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Lim S, Yoo E, Hong I, Park JH. Age-specific findings on lifestyle and trajectories of cognitive function from the Korean Longitudinal Study of Aging. Epidemiol Health 2023; 45:e2023098. [PMID: 37946412 PMCID: PMC10876444 DOI: 10.4178/epih.e2023098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 10/15/2023] [Indexed: 11/12/2023] Open
Abstract
OBJECTIVES Few longitudinal studies have explored age-related differences in the relationship between lifestyle factors and cognitive decline. This study investigated lifestyle factors at baseline that slow the longitudinal rate of cognitive decline in young-old (55-64 years), middle-old (65-74 years), and old-old (75+ years) individuals. METHODS We conducted an 11-year follow-up that included 6,189 older adults from the Korean Longitudinal Study of Aging, which is a cohort study of community-dwelling older Koreans. Lifestyle factors, including physical activity, social activity (SA), smoking, and alcohol consumption were assessed at baseline. Cognitive function was measured at 2-year intervals over 11 years. Latent growth modeling and multi-group analysis were performed. RESULTS The influence of lifestyle factors on the rate of cognitive decline differed by age. Smoking at baseline (-0.05; 95% confidence interval [CI], -0.11 to -0.00, per study wave) accelerated cognitive decline in young-old individuals, whereas frequent participation in SA at baseline (0.02; 95% CI, 0.01 to 0.03, per study wave) decelerated cognitive decline in middle-old individuals. None of the lifestyle factors in this study decelerated cognitive decline in old-old individuals. CONCLUSIONS Cognitive strategies based on modifiable lifestyle factors such as smoking cessation in young-old individuals and frequent SA participation in middle-old age individuals may have great potential for preventing cognitive decline. Because the influence of lifestyle factors varied by age group, age-specific approaches are recommended to promote cognitive health.
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Affiliation(s)
- Seungju Lim
- Department of Occupational Therapy, Graduate School, Yonsei University, Wonju,
Korea
| | - Eunyoung Yoo
- Department of Occupational Therapy, College of Software and Digital Healthcare Convergence, Yonsei University, Wonju,
Korea
| | - Ickpyo Hong
- Department of Occupational Therapy, College of Software and Digital Healthcare Convergence, Yonsei University, Wonju,
Korea
| | - Ji-Hyuk Park
- Department of Occupational Therapy, College of Software and Digital Healthcare Convergence, Yonsei University, Wonju,
Korea
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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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Salvador L, Giatti L, Viana MC, Suemoto CK, Duncan BB, Del Carmen Bisi Molina M, de Jesus Mendes da Fonseca M, Brunoni AR, Barreto SM, Caramelli P. Sex differences in the association between alcohol intake and cognitive decline over four years in a middle-aged cohort: the Brazilian Longitudinal Study of Adult Health. Eur J Neurol 2022; 29:1903-1912. [PMID: 35262995 DOI: 10.1111/ene.15315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Accepted: 02/24/2022] [Indexed: 11/28/2022]
Abstract
The association between alcohol intake and cognitive decline has been widely studied. Sex differences and cognitive domains affected by alcohol intake patterns make this topic overly complex. OBJECTIVE To investigate the effect of alcohol intake on cognition of middle-aged participants from ELSA-Brasil by sex during four-years of follow-up. METHODS 7,595 participants (55% women) aged between 50 to 75 years at baseline were assessed. Semantic and phonemic fluency, memory, and executive functions were assessed at baseline (2008-2010) and repeated during Visit 2. Linear mixed models were used to investigate the association between cognition and current abstainers, never drinkers, light drinkers, moderate drinkers, and heavy drinkers. RESULTS Heavy alcohol intake accentuated the decline in executive functions for men (β = -0.01; p < 0.05), and in semantic fluency (β = -0.02; p < 0.05), and memory (β = -0.02; p < 0.05) for women. Never drinker's men also showed an accentuated decline in semantic fluency (β = -0.02; p < 0.01). Moderate alcohol intake slowed cognitive decline in phonemic fluency for men (β = 0.02, p < 0.01) and women (β = 0.01, p < 0.01) and in executive functions (β = 0.01, p < 0.05) for women. CONCLUSIONS Having more than 14 drinks per week can impact executive functions in men and memory in women. In addition, alcohol consumption of 7 to 14 drinks per week may have a protective effect on gender-specific cognitive functions. These findings should be considered in public health policies and guidelines on alcohol and cognitive aging.
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Affiliation(s)
- Larissa Salvador
- Post-Doctoral Student at the Graduate Program in Sciences Applied to Adult Health, Faculty of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Luana Giatti
- School of Medicine and Clinical Hospital, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Maria Carmen Viana
- Department of Social Medicine and Postgraduate Program in Public Health at the Universidade Federal do Espírito. Center for Study and Research in Psychiatric Epidemiology (CEPEP/UFES), Vitória, Espirito Santo, Brazil
| | | | - Bruce B Duncan
- Postgraduate program in Epidemiology and Clinical Hospital, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Maria Del Carmen Bisi Molina
- Postgraduate Program in Public Health, Universidade Federal do Espírito Santo, Postgraduate Program in Health and Nutrition, Universidade Federal de Ouro Preto, Minas Gerais, Brazil
| | - Maria de Jesus Mendes da Fonseca
- Department of Epidemiology and Quantitative Methods in Health, Escola Nacional de Saúde Pública/ FIOCRUZ, Rio de Janeiro, Brazil
| | - André R Brunoni
- School of Medicine and Clinical Hospital, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Sandhi Maria Barreto
- School of Medicine and Clinical Hospital, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Paulo Caramelli
- Post-Doctoral Student at the Graduate Program in Sciences Applied to Adult Health, Faculty of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.,Research Group in Cognitive and Behavioral Neurology, Medical Clinic Department, School of Medicine and Clinical Hospital, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
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Effect of the Intake of Brown Rice for Six Months on the Cognitive Function in Healthy Elderly Persons: A Study Protocol for a Pilot, Non-Randomized Controlled Trial. Methods Protoc 2021; 4:mps4040078. [PMID: 34842782 PMCID: PMC8628973 DOI: 10.3390/mps4040078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 10/23/2021] [Accepted: 10/25/2021] [Indexed: 11/16/2022] Open
Abstract
The nutritional components of brown rice have been reported to be effective against diabetes mellitus. Recent animal studies have suggested that it is also effective in maintaining cognitive function. Therefore, in this study, we examined the effect of a brown rice diet on cognitive function in individuals aged over 60 years. The study participants were recruited from a pool of individuals aged ≥60 years who were using elderly care facilities. The participants were provided with four servings of brown or white rice per week for 6 months, and their cognitive function was measured before and after the intervention period. Prior to the intervention, participants tasted the white and brown rice to determine which type they would like to be offered over the 6-month period. Since rice is the staple food of the participants in this study, they were allowed to decide whether they wanted to eat white or brown rice.
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Siddiquee AT, Kadota A, Fujiyoshi A, Miyagawa N, Saito Y, Suzuki H, Kondo K, Yamauchi H, Ito T, Segawa H, Tooyama I, Miura K, Ueshima H. Alcohol consumption and cognitive function in elderly Japanese men. Alcohol 2020; 85:145-152. [PMID: 31923561 DOI: 10.1016/j.alcohol.2020.01.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Revised: 12/07/2019] [Accepted: 01/02/2020] [Indexed: 02/06/2023]
Abstract
Although heavy alcohol consumption has been identified as a risk factor for adverse cognitive functioning, it currently remains unclear whether moderate alcohol consumption exerts similar effects. Observational studies previously reported the potential benefits of moderate alcohol consumption on cognition, particularly in the elderly; however, these effects have not yet been demonstrated in Asian populations. The aim of the present study was to investigate the relationship between alcohol consumption levels and global and domain-specific cognitive functions in cognitively intact elderly Japanese men. Cross-sectional data from the Shiga Epidemiological Study of Subclinical Atherosclerosis (SESSA), an ongoing prospective, population-based study in Shiga, Japan, were used to examine the relationship between alcohol consumption and cognitive function. Men (n = 585) aged ≥65 years provided information on their weekly consumption of alcohol, and the data obtained were used to construct categories of never, ex- (quit before interview), very light (<14 g/day), light (14-23 g/day), moderate (>23-46 g/day), and heavy (>46 g/day) drinkers. Cognitive function was measured using the Cognitive Abilities Screening Instrument (CASI). A fractional logistic regression model adjusted for age, education, body mass index, smoking, exercise, hypertension, diabetes, and dyslipidemia showed that the CASI scores for global and domain-specific cognitive functions were not significantly different between all subgroups of current drinkers and never-drinkers. However, the CASI score of ex-drinkers (multivariable adjusted mean CASI score [SD]) was significantly lower than that of never-drinkers in the global [never vs. ex: 90.16 (2.21) vs. 88.26 (2.58)] and abstraction and judgment domain [never vs. ex: 9.48 (0.46) vs. 8.61 (0.57)]). The present results do not suggest any beneficial or adverse relationship between current alcohol consumption levels and cognitive functioning (both global and domain specific) in elderly Japanese men; however, low cognitive function among ex-drinkers warrants future investigations to identify the factors causing drinkers to quit.
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Zhang R, Shen L, Miles T, Shen Y, Cordero J, Qi Y, Liang L, Li C. Association of Low to Moderate Alcohol Drinking With Cognitive Functions From Middle to Older Age Among US Adults. JAMA Netw Open 2020; 3:e207922. [PMID: 32597992 PMCID: PMC7324954 DOI: 10.1001/jamanetworkopen.2020.7922] [Citation(s) in RCA: 69] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
IMPORTANCE Studies examining the association of low to moderate drinking with various cognitive functions have yielded mixed findings. OBJECTIVE To investigate whether associations exist between low to moderate alcohol drinking and cognitive function trajectories or rates of change in cognitive function from middle age to older age among US adults. DESIGN, SETTING, AND PARTICIPANTS A prospective cohort study of participants drawn from the Health and Retirement Study (HRS), a nationally representative sample of US adults, with mean (SD) follow-up of 9.1 (3.1) years. In total, 19 887 participants who had their cognitive functions measured in the HRS starting in 1996 through 2008 and who had participated in at least 3 biennial surveys were included. The data analysis was conducted from June to November 2019. EXPOSURES Alcohol consumption and aging. MAIN OUTCOMES AND MEASURES Trajectories and annual rates of change for the cognitive domains of mental status, word recall, and vocabulary and for the total cognitive score, which was the sum of the mental status and word recall scores. Participants were clustered into 2 cognitive function trajectories for each cognition measure assessed based on their scores at baseline and through at least 3 biennial surveys: a consistently low trajectory (representing low cognitive scores throughout the study period) and a consistently high trajectory (representing high cognitive scores throughout the study period). RESULTS The mean (SD) age of 19 887 participants was 61.8 (10.2) years, and the majority of the HRS participants were women (11 943 [60.1%]) and of white race/ethnicity (16 950 [85.2%]). Low to moderate drinking (<8 drinks per week for women and <15 drinks per week for men) was significantly associated with a consistently high cognitive function trajectory and a lower rate of cognitive decline. Compared with never drinkers, low to moderate drinkers were less likely to have a consistently low trajectory for total cognitive function (odds ratio [OR], 0.66; 95% CI, 0.59-0.74), mental status (OR, 0.71; 95% CI, 0.63-0.81), word recall (OR, 0.74; 95% CI, 0.69-0.80), and vocabulary (OR, 0.64; 95% CI, 0.56-0.74) (all P < .001). In addition, low to moderate drinking was associated with decreased annual rates of total cognitive function decline (β coefficient, 0.04; 95% CI, 0.02-0.07; P = .002), mental status (β coefficient, 0.02; 95% CI, 0.01-0.03; P = .002), word recall (β coefficient, 0.02; 95% CI, 0.01-0.04; P = .01), and vocabulary (β coefficient, 0.01; 95% CI, 0.00-0.03; P = .08). A significant racial/ethnic difference was observed for trajectories of mental status (P = .02 for interaction), in which low to moderate drinking was associated with lower odds of having a consistently low trajectory for white participants (OR, 0.65; 95% CI, 0.56-0.75) but not for black participants (OR, 1.02; 95% CI, 0.74-1.39). Finally, the dosage of alcohol consumed had a U-shaped association with all cognitive function domains for all participants, with an optimal dose of 10 to 14 drinks per week. CONCLUSIONS AND RELEVANCE These findings suggested that low to moderate alcohol drinking was associated with better global cognition scores, and these associations appeared stronger for white participants than for black participants. Studies examining the mechanisms underlying the association between alcohol drinking and cognition in middle-aged or older adults are needed.
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Affiliation(s)
- Ruiyuan Zhang
- Department of Epidemiology and Biostatistics, University of Georgia College of Public Health, Athens
| | - Luqi Shen
- Department of Epidemiology and Biostatistics, University of Georgia College of Public Health, Athens
| | - Toni Miles
- Department of Epidemiology and Biostatistics, University of Georgia College of Public Health, Athens
| | - Ye Shen
- Department of Epidemiology and Biostatistics, University of Georgia College of Public Health, Athens
| | - Jose Cordero
- Department of Epidemiology and Biostatistics, University of Georgia College of Public Health, Athens
| | - Yanling Qi
- Department of Health Care Administration, College of Health and Human Services, California State University, Long Beach
| | - Lirong Liang
- Clinical Epidemiology and Tobacco Dependence Treatment Research Department, Beijing Institute of Respiratory Medicine, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Changwei Li
- Department of Epidemiology and Biostatistics, University of Georgia College of Public Health, Athens
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Conditional Effects of Lifetime Alcohol Consumption on Methamphetamine-Associated Neurocognitive Performance. J Int Neuropsychol Soc 2019; 25:787-799. [PMID: 31179969 PMCID: PMC6733657 DOI: 10.1017/s1355617719000493] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVES Methamphetamine (MA) dependence contributes to neurotoxicity and neurocognitive deficits. Although combined alcohol and MA misuse is common, how alcohol consumption relates to neurocognitive performance among MA users remains unclear. We hypothesized that alcohol and MA use would synergistically diminish neurocognitive functioning, such that greater reported alcohol consumption would exert larger negative effects on neurocognition among MA-dependent individuals compared to MA-nonusing persons. METHODS Eighty-seven MA-dependent (MA+) and 114 MA-nonusing (MA-) adults underwent neuropsychological and substance use assessments. Linear and logistic regressions examined the interaction between MA status and lifetime average drinks per drinking day on demographically corrected global neurocognitive T scores and impairment rates, controlling for recent alcohol use, lifetime cannabis use, WRAT reading performance, and lifetime depression. RESULTS MA+ displayed moderately higher rates of impairment and lower T scores compared to MA-. Lifetime alcohol use significantly interacted with MA status to predict global impairment (ORR = 0.70, p = .003) such that greater lifetime alcohol use increased likelihood of impairment in MA-, but decreased likelihood of impairment in MA+. Greater lifetime alcohol use predicted poorer global T scores among MA- (b = -0.44, p = .030) but not MA+ (b = 0.08, p = .586). CONCLUSIONS Contrary to expectations, greater lifetime alcohol use related to reduced risk of neurocognitive impairment among MA users. Findings are supported by prior research identifying neurobiological mechanisms by which alcohol may attenuate stimulant-driven vasoconstriction and brain thermotoxicity. Replication and examination of neurophysiologic mechanisms underlying alcohol use in the context of MA dependence are warranted to elucidate whether alcohol confers a degree of neuroprotection.
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Associations between modifiable lifestyle factors and multidimensional cognitive health among community-dwelling old adults: stratified by educational level. Int Psychogeriatr 2018; 30:1465-1476. [PMID: 29444740 PMCID: PMC6316383 DOI: 10.1017/s1041610217003076] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
UNLABELLED ABSTRACTBackground:Cognition is multidimensional, and each domain plays a unique and crucial part in successful daily life engagement. However, less attention has been paid to multi-domain cognitive health for the elderly, and the role of lifestyle factors in each domain remains unclear. METHODS We conducted a cross-sectional study of 3,230 older adults aged 60+ years in Xiamen, China, in 2016. The Montreal Cognitive Assessment (MoCA) was used to measure general cognition and six specific sub-domains. To account for educational effects, we adjusted the MoCA score and divided respondents into three education-specific groups (low, moderate, and high education groups with ≤5, 6~8, and ≥9 years of education, respectively). A series of proportional odds models were used to detect the associations between two categories of lifestyle factors - substance abuse (cigarette and alcohol) and leisure activity (TV watching, reading, smartphone use, social activity, and exercise) - and general cognition and the six sub-domains in those three groups. RESULTS Among the 3,230 respondents, 2,617 eligible participants were included with a mean age of 69.05 ± 7.07 years. Previous or current smoking/drinking was not associated with MoCA scores in the whole population, but unexpectedly, the ex-smokers in the low education group performed better in general cognition (OR = 2.22) and attention (OR = 2.05) than their never-smoking counterparts. Modest TV watching, reading, and smartphone use also contributed to better cognition among elderly participants in the low education group. For the highly educated elderly, comparatively longer reading (>3.5 hours/week) was inversely associated with general cognition (OR = 0.53), memory (OR = 0.59), and language (OR = 0.54), while adequate exercise (5~7 days/week) was positively related to these factors with OR = 1.48, OR = 1.49, and OR = 1.53, respectively. For the moderately educated elderly, only modest reading was significantly beneficial. CONCLUSIONS Lifestyle factors play different roles in multidimensional cognitive health in different educational groups, indicating that individual intervention strategies should be designed according to specific educational groups and different cognitive sub-domains.
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Gross AL, Lu H, Meoni L, Gallo JJ, Schrack JA, Sharrett AR. Physical Activity in Midlife is not Associated with Cognitive Health in Later Life Among Cognitively Normal Older Adults. J Alzheimers Dis 2017; 59:1349-1358. [DOI: 10.3233/jad-170290] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Alden L. Gross
- Departments of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Johns Hopkins University Center on Aging and Health, Baltimore, MD, USA
| | - Haidong Lu
- Department of Epidemiology, University of North Carolina Gillings School of Global Public Health, Chapel Hill, NC, USA
| | - Lucy Meoni
- Departments of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Joseph J. Gallo
- Departments of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Jennifer A. Schrack
- Departments of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Johns Hopkins University Center on Aging and Health, Baltimore, MD, USA
| | - A. Richey Sharrett
- Departments of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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Kalapatapu RK, Ventura MI, Barnes DE. Lifetime alcohol use and cognitive performance in older adults. J Addict Dis 2016; 36:38-47. [PMID: 27719514 DOI: 10.1080/10550887.2016.1245029] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Substance use is an important clinical issue in the older adult population. As older adults are susceptible to cognitive disorders, the intersection of the fields of substance use and cognitive neuroscience is an active area of research. Prior studies of alcohol use and cognitive performance are mixed, and inconsistencies may be due to under- or over-adjustment for confounders. This article adds to this literature by conducting a secondary analysis of self-reported lifetime history of alcohol use and cognitive performance in older adults (n = 133). It was hypothesized that current alcohol users would have poorer cognitive performance compared to never/minimal and former alcohol users. Older adult participants were classified into never/minimal alcohol users, former alcohol users, and current alcohol users. A neurocognitive battery included a global cognitive measure and individual measures of attention, memory, fluency, and executive function. A directed acyclic graph-based approach was used to select variables to be included in the multiple linear regression models. Though unadjusted analyses showed some significant associations between alcohol use and cognitive performance, all associations between alcohol use and cognitive performance were eliminated after adjusting for age, education, sex, race, and smoking pack years. Alcohol drink years were not significantly associated with cognitive performance among current and former alcohol users. These results suggest that lifetime alcohol use is not significantly associated with cognitive performance in older adults after adjustment for key confounders. Inconsistencies in prior studies may be due to uncontrolled confounding and/or unnecessary adjustment of mediators and/or colliders.
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Affiliation(s)
- Raj K Kalapatapu
- a Department of Psychiatry , University of California , San Francisco , California , USA.,b Department of Epidemiology and Biostatistics , University of California , San Francisco , California , USA.,c San Francisco Veterans Affairs Medical Center , San Francisco , California , USA
| | - Maria I Ventura
- b Department of Epidemiology and Biostatistics , University of California , San Francisco , California , USA
| | - Deborah E Barnes
- a Department of Psychiatry , University of California , San Francisco , California , USA.,b Department of Epidemiology and Biostatistics , University of California , San Francisco , California , USA.,c San Francisco Veterans Affairs Medical Center , San Francisco , California , USA
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Stockley CS. Wine consumption, cognitive function and dementias – A relationship? ACTA ACUST UNITED AC 2016. [DOI: 10.3233/nua-150055] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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Guidolin BL, Silva Filho IGD, Nogueira EL, Ribeiro Junior FP, Cataldo Neto A. Patterns of alcohol use in an elderly sample enrolled in the Family Health Strategy program in the city of Porto Alegre, Brazil. CIENCIA & SAUDE COLETIVA 2016; 21:27-35. [PMID: 26816160 DOI: 10.1590/1413-81232015211.10032015] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2015] [Accepted: 08/24/2015] [Indexed: 11/22/2022] Open
Abstract
This article aims to determine the pattern of alcohol use in the elderly and its associations with sociodemographic characteristics in an elderly sample of patients from the city of Porto Alegre, Rio Grande do Sul, Brazil. A cross-sectional study was conducted involving 557 seniors, aged 60 years or more, through application of the Mini International Neuropsychiatric Interview and a global assessment questionnaire for the elderly. The majority of the 557 senior citizens did not complete elementary school (58.3%), were white (65.1%), married (37.6%), had no caregiver (62.2%), were catholic (65.5%) and practicing their religion (68.6%), were retired (67.7%), and had a personal income of up to one minimum salary (56.1%). The study revealed 67 (12%) elderly people with a history of alcoholism, of which 17 (3.1%) had a diagnosis of current alcoholism, 50 (9%) had a history of alcohol dependence in the past and 16 (2.9%) had a current alcohol abuse problem. Men had a prevalence ratio of 11.6 times for a history of alcoholism in comparison to women. The results confirm that alcoholism is frequent in the population of Brazilian elderly, drawing attention to some socio-demographic characteristics that can make a difference in the early diagnosis of alcoholism.
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Affiliation(s)
- Bruno Luiz Guidolin
- Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brasil,
| | | | | | | | - Alfredo Cataldo Neto
- Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brasil,
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Handing EP, Andel R, Kadlecova P, Gatz M, Pedersen NL. Midlife Alcohol Consumption and Risk of Dementia Over 43 Years of Follow-Up: A Population-Based Study From the Swedish Twin Registry. J Gerontol A Biol Sci Med Sci 2015; 70:1248-54. [PMID: 25881581 DOI: 10.1093/gerona/glv038] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2014] [Accepted: 03/04/2015] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Midlife alcohol consumption (beer, wine, and spirits) was examined in relation to dementia incidence over 43 years. METHODS Participants were 12,326 members of the population-based Swedish Twin Registry born during 1907-1925 who responded to items about alcohol consumption in 1967/1970, subsequently classified as nondrinking (0 grams of ethanol per day), light (1-5g/d), moderate (5-12g/d), heavy (12-24g/d), and very heavy (>24g/d) drinking. Dementia was identified from the National Patient and Cause of Death Registries. Cox proportional hazard models adjusted for cluster-correlated data were used in cohort analyses. Conditional logistic regression (dementia-discordant pairs) and mixed effects models (dementia-concordant pairs) were used in twin analyses. RESULTS Overall, nondrinkers did not differ from light drinkers in dementia risk. Heavy drinking (hazard ratio = 1.10, p = .028) and very heavy drinking (hazard ratio = 1.18, p = .033) were associated with increased dementia risk controlling for sociodemographic, lifestyle, and cardiovascular factors. More alcohol from spirits was related to increased risk of dementia, whereas more alcohol from wine with decreased risk, although the association for wine reversed direction at high amounts. Relative to co-twins drinking light amounts, moderate-to-heavy drinking twins had (a) greater risk of dementia by 57% (p = .006, 300% in monozygotic pairs only) and (b) reduced time to dementia by 4.76 years (p = .019, 4.78 years in monozygotic pairs only). CONCLUSION Averaging more than 12 grams of alcohol per day may increase risk of dementia. Alcohol from spirits appears particularly important for the increased dementia risk. Genetic and/or familial factors do not explain these associations. Alcohol use reduction may be a useful population-wide intervention strategy.
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Affiliation(s)
| | - Ross Andel
- School of Aging Studies, University of South Florida, Tampa. International Clinical Research Center, St. Anne's Hospital, Brno, Czech Republic
| | - Pavla Kadlecova
- International Clinical Research Center, St. Anne's Hospital, Brno, Czech Republic
| | - Margaret Gatz
- Department of Psychology, University of Southern California, Los Angeles. Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden
| | - Nancy L Pedersen
- Department of Psychology, University of Southern California, Los Angeles. Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden
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Day AM, Kahler CW, Ahern DC, Clark US. Executive Functioning in Alcohol Use Studies: A Brief Review of Findings and Challenges in Assessment. CURRENT DRUG ABUSE REVIEWS 2015; 8:26-40. [PMID: 25877524 PMCID: PMC4638323 DOI: 10.2174/1874473708666150416110515] [Citation(s) in RCA: 78] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/23/2015] [Revised: 04/06/2015] [Accepted: 04/09/2015] [Indexed: 11/22/2022]
Abstract
There is a wealth of research about the links between executive functioning (EF) and alcohol use. However, difficulty may arise in interpreting findings because of the variability between studies regarding the specific components of EF measured, as well as the variability of tasks used to examine each EF construct. The current article considers each of these problems within the context of a literature review that focuses on two topics: (1) the efficacy of EF in predicting alcohol use and alcohol-related consequences, and (2) the effect of acute alcohol intoxication on EF task performance. An additional goal was to identify and describe commonly used EF measures with the intention of providing alcohol researchers information on the assessment of different EF domains. Our findings indicate that there is strong evidence supporting a relation between EF difficulties (particularly response inhibition and information updating) and alcohol use, with additional evidence of a significant interaction between EF and implicit associations on alcohol use. In contrast, research supporting a link between set shifting abilities and later alcohol use is scarce. Additionally, this review found evidence of alcohol acutely affecting many EF processes (particularly response inhibition). Overall, there is a need to replicate these findings with commonly used EF tasks (versus developing numerous tasks within individual laboratories) to better advance our understanding of the relation between EF and alcohol use.
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Affiliation(s)
- Anne M Day
- Center for Alcohol and Addiction Studies, Brown University, Box G-S121-4, Providence, RI 02912, USA.
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Horvat P, Richards M, Kubinova R, Pajak A, Malyutina S, Shishkin S, Pikhart H, Peasey A, Marmot MG, Singh-Manoux A, Bobak M. Alcohol consumption, drinking patterns, and cognitive function in older Eastern European adults. Neurology 2014; 84:287-95. [PMID: 25503981 PMCID: PMC4335999 DOI: 10.1212/wnl.0000000000001164] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Objective: To investigate associations of frequency, quantity, binge, and problem drinking with cognitive function in older Eastern European adults. Methods: The investigation included 14,575 participants, aged 47 to 78 years at cognitive assessment in 2006–2008 from Novosibirsk (Russia), Krakow (Poland), and 6 Czech towns participating in the HAPIEE (Health, Alcohol, and Psychosocial Factors in Eastern Europe) prospective cohort study. Average response rates were 59% at baseline (2002–2005) and 63% in 2006–2008. Alcohol consumption was assessed at baseline and in 2006–2008. Cognitive tests included immediate and delayed word recall, semantic fluency (animal naming), and letter cancellation. Associations between alcohol indices and cognitive scores were analyzed cross-sectionally (all measures from 2006 to 2008) and prospectively (alcohol and covariates from 2002 to 2005 and cognition from 2006 to 2008). Results: In cross-sectional analyses, nondrinkers had lower cognitive scores and female moderate drinkers had better cognitive performance than light drinkers. Heavy, binge, and problem drinking were not consistently associated with cognitive function. Few associations were replicated in prospective analyses. Participants who stopped drinking during follow-up had worse cognition than stable drinkers; in men, regression coefficients (95% confidence interval) ranged from −0.26 (−0.36, −0.16) for immediate recall to −0.14 (−0.24, −0.04) for fluency. Conclusion: Regular and episodic heavy drinking were not consistently associated with cognitive function. Worse cognition in participants who stopped drinking during follow-up suggests that inclusion of less healthy ex-drinkers may partly explain poorer cognition in nondrinkers.
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Affiliation(s)
- Pia Horvat
- From the Department of Epidemiology & Public Health (P.H., H.P., A. Peasey, M.G.M., A.S.-M., M.B.), and MRC Unit for Lifelong Health and Ageing at UCL (M.R.), University College London, UK; National Institute of Public Health (R.K.), Prague, Czech Republic; Department of Epidemiology and Population Studies (A. Pajak), Jagellonian University Collegium Medicum, Krakow, Poland; Institute of Internal and Preventive Medicine Siberian Branch under the Russian Academy of Medical Sciences (S.M., S.S.), Novosibirsk; Novosibirsk State Medical University (S.M.), Novosibirsk, Russia; and INSERM (A.S.-M.), U1018, Hopital Paul Brousse, Villejuif, France.
| | - Marcus Richards
- From the Department of Epidemiology & Public Health (P.H., H.P., A. Peasey, M.G.M., A.S.-M., M.B.), and MRC Unit for Lifelong Health and Ageing at UCL (M.R.), University College London, UK; National Institute of Public Health (R.K.), Prague, Czech Republic; Department of Epidemiology and Population Studies (A. Pajak), Jagellonian University Collegium Medicum, Krakow, Poland; Institute of Internal and Preventive Medicine Siberian Branch under the Russian Academy of Medical Sciences (S.M., S.S.), Novosibirsk; Novosibirsk State Medical University (S.M.), Novosibirsk, Russia; and INSERM (A.S.-M.), U1018, Hopital Paul Brousse, Villejuif, France
| | - Ruzena Kubinova
- From the Department of Epidemiology & Public Health (P.H., H.P., A. Peasey, M.G.M., A.S.-M., M.B.), and MRC Unit for Lifelong Health and Ageing at UCL (M.R.), University College London, UK; National Institute of Public Health (R.K.), Prague, Czech Republic; Department of Epidemiology and Population Studies (A. Pajak), Jagellonian University Collegium Medicum, Krakow, Poland; Institute of Internal and Preventive Medicine Siberian Branch under the Russian Academy of Medical Sciences (S.M., S.S.), Novosibirsk; Novosibirsk State Medical University (S.M.), Novosibirsk, Russia; and INSERM (A.S.-M.), U1018, Hopital Paul Brousse, Villejuif, France
| | - Andrzej Pajak
- From the Department of Epidemiology & Public Health (P.H., H.P., A. Peasey, M.G.M., A.S.-M., M.B.), and MRC Unit for Lifelong Health and Ageing at UCL (M.R.), University College London, UK; National Institute of Public Health (R.K.), Prague, Czech Republic; Department of Epidemiology and Population Studies (A. Pajak), Jagellonian University Collegium Medicum, Krakow, Poland; Institute of Internal and Preventive Medicine Siberian Branch under the Russian Academy of Medical Sciences (S.M., S.S.), Novosibirsk; Novosibirsk State Medical University (S.M.), Novosibirsk, Russia; and INSERM (A.S.-M.), U1018, Hopital Paul Brousse, Villejuif, France
| | - Sofia Malyutina
- From the Department of Epidemiology & Public Health (P.H., H.P., A. Peasey, M.G.M., A.S.-M., M.B.), and MRC Unit for Lifelong Health and Ageing at UCL (M.R.), University College London, UK; National Institute of Public Health (R.K.), Prague, Czech Republic; Department of Epidemiology and Population Studies (A. Pajak), Jagellonian University Collegium Medicum, Krakow, Poland; Institute of Internal and Preventive Medicine Siberian Branch under the Russian Academy of Medical Sciences (S.M., S.S.), Novosibirsk; Novosibirsk State Medical University (S.M.), Novosibirsk, Russia; and INSERM (A.S.-M.), U1018, Hopital Paul Brousse, Villejuif, France
| | - Sergey Shishkin
- From the Department of Epidemiology & Public Health (P.H., H.P., A. Peasey, M.G.M., A.S.-M., M.B.), and MRC Unit for Lifelong Health and Ageing at UCL (M.R.), University College London, UK; National Institute of Public Health (R.K.), Prague, Czech Republic; Department of Epidemiology and Population Studies (A. Pajak), Jagellonian University Collegium Medicum, Krakow, Poland; Institute of Internal and Preventive Medicine Siberian Branch under the Russian Academy of Medical Sciences (S.M., S.S.), Novosibirsk; Novosibirsk State Medical University (S.M.), Novosibirsk, Russia; and INSERM (A.S.-M.), U1018, Hopital Paul Brousse, Villejuif, France
| | - Hynek Pikhart
- From the Department of Epidemiology & Public Health (P.H., H.P., A. Peasey, M.G.M., A.S.-M., M.B.), and MRC Unit for Lifelong Health and Ageing at UCL (M.R.), University College London, UK; National Institute of Public Health (R.K.), Prague, Czech Republic; Department of Epidemiology and Population Studies (A. Pajak), Jagellonian University Collegium Medicum, Krakow, Poland; Institute of Internal and Preventive Medicine Siberian Branch under the Russian Academy of Medical Sciences (S.M., S.S.), Novosibirsk; Novosibirsk State Medical University (S.M.), Novosibirsk, Russia; and INSERM (A.S.-M.), U1018, Hopital Paul Brousse, Villejuif, France
| | - Anne Peasey
- From the Department of Epidemiology & Public Health (P.H., H.P., A. Peasey, M.G.M., A.S.-M., M.B.), and MRC Unit for Lifelong Health and Ageing at UCL (M.R.), University College London, UK; National Institute of Public Health (R.K.), Prague, Czech Republic; Department of Epidemiology and Population Studies (A. Pajak), Jagellonian University Collegium Medicum, Krakow, Poland; Institute of Internal and Preventive Medicine Siberian Branch under the Russian Academy of Medical Sciences (S.M., S.S.), Novosibirsk; Novosibirsk State Medical University (S.M.), Novosibirsk, Russia; and INSERM (A.S.-M.), U1018, Hopital Paul Brousse, Villejuif, France
| | - M G Marmot
- From the Department of Epidemiology & Public Health (P.H., H.P., A. Peasey, M.G.M., A.S.-M., M.B.), and MRC Unit for Lifelong Health and Ageing at UCL (M.R.), University College London, UK; National Institute of Public Health (R.K.), Prague, Czech Republic; Department of Epidemiology and Population Studies (A. Pajak), Jagellonian University Collegium Medicum, Krakow, Poland; Institute of Internal and Preventive Medicine Siberian Branch under the Russian Academy of Medical Sciences (S.M., S.S.), Novosibirsk; Novosibirsk State Medical University (S.M.), Novosibirsk, Russia; and INSERM (A.S.-M.), U1018, Hopital Paul Brousse, Villejuif, France
| | - Archana Singh-Manoux
- From the Department of Epidemiology & Public Health (P.H., H.P., A. Peasey, M.G.M., A.S.-M., M.B.), and MRC Unit for Lifelong Health and Ageing at UCL (M.R.), University College London, UK; National Institute of Public Health (R.K.), Prague, Czech Republic; Department of Epidemiology and Population Studies (A. Pajak), Jagellonian University Collegium Medicum, Krakow, Poland; Institute of Internal and Preventive Medicine Siberian Branch under the Russian Academy of Medical Sciences (S.M., S.S.), Novosibirsk; Novosibirsk State Medical University (S.M.), Novosibirsk, Russia; and INSERM (A.S.-M.), U1018, Hopital Paul Brousse, Villejuif, France
| | - Martin Bobak
- From the Department of Epidemiology & Public Health (P.H., H.P., A. Peasey, M.G.M., A.S.-M., M.B.), and MRC Unit for Lifelong Health and Ageing at UCL (M.R.), University College London, UK; National Institute of Public Health (R.K.), Prague, Czech Republic; Department of Epidemiology and Population Studies (A. Pajak), Jagellonian University Collegium Medicum, Krakow, Poland; Institute of Internal and Preventive Medicine Siberian Branch under the Russian Academy of Medical Sciences (S.M., S.S.), Novosibirsk; Novosibirsk State Medical University (S.M.), Novosibirsk, Russia; and INSERM (A.S.-M.), U1018, Hopital Paul Brousse, Villejuif, France
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Hoang TD, Byers AL, Barnes DE, Yaffe K. Alcohol consumption patterns and cognitive impairment in older women. Am J Geriatr Psychiatry 2014; 22:1663-7. [PMID: 24862680 PMCID: PMC4353638 DOI: 10.1016/j.jagp.2014.04.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2013] [Revised: 03/18/2014] [Accepted: 04/21/2014] [Indexed: 11/18/2022]
Abstract
OBJECTIVE Few studies have investigated changes in alcohol consumption and risk of cognitive impairment among oldest old adults. METHODS In a prospective study of 1309 women ≥65 years old, alcohol use was assessed at repeated visits and used to estimate average change in alcohol consumption over 16 years. Clinically significant cognitive impairment (mild cognitive impairment and dementia) was assessed at year 20. RESULTS Compared with the reference group (slight decrease in alcohol consumption by 0-0.5 drinks/week, 60.4%), increasing consumption over time (>0 drinks/week) was not associated with risk of cognitive impairment (5.0%, odds ratio [OR]: 1.00, 95% confidence interval [CI]: 0.54-1.85). Decreasing consumption by >0.5 drinks/week was associated with increased risk (34.5%, OR: 1.34, 95% CI: 1.05-1.70). Adjustment for age, education, diabetes, smoking, BMI, and physical activity attenuated the magnitude of the effect slightly and resulted in borderline statistical significance. CONCLUSION Women in their ninth and tenth decade of life who decrease alcohol use may be at risk of cognitive impairment.
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Affiliation(s)
- Tina D Hoang
- Northern California Institute for Research and Education, San Francisco, CA.
| | - Amy L Byers
- Department of Psychiatry, University of California, San Francisco, CA
| | - Deborah E Barnes
- Department of Psychiatry, University of California, San Francisco, CA
| | - Kristine Yaffe
- Department of Psychiatry, University of California, San Francisco, CA; Department of Neurology, University of California, San Francisco, CA; Department of Epidemiology, University of California, San Francisco, CA; San Francisco Veterans Affairs Medical Center, San Francisco, CA
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Beydoun MA, Beydoun HA, Gamaldo AA, Teel A, Zonderman AB, Wang Y. Epidemiologic studies of modifiable factors associated with cognition and dementia: systematic review and meta-analysis. BMC Public Health 2014; 14:643. [PMID: 24962204 PMCID: PMC4099157 DOI: 10.1186/1471-2458-14-643] [Citation(s) in RCA: 474] [Impact Index Per Article: 47.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2013] [Accepted: 05/13/2014] [Indexed: 12/15/2022] Open
Abstract
Background Cognitive impairment, including dementia, is a major health concern with the increasing aging population. Preventive measures to delay cognitive decline are of utmost importance. Alzheimer’s disease (AD) is the most frequent cause of dementia, increasing in prevalence from <1% below the age of 60 years to >40% above 85 years of age. Methods We systematically reviewed selected modifiable factors such as education, smoking, alcohol, physical activity, caffeine, antioxidants, homocysteine (Hcy), n-3 fatty acids that were studied in relation to various cognitive health outcomes, including incident AD. We searched MEDLINE for published literature (January 1990 through October 2012), including cross-sectional and cohort studies (sample sizes > 300). Analyses compared study finding consistency across factors, study designs and study-level characteristics. Selecting studies of incident AD, our meta-analysis estimated pooled risk ratios (RR), population attributable risk percent (PAR%) and assessed publication bias. Results In total, 247 studies were retrieved for systematic review. Consistency analysis for each risk factor suggested positive findings ranging from ~38.9% for caffeine to ~89% for physical activity. Education also had a significantly higher propensity for “a positive finding” compared to caffeine, smoking and antioxidant-related studies. Meta-analysis of 31 studies with incident AD yielded pooled RR for low education (RR = 1.99; 95% CI: 1.30-3.04), high Hcy (RR = 1.93; 95% CI: 1.50-2.49), and current/ever smoking status (RR = 1.37; 95% CI: 1.23-1.52) while indicating protective effects of higher physical activity and n-3 fatty acids. Estimated PAR% were particularly high for physical activity (PAR% = 31.9; 95% CI: 22.7-41.2) and smoking (PAR%=31.09%; 95% CI: 17.9-44.3). Overall, no significant publication bias was found. Conclusions Higher Hcy levels, lower educational attainment, and decreased physical activity were particularly strong predictors of incident AD. Further studies are needed to support other potential modifiable protective factors, such as caffeine.
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Affiliation(s)
- May A Beydoun
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, NIA/NIH/IRP, 251 Bayview Blvd,, Suite 100, Room #: 04B118, Baltimore, MD 21224, USA.
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Beydoun MA, Gamaldo AA, Beydoun HA, Tanaka T, Tucker KL, Talegawkar SA, Ferrucci L, Zonderman AB. Caffeine and alcohol intakes and overall nutrient adequacy are associated with longitudinal cognitive performance among U.S. adults. J Nutr 2014; 144:890-901. [PMID: 24744319 PMCID: PMC4018952 DOI: 10.3945/jn.113.189027] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Among modifiable lifestyle factors, diet may affect cognitive health. Cross-sectional and longitudinal associations may exist between dietary exposures [e.g., caffeine (mg/d), alcohol (g/d), and nutrient adequacy] and cognitive performance and change over time. This was a prospective cohort study, the Baltimore Longitudinal Study of Aging (n = 628-1305 persons depending on the cognitive outcome; ∼2 visits/person). Outcomes included 10 cognitive scores, spanning various domains of cognition. Caffeine and alcohol intakes and a nutrient adequacy score (NAS) were estimated from 7-d food diaries. Among key findings, caffeine intake was associated with better baseline global cognition among participants with a baseline age (Agebase) of ≥70 y. A higher NAS was associated with better baseline global cognition performance (overall, women, Agebase <70 y), better baseline verbal memory (immediate and delayed recall, Agebase ≥70 y), and slower rate of decline or faster improvement in the attention domain (women). For an Agebase of <70 y, alcohol consumption was associated with slower improvement on letter fluency and global cognition over time. Conversely, for an Agebase of ≥70 y and among women, alcohol intake was related to better baseline attention and working memory. In sum, patterns of diet and cognition associations indicate stratum-specific associations by sex and baseline age. The general observed trend was that of putative beneficial effects of caffeine intake and nutrient adequacy on domains of global cognition, verbal memory, and attention, and mixed effects of alcohol on domains of letter fluency, attention, and working memory. Further longitudinal studies conducted on larger samples of adults are needed to determine whether dietary factors individually or in combination are modifiers of cognitive trajectories among adults.
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Affiliation(s)
- May A. Beydoun
- Intramural Research Program (NIA/NIH/IRP), National Institute on Aging, Baltimore, MD,To whom correspondence should be addressed. E-mail:
| | - Alyssa A. Gamaldo
- Intramural Research Program (NIA/NIH/IRP), National Institute on Aging, Baltimore, MD,School of Aging Studies, University of South Florida, Tampa, FL
| | - Hind A. Beydoun
- Graduate Program in Public Health, Eastern Virginia Medical School, Norfolk, VA
| | - Toshiko Tanaka
- Intramural Research Program (NIA/NIH/IRP), National Institute on Aging, Baltimore, MD
| | | | - Sameera A. Talegawkar
- Department of International Health, Center for Human Nutrition, Johns Hopkins School of Public Health, Baltimore, MD
| | - Luigi Ferrucci
- Intramural Research Program (NIA/NIH/IRP), National Institute on Aging, Baltimore, MD
| | - Alan B. Zonderman
- Intramural Research Program (NIA/NIH/IRP), National Institute on Aging, Baltimore, MD
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Wilkinson C, Dare J. Shades of Grey: The Need for a Multi-disciplinary Approach to Research Investigating Alcohol and Ageing. J Public Health Res 2014; 3:180. [PMID: 25170507 PMCID: PMC4140383 DOI: 10.4081/jphr.2014.180] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2013] [Revised: 10/10/2013] [Accepted: 10/16/2013] [Indexed: 11/23/2022] Open
Abstract
This paper calls for an increase in multi-disciplinary research on the issue of alcohol and ageing, to ensure public health interventions reflect the complex and diverse needs of older drinkers. Older people (65+ years) represent a unique segment of the population; compared to adolescents and younger people, they are more likely to have a range of co-morbid conditions and be taking prescribed medication, and are more physiologically vulnerable to the effects of alcohol. This suggests that from a public health perspective, alcohol use by older people is problematic. However, as with younger people, alcohol use is closely associated with socialisation and social engagement. While social engagement is important at all stages of life, it is particularly critical as people age, when many of the formal social roles which provide a catalyst for social integration shift or are lost. Currently, however, there is little evidence of an integrated public health response to the complex issue of alcohol and ageing. That is, what is needed is a concurrent acknowledgement of the health problems that may be associated with contraindicated alcohol use, versus the potential health benefits that can accrue from social drinking. This will require a holistic rather than reductionist approach that integrates biomedical and social science insights to develop a more comprehensive and nuanced understanding of the implications of alcohol use amongst diverse populations of older people. Significance for public healthWith the rapid ageing of the global population and concerns about recent increases in the consumption of alcohol amongst older people, the issue of alcohol and ageing is becoming an important public health issue. However, there remains little research that adopts a holistic multi-disciplinary perspective. Such research is important and may offer the best way forward in terms of unravelling the complexity of competing risks and benefits associated with low to moderate drinking amongst older people.
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Affiliation(s)
- Celia Wilkinson
- Edith Cowan University, Joondalup, Australia
- National Drug Research Institute, Curtin University, Perth, Australia
| | - Julie Dare
- Edith Cowan University, Joondalup, Australia
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The Use of Multiple Correspondence Analysis to Explore Associations between Categories of Qualitative Variables in Healthy Ageing. J Aging Res 2013; 2013:302163. [PMID: 24222852 PMCID: PMC3810057 DOI: 10.1155/2013/302163] [Citation(s) in RCA: 68] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2013] [Revised: 08/23/2013] [Accepted: 08/30/2013] [Indexed: 01/07/2023] Open
Abstract
The main focus of this study was to illustrate the applicability of multiple correspondence analysis (MCA) in detecting and representing underlying structures in large datasets used to investigate cognitive ageing. Principal component analysis (PCA) was used to obtain main cognitive dimensions, and MCA was used to detect and explore relationships between cognitive, clinical, physical, and lifestyle variables. Two PCA dimensions were identified (general cognition/executive function and memory), and two MCA dimensions were retained. Poorer cognitive performance was associated with older age, less school years, unhealthier lifestyle indicators, and presence of pathology. The first MCA dimension indicated the clustering of general/executive function and lifestyle indicators and education, while the second association was between memory and clinical parameters and age. The clustering analysis with object scores method was used to identify groups sharing similar characteristics. The weaker cognitive clusters in terms of memory and executive function comprised individuals with characteristics contributing to a higher MCA dimensional mean score (age, less education, and presence of indicators of unhealthier lifestyle habits and/or clinical pathologies). MCA provided a powerful tool to explore complex ageing data, covering multiple and diverse variables, showing if a relationship exists and how variables are related, and offering statistical results that can be seen both analytically and visually.
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Kesse-Guyot E, Andreeva VA, Jeandel C, Ferry M, Touvier M, Hercberg S, Galan P. Alcohol consumption in midlife and cognitive performance assessed 13 years later in the SU.VI.MAX 2 cohort. PLoS One 2012; 7:e52311. [PMID: 23284983 PMCID: PMC3526526 DOI: 10.1371/journal.pone.0052311] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2012] [Accepted: 11/16/2012] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Associations between alcohol consumption and cognitive function are discordant and data focusing on midlife exposure are scarce. OBJECTIVE To estimate the association between midlife alcohol consumption and cognitive performance assessed 13 y later while accounting for comorbidities and diet. METHODS 3,088 French middle-aged adults included in the SU.VI.MAX (1994) study with available neuropsychological evaluation 13 y later. Data on alcohol consumption were obtained from repeated 24h dietary records collected in 1994-1996. Cognitive performance was assessed in 2007-2009 via a battery of 6 neuropsychological tests. A composite score was built as the mean of the standardized individual test scores (mean=50, SD=10). ANCOVA were performed to estimate mean differences in cognitive performance and 95% confidence intervals (CI). RESULTS In women, abstainers displayed lower cognitive scores than did low-to-moderate alcohol drinkers (1 to 2 drinks/day) (mean difference= -1.77; 95% CI: -3.29, -0.25). In men, heavy drinkers (>3 drinks/day) had higher cognitive scores than did low-to-moderate (1 to 3 drinks/day) (mean difference=1.05; 95% CI: 0.10, 1.99). However, a lower composite cognitive score was detected in male drinkers consuming ≥ 90 g/d (≈8 drinks/d). A higher proportion of alcohol intake from beer was also associated with lower cognitive scores. These associations remained significant after adjustment for diet, comorbidities and sociodemographic factors. CONCLUSION In men, heavy but not extreme drinking was associated with higher global cognitive scores. Given the known harmful effects of alcohol even in low doses regarding risk of cancer, the study does not provide a basis for modifying current public health messages. TRIAL REGISTRATION ClinicalTrials.gov NCT00272428.
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Affiliation(s)
- Emmanuelle Kesse-Guyot
- UMR Inserm U557; Inra U1125; Cnam; Université Paris 13 Sorbonne Paris-Cité, CRNH Ile-de-France, Bobigny, France.
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Abstract
OBJECTIVES This study examines cognitive outcomes for alcohol drinking status over time, across cognitive ability and age groups. METHODS Data (1998-2005) from n = 571 Seattle Longitudinal Study participants aged 45+years (middle-aged: 45-64, young-old: 65-75, old-old: 75+) were analyzed to examine the alcohol drinking status effect (e.g., abstinent, moderate (less than seven drinks/week), at-risk (more than eight drinks/week)) on cognitive ability (e.g., memory, reasoning, spatial, verbal number, speed abilities). RESULTS Findings indicated that alcohol drinking status was associated with change in verbal ability, spatial ability, and perceptual speed. Decline in verbal ability was seen among alcohol abstainers and moderate alcohol consumers, but at-risk drinkers displayed relative stability. At-risk old-old adults and middle-aged adults (regardless of drinking status), displayed relative stability in spatial ability. Decline in spatial ability was however present among young-old adults across drinking status, and among abstaining and moderate drinking old-old adults. At-risk drinkers showed the most positive spatial ability trajectory. A gender effect in perceptual speed was detected, with women who abstained from drinking displaying the most decline in perceptual speed compared with women that regularly consumed alcohol, and men displaying decline in perceptual speed across drinking status. DISCUSSION In this study, consuming alcohol is indicative of cognitive stability. This conclusion should be considered cautiously, due to study bias created from survivor effects, analyzing two time points, health/medication change status, and overrepresentation of higher socioeconomic status and white populations in this study. Future research needs to design studies that can make concrete recommendations about the relationship between drinking status and cognition.
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Affiliation(s)
- Faika Zanjani
- Department of Gerontology, University of Kentucky, Lexington, KY, USA.
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