correlates illustrates continuing inconsistencies. Although substantive reductions in risk for cardiovascular and T2D events are reported, robust conclusions remain elusive. Similarly, whereas moderate drinking is often associated with enhanced cognition and lower dementia risk, few benefits are noted in rates of decline or alterations in brain structure. The effect of sex/gender varies across health domains and by consumption levels. For example, women appear to differentially benefit from alcohol use in terms of T2D, but experience greater risk when considering aspects of cardiovascular function. Finally, we observe that socially relevant alcohol doses do not consistently impair performance in older adults. Rather, older drinkers demonstrate divergent, but not necessarily detrimental, patterns in neural activation and some behavioral measures relative to younger drinkers. Taken together, the epidemiological and laboratory studies reinforce the need for greater attention to key individual differences and for the conduct of systematic studies sensitive to age-related shifts in neurobiological systems.
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Affiliation(s)
- Sara Jo Nixon
- University of Florida, Department of Psychiatry, Gainesville, FL, United States; University of Florida Center for Addiction Research & Education, Gainesville, FL, United States.
| | - Ben Lewis
- University of Florida, Department of Psychiatry, Gainesville, FL, United States; University of Florida Center for Addiction Research & Education, Gainesville, FL, United States
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Reas ET, Laughlin GA, Bergstrom J, Kritz-Silverstein D, Barrett-Connor E, McEvoy LK. Effects of APOE on cognitive aging in community-dwelling older adults. Neuropsychology 2019; 33:406-416. [PMID: 30730162 DOI: 10.1037/neu0000501] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
OBJECTIVE The apolipoprotein E (APOE) gene is an established risk factor for sporadic Alzheimer's disease, with elevated risk for ε4-carriers and reduced risk for ε2-carriers. However, it is unclear whether APOE modifies risk for cognitive decline in normal aging. The objective of this study was to determine whether ε2 and ε4 are associated with rates of normal cognitive aging, and whether associations of ε4 with cognitive decline are modified by sex, education or health behaviors (exercise, alcohol consumption, smoking). METHOD A community-based sample of 1,393 older adults were genotyped for APOE and underwent cognitive assessment up to seven times over a maximum of period of 27 years. RESULTS ε2-carriers showed slower executive function decline with age relative to ε3 homozygotes or ε4-carriers, whereas ε4-carriers demonstrated more rapid executive function and verbal fluency decline. Accelerated executive function decline was particularly pronounced in ε4-carriers with lower education. After excluding individuals with cognitive impairment, faster executive function decline was still apparent in ε4-carriers, and the effect of ε4 on episodic memory interacted with alcohol consumption, such that only ε4-carriers who did not drink showed more rapid memory decline than ε4 noncarriers. The influence of ε4 on cognitive aging did not differ by sex, nor was it modified by smoking or exercise. CONCLUSIONS These findings indicate that the ε2 and ε4 alleles have differential effects on cognitive aging, and that negative effects of ε4 may be partly mitigated by behavioral choices. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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