So What’s The Link With Dementia
Research shows that heavy drinking can increase the risk of developing dementia.
Alcohol abuse is toxic to the brain and can damage memory. It has also been shown to accelerate vascular brain damage. In other words, it’s bad for your brain.
The Lancet Public Health has published new research from France on more than one million adults with dementia. Researchers found that being hospitalised with alcohol dependence or a health issue caused by continuous heavy drinking was a strong risk factor for the progressive brain condition, especially in the under-65s.
Their risk of dementia was three times greater than other people’s.
But it’s difficult to know whether it was a direct cause or just one factor among many.
Heavy drinkers are more likely to be smokers, have depression and lead unhealthy lives, which increases the risk of dementia.
So Moderate Drinking Is Ok
The research is contradictory and so the answer isn’t straightforward.
Some research suggests that drinking one or two units of alcohol a day – particularly red wine – could be of benefit to brain health, but other scientists are more sceptical.
A study published on Thursday in the British Medical Journal found that moderate drinkers were at lowest risk of dementia, compared to heavy drinkers and non-drinkers, but this may be because they tend to lead generally healthy lives and are less likely to smoke or eat unhealthily.
How To Get Help
If you or a loved one drink heavily and its affecting your memory and overall health, help is available. Here are some places to start:
- Talk to your primary care doctor. If you drink heavily, you may need medical support for when you decide to stop drinking to prevent potentially severe withdrawal symptoms. Your doctor may suggest admitting you to a hospital or alcohol treatment facility to help.
- Call the Substance Abuse and Mental Health Services Administration free national helpline at 1-800-662-HELP . The helpline is available 24 hours a day.
- Find a local Alcoholics Anonymous meeting near you. These meetings are free and have helped thousands of people stay sober.
- Talk to friends and family members, and tell them if you think you need help. Their support can help get you through.
You should never be ashamed or afraid to ask for help. These steps can save your life.
Alcohol And Dementia: A Complicated Relationship
James M. Ellison, MD, MPH
Swank Center for Memory Care and Geriatric Consultation, ChristianaCare
- Expert Advice
The role of alcohol use as a risk factor for dementia is complicated. At different times, alcohol has been seen as protective, harmful, or incidental to the risk of dementia. Each of these views is partially correct, and the entire story is not yet fully known. This article discusses some of what we do know.
Terry* was a heavy drinker for most of his life. He started with beer in high school and upped his intake over time. By his mid-60s, he was drinking a pint of vodka or more on most days. Faced with the symptoms of progressive liver disease at age 68, he resolved to stop, and he used AA successfully for support. However, his family brought him for cognitive assessment because they wondered if he was developing Alzheimersor was it the long-term effect of alcoholor both?
*Terry is a fictitious composite of multiple patients, to illustrate the important issues without risking the privacy of any individuals protected health information.
Alcohol Consumption After Dementia
People who have a form of dementia, whether caused by alcohol use disorder or not, are likely to suffer more serious memory loss if they consume alcohol. In part, this is caused by reactions between dementia medications, other medications for other ailments, and alcohol. It can also be caused by alcohol itself, especially in the later stages of dementia. Senior citizens who binge drank twice per month were 147 percent were more likely to experience cognitive decline and 146 percent more likely to have more memory problems compared to those who did not drink.
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Negative Effects Of Alcohol
But “non-drinkers should not take a drink for this purpose,” Tangney says.
Alcohol has calories and can lead to weight gain over time, she says. Obesity has been linked to Alzheimer’s in some studies.
William H. Thies, PhD, the chief medical and scientific officer of the Alzheimer’s Association in Chicago, agrees that it is too difficult to make a blanket recommendation about moderate alcohol consumption for Alzheimer’s disease prevention.
“Moderate alcohol consumption is associated with positive effects in a number of disease states,” he says. But Thies cautions that this doesn’t mean that it is safe to make a general recommendation for everyone to drink in moderation because we don’t know what the health consequences would be.
“A portion of the population is predisposed to alcoholism and if they are teetotalers, they will never express this tendency. But if given instructions to drink for their health, they likely won’t stop at the moderate stage,” he says.
See Ketamine Could Help Cut Alcohol Consumption By Rewiring Memory
Over the past several years, researchers have published a handful of massive genome-wide association studies studies identifying lociregions of the genome that can contain 10 or more individual genesthat likely influence a persons risk of developing an alcohol use disorder .
In a study published two years ago, Manav Kapoor, a neuroscientist and geneticist at the Icahn School of Medicine at Mount Sinai and first author on the new paper, and his team found evidence that the immune system might be overactive in people with AUD, but the finding left him with more questions. The first was whether excessive drinking directly causes immune dysfunction, or if instead some peoples genetic makeup puts them at risk for both simultaneously. The second was which of the dozen or so genes at each previous GWAS-identified locus actually influences drinking behaviors. Lastly, he wanted to know if there is a genetic difference between people who consume higher numbers of alcoholic beverages per week but are not diagnosed with AUD and those who have received the diagnosis.
This multi-omic approach enabled the researchers to map to the level of changes in a single base pair, which was amazing, says Kapoor.
To make full biological use of GWAS results, we need to understand the biology underlying the statistical association signals. This paper describes a substantial move forward in that direction.
Joel Gelernter, Yale University School of Medicine
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Symptoms Of Alcohol Dementia
There are several symptoms which can be easily identified and might indicate that one suffers from this health problem. For example, headaches, frequent anger episodes, mood swings, slurred speech as well as memory gaps are serious signs of alcoholic dementia. Having regular alcohol blackout symptoms while drinking is also dangerous to the human brain and acts as a contributing factor to this condition.
Elderly alcoholic dementia is a closely-related condition which affects elderly people, and the health effects of alcohol are worse when coupled with other neurological illnesses such as Alzheimers disease or Parkinsons disease. This combination of brain issues might be incurable and are known as alcohol-induced psychosis.
Strengths And Limitations Of This Study
Data in this study are disease-specific for Alzheimer’s disease . This gives us important knowledge on how a very common lifestyle factor such as alcohol affects the lives of people diagnosed with AD specifically.
Since extensive data were collected on each patient in the Danish Alzheimer’s Intervention Study study, we were able to adjust for a wide range of potential confounders, which is essential when studying the effects of alcohol consumption.
The results of this study are based on post hoc analysis, that is, the investigation of alcohol intake on mortality was not described in the original DAISY protocol.
In the alcohol groups, other than our reference group , the number of study participants was relatively low.
The participants in this study have been specifically selected for an intervention study and there might therefore be an over-representation of better functioning patients. Patients with more severe disease, those with significant comorbidity and patients living in a nursing home without a primary caregiver might have other effects of alcohol.
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Alcohol Aids Accumulation Of Harmful Protein
That being said, only very few genes played a role in both the phagocytosis of amyloid beta and inflammatory processes at cellular level.
Among the genes we saw altered were many involved in phagocytosis, says Dr. Feinstein, which is the first time this has been shown.
While these studies were performed in isolated cells, he goes on to explain, our results suggest that alcohol impedes the ability of microglia to keep the brain clear of amyloid beta and may contribute to the development of Alzheimers disease.
Importantly, when the team tried exposing the microglia to alcohol levels consistent with those that might be seen in humans who binge drink or who have a heavy drinking habit they saw that the microglial cells ability to clear amyloid beta was suppressed by approximately 15 percent following only 1 hour of exposure.
This led the researchers to conclude that it may be impaired microglial phagocytosis due to the effect of alcohol that could leave the brain vulnerable to neurodegeneration.
We didnt continue the study to see whether phagocytosis was further impaired after longer exposures to alcohol, but it appears that these changes in microglial cells could be a contributing factor to the development of Alzheimers disease.
Dr. Douglas Feinstein
The Start And Progression Of Alcoholic Dementia
Dementia caused by alcoholism can appear to people of all ages, and it usually starts as a result of abusing alcohol regularly for many years. Alcohol addicts develop the Wernickes encephalopathy first, and then this causes the Korsakoff syndrome. Ultimately, the serious memory problems caused by Korsakoff syndrome will lead to alcoholic dementia. The process takes time to develop, but it can be an incurable disease. The Wernickes encephalopathy appears because heavy drinkers lose thiamine from the body as a result of frequent and long binge drinking episodes. Most alcohol addicts do not replenish this vital substance , and as a result, alcoholic dementia can appear.
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Genetic Transcriptomic And Epigenetic Data Reveal Molecular Mechanisms Tying These Disorders To Each Other And To Immune Disfunction
Learn about our editorial policies.
ABOVE: MAPT, one of the genes linked to both heavy drinking and neurodegenerative diseases, codes for the protein tau inside a neuron.NATIONAL INSTITUTE ON AGING/NATIONAL INSTITUTES OF HEALTH
Some genetic risk factors for alcohol use disorder overlap with those for neurodegenerative diseases like Alzheimers, scientists reported in Nature Communications on August 20. The study, which relied on a combination of genetic, transcriptomic, and epigenetic data, also offers insight into the molecular commonalities among these disorders, and their connections to immune disfunction.
By meshing findings from genome wide association studies . . . with gene expression in brain and other tissues, this new study has prioritized genes likely to harbor regulatory variants influencing risk of Alcohol Use Disorder, writes David Goldman, a neurogenetics researcher at the National Institute on Alcohol Abuse and Alcoholism , in an email to The Scientist. Several of these genes are also associated with neurodegenerative disordersan intriguing connection because of alcohols ability to prematurely age the brain.
Alcohol And Brain Health
Alcohol affects our brain on several levels. It affects the functioning of several neurotransmitters in our brain, which in turn can affect our behaviour and memory. Alcohol also impacts our cardiovascular health, which we know is important for our brain. Both factors not only impact our brain health but also are known to increase our risk for dementia. However, one factor that is particularly relevant for our brain health is that that alcohol also has a direct effect on our nerve cells by literally killing them, or to put it in scientific terms, alcohol is neurotoxic.
We all had the feeling after a hard night out that we must have lost some brain cells but that is not only a feeling but reality. Alcohol is known to be highly neurotoxicity, which means that it kills nerve cells when they are exposed to it. You might remember from my previous articles that the blood brain barrier is a key protective mechanism for the brain to protect itself from poisons or toxins. Does that blood brain barrier protect us from alcohol?
How about more standard alcohol consumption? Can it also increase our risk for dementia?
Analysis By Bbc Reality Check
Another study has come out to add to the confusing picture of public health advice around drinking.
The British Medical Journal study found that a group of people who did not drink alcohol in middle age were more likely to develop dementia later on than people who drank moderately.
So should non-drinkers take up the habit for the sake of their health? The answer is almost certainly no.
There are a few reasons this study should be treated with caution.
First of all, it can only really say that more of the people observed who didn’t drink in midlife went on to develop dementia – it cannot say that abstaining from drinking itself is causing dementia.
And people in this group may have drunk heavily in the past or had to give up drinking for health reasons.
The study only looked at whether people drank during a particular snapshot in time, so some of that group might already be in poor health.
There have been a number of studies in this area with conflicting results and this one doesn’t provide enough evidence to suggest that anyone should go ahead and change their drinking habits.
Alzheimer’s And Alcohol: The Real Connection
As a doctor who takes care of older adults, I am often asked two types of questions about drinking or alcohol consumption.
An 80-year-old male patient, who is “sharp as a bell,” recently told me that for the past many years his singular vice has been having “a martini with two olives” every night before dinner. He wanted to know if this was medically acceptable, or whether he should quit.
An 84-year-old female patient, who is cognitively intact and a life-time teetotaler, had read that mild-moderate alcohol consumption was good for the heart and may even decrease the risk of Alzheimer’s disease.
She asks: “Would you recommend that I start having a daily drink?”
Two studies presented at the Alzheimer’s Association International Conference in Vancouver on Wednesday help us to better address these questions.
One study followed a group of women 65 or older who started out as non-drinker, mild drinkers, or moderate drinkers . After 20 years, they were evaluated for memory problems and dementia. The women who went from non-drinking to any level of drinking increased their chances of developing memory or dementia problems by 200 percent. Also, the women who were moderate drinkers at the start and stayed that way did not have a lower risk of developing problems than the ones who didn’t drink the whole way through. So going from teetotaler to any level of drinking was actually harmful. Being a drinker from the start didn’t necessarily hurt, but it wasn’t protective.
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What Is The Current Advice
According to the UK chief medical officers, we should stick to drinking no more than 14 units of alcohol a week. This keeps health risks to a low and safe level.
- Large glass of wine – 3 units
- Pint of higher-strength lager or beer – 3 units
- Standard glass of wine – 2 units
- Pint of lower-strength lager or beer – 2 units
- Bottle of lager or beer – 1.7 units
- Single shot of spirits – 1 unit
Drinking Alcohol Even In Moderation ‘a Dementia Risk’
Health editor, BBC News online
Drinking even “moderate” amounts of alcohol increases dementia risk, US research suggests.
The findings, presented at an international conference, challenge the notion that some alcohol could be good for ageing brains.
People who stick to recommended alcohol limits are still at risk, as well as bingers and heavy drinkers, according to the work.
The study tracked the health over 20 years of 1,300 women in their mid-60s.
The risk, ranging from mild cognitive impairment to full blown dementia, was higher among those who reported drinking more alcohol.
Women who switched from abstinence to drinking over the course of the study also increased their risk.
Those who drank alcohol “in moderation”, meaning seven to 14 alcoholic drinks a week, were also more likely to develop problems with memory and brain functioning that can be a warning sign of future dementia.
The lower end of this range falls within the UK’s recommended limit for women, but since alcohol measures in the US are larger than in the UK, 14 drinks a week would exceed this UK weekly cut off.
And since the study only looked at women, it is not possible to say if the same link will apply in elderly men.
Researcher Tina Hoang, of the Veterans Health Research Institute in San Francisco, said: “In this group of older women, moderate alcohol consumption was not protective.
Some UK experts have recommended alcohol limits should be even tighter for older people for this reason.
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How Can Alcohol Related Brain Damage Be Prevented
- stick within low risk drinking guidelines of no more than 14 units per week
- spread alcohol intake over three or more days
- have alcohol free days
- increase physical and mental activity
- have a healthy balanced diet
- avoid smoking
- manage stress, depression and anxiety symptoms by finding alternative methods of coping than alcohol use
- keeping weight, cholesterol and blood pressure in check