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Should Dementia Patients Drink Alcohol

Drinking Alcohol Even In Moderation ‘a Dementia Risk’

Alcohol & Alzheimer’s Dementia Risk: Does Moderate Drinking Help Or Hurt?

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.

What Are The Symptoms

This can vary from person to person, but generally symptoms will include:

  • Impaired ability to learn things
  • Personality changes
  • Problems with memory
  • Difficulty with clear and logical thinking on tasks which require planning, organising, common sense judgement and social skills
  • Problems with balance

Generally skills learned earlier in life and old habits such as language and gestures tend to be relatively unaffected.

Stage : Mild Cognitive Impairment

Clear cognitive problems begin to manifest in stage 3. A few signs of stage 3 dementia include:

  • Getting lost easily
  • Noticeably poor performance at work
  • Forgetting the names of family members and close friends
  • Difficulty retaining information read in a book or passage
  • Losing or misplacing important objects
  • Difficulty concentrating

Patients often start to experience mild to moderate anxiety as these symptoms increasingly interfere with day to day life. Patients who may be in this stage of dementia are encouraged to have a clinical interview with a clinician for proper diagnosis.

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Does The Type Of Alcohol Matter

It depends on whom you ask. Research has come to different conclusions about this question. Multiple studies have cited wine as specifically having protective effects on people’s memory and cognitive ability. Other studies, however, have concluded that wine, beer, and liquor all have similar effects on cognition.

Associations Between Dimensions Of Alcohol Use And Specific Brain Functions

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The systematic reviews that assessed the relationship between alcohol use and the resulting effects on brain structures and specific brain functioning assessed diverse associations. Verbaten tested the hypothesis that low to moderate drinking had beneficial effects on brain structure studies) and cognitive performance . In the MRI studies, a linear negative association was observed between the volume of alcohol consumed and brain volume and grey matter, and a positive linear association was observed between the volume of alcohol consumed and white matter volumes . However, when restricted to people aged 65years and older, low to moderate alcohol use was related to grade of white matter integrity and cognition in a curvilinear manner . A recently published large-scale study with a follow-up at 30years, which measured alcohol use every 5years and involved multiple MRI images and cognitive tests, concluded that alcohol use, even at light or moderate levels, was associated with adverse brain outcomes, including hippocampal atrophy , thereby corroborating the general results of the systematic review by Verbaten for people under 65years of age.

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Stage : Moderate Dementia

Patients in stage 5 need some assistance in order to carry out their daily lives. The main sign for stage 5 dementia is the inability to remember major details such as the name of a close family member or a home address. Patients may become disoriented about the time and place, have trouble making decisions, and forget basic information about themselves, such as a telephone number or address.

While moderate dementia can interfere with basic functioning, patients at this stage do not need assistance with basic functions such as using the bathroom or eating. Patients also still have the ability to remember their own names and generally the names of spouses and children.

What Do Experts Say

Recognising that heavy drinking and being dependent on alcohol are going to increase the risk of developing dementia is important, they say.

Prof Tara Spires-Jones, from the Centre for Discovery Brain Sciences at the University of Edinburgh, said: “It is crystal clear that alcohol abuse is bad for your brain.”

But there is also agreement that more research is needed to work out the role played by the volume of alcohol consumed against how often alcohol is drunk – and how this affects the risk of early-onset dementia.

Most cases of Alzheimer’s disease, the most important cause of dementia, happen after the age of 65 and rise dramatically as people age. Discovering how to prevent those would be particularly useful.

Dr Doug Brown from the Alzheimer’s Society said that “alcohol abuse disorders may be responsible for more cases of early-onset dementia than previously thought”.

But he said the Lancet research did not change the current advice and did not suggest that moderate alcohol intake could cause early-onset dementia.

And there is a warning from Dr Sara Imarisio, head of research at Alzheimer’s Research UK.

“People shouldn’t be under the impression that only drinking to the point of hospitalisation carries a risk.”

She said there were steps everyone could take to improve brain health.

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Halting The Progression Of Cognitive Decline

In both ARD and WKS, alcohol abstinence can lead to significant improvement. Alcohol abstinence, good nutrition , adequate sleep and activity, and peer support may help someone with ARD avoid further decline. In addition, one study found beneficial effects of treatment with memantine. With such an approach, Terry might be successful in halting the progression of cognitive decline and reclaiming a more satisfying life.


Scope Of The Systematic Search

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Following the PRISMA guidelines , a systematic search was performed by using OVID to identify all systematic reviews published from January 2000 to October 2017 on Medline, Embase, and PsycINFO and by using a combination of keywords and Medical Subject Headings terms related to alcohol use, dementia, AD, brain function, memory, and cognitive health. Additional file : Tables S1 to S3 in the Additional file outline the exact search strategy used for each database a PRISMA checklist is also provided in the Additional file . The World Alzheimer Reports were additionally used to identify potential systematic reviews . A systematic search of grey literature was performed via Google but provided no contributions which fulfilled our inclusion criteria . It is highly unlikely that systematic reviews and meta-analyses would not be published in scientific journals .

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What Should I Take Away From This Research

The link between alcohol and dementia in non-drinkers however is not fully understood and individuals who do not currently drink alcohol should not start as a method of protection against the development of dementia.

From the evidence collected to date, it is not possible to determine what effect drinking within the NHS recommended alcohol guidelines has on a person’s risk of dementia.

Guidelines recommend that alcohol consumption be reduced as much as possible, particularly in mid-life, to minimize the risk of developing other age-related conditions such as frailty. Current evidence indicates that adopting a healthy lifestyle throughout your life is the best way to reduce risk of dementia and other long-term health problems. This includes drinking in moderation but also other factors such as not smoking, taking plenty of physical exercise and eating a healthy, balanced diet.

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Is Moderate Alcohol Consumption Safe For The Brain

Some research has indicated that individuals who drank in moderation were less likely to develop Alzheimer’s disease or any other form of dementia than those who consumed zero alcohol.

Some protective effects of alcohol have been seen on the brain, such as reduced thickness of blood and increased levels of healthy cholesterol in the body. Both of these effects have been suggested to help lower the risk of developing dementia.

However, the evidence produced by studies that link moderate alcohol consumption with a lower likelihood of Alzheimer’s disease does have some flaws. For example, many of these studies classified ‘non-drinkers’ as both people who have given up alcohol consumption due to health reasons and lifetime non-drinkers.

These two subsets of people are actually quite different as people who have given up drinking for health reasons may have already had alcohol-induced brain damage, so are more likely to be similar to people in the heavy-drinking category than lifetime non-drinkers.

Therefore the mixing of these distinct populations into one study group may have skewed the results and lead to conclusions which overstate the potential risk of not drinking alcohol to developing Alzheimer’s and dementia.

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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.

Alcohol Plays A Large Role In Dementia

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Even when looking at all types of dementia, alcohol appeared to play a larger part than previously thought. Overall, alcohol use disorders were associated with a threefold increase in the risk of all types of dementia. And importantly, they were found to be the most significant modifiable risk factor for dementia.

When alcohol-related brain damage was excluded, alcohol use disorders still doubled the risk of vascular and other dementias. Even when adjusting the data for confounding variables, the link remained significant.

As mentioned earlier, heavy drinking comes with a constellation of factors that increase dementia risks. In this study, that was confirmed: alcohol use disorders were associated with smoking, depression, lower education, diabetes, and hypertension.

Our findings suggest that the burden of dementia attributable to alcohol use disorders is much larger than previously thought, suggesting that heavy drinking should be recognized as a major risk factor for all types of dementia.

Lead study author Dr. Michaël Schwarzinger

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The Dangers Of Alcohol

As pleasant as it is to hear that sharing a drink with a friend can decrease your chances of developing Alzheimers disease, we need to acknowledge the significant dangers of regularly over-consuming alcohol. Over-consumption is defined as consuming 4 drinks for men and 3 drinks for women in a single day.

A recent study examined more than thirty-million Europeans to identify the largest factors determining whether an individual develops Alzheimers or dementia. The study found that alcohol was the largest non-genetic risk factor for dementia and Alzheimers disease.

The researchers were shocked at how significantly alcohol contributed. We hypothesized that alcohol would play some role, but I dont think anyone expected the size of the effect to be so large, said lead author Dr. Jürgen Rehm.

The study found that individuals who regularly over-consumed were three times more likely to develop a dementia as those who did not. Over-consumption of alcohol was especially common in study participants diagnosed with early-onset dementia or Alzheimers disease. Early-onset is defined as being diagnosed before the age of 65.

While frequently drinking to excess has been known to have a wide range of negative, this new research shows that the damage caused by alcohol is much more common and much more severe than previously imagined.

Can Alcohol Cause Dementia

People who do not binge drink or become dependent on alcohol do not need to worry about an alcohol-dementia link, says Nikola Djordjevic, MD. “Alcohol consumption in moderate amounts has not been found to cause dementia or any other cognitive impairments. However, excessive use and abuse in old age have been associated with changes in brain structure that increase the risk of Alzheimerâs and variants of dementia,” he explains.

A 2018 study found that heavy drinking increased the risk of dementia by about three times. Alcoholism may increase the risk of certain medical conditions that damage the cardiovascular system, including high blood pressure. Research increasingly links both heart disease and heart disease risk factors to an elevated risk of developing dementia.

Alcoholism may also cause a rare type of dementia called Korsakoff syndrome, according to The Alzheimer’s Association. This dementia appears when a person is deficient in thiamine/vitamin B1, a deficiency that is more prevalent among chronic alcoholics.

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Genetic Transcriptomic And Epigenetic Data Reveal Molecular Mechanisms Tying These Disorders To Each Other And To Immune Disfunction

Emma Yasinski

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 The Brain

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Dr. Joseph Garbely, vice president of medical services and medical director at Caron Treatment Centers, is of the belief that alcohol affects the brain, especially in older adults.

Alcohol consumption causes cognitive abnormalities because alcohol has amnesia-like effects, Garbely told Healthline. It impairs your ability to encode new memories, which is where the term black out comes into play. Although the effects of alcohol use include reduced short-term memory, it can affect other areas of memory in the brain as well, mimicking the symptoms of dementia, and because it targets higher-executive functioning of the brain, the impairment to an older adults cognitive capability is much higher.

Schwarzinger said that while the neurotoxic effects of heavy drinking have been known for decades, this study confirms both the major neurotoxic effect of heavy drinking on the brain as well as the strong associations of heavy drinking with all other independent risk factors for dementia onset.

A growing body of neuroimaging studies support that alcohol use is directly correlated with brain damage, added Schwarzinger.

Dr. Ming Wang, a staff physician at Caron Treatment Centers, notes that drinking can spiral out of control, making a bad situation even more serious.

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What Caregivers Should Know About Alcohol Use And Alzheimer’s Disease

If you are a caregiver for a person with Alzheimers, you may be concerned about the effects of alcohol on the disease. When alcohol use is being discussed, circumstances such as the severity of the dementia, and the amount of alcohol being consumed should be considered, among other factors.

Alcohol Consumption and Stages of Alzheimers Disease

In the early stages of AD dementia, a glass of wine a day with a meal may not cause much harm at all. That is, provided your loved is NOT taking medications that interfere with alcohol, and that the treating physician is in agreement. To further complicate the issue, consider that many individuals with moderate dementia may not remember how much they drank and may inadvertently partake in heavy drinking without even realizing it.

It is also important to note that some research findings point to the fact that drinking on a daily basis is not recommended for an older person in the senior years who has never been a regular drinker . Studies showed that alcohol may have less of an adverse effect on seniors who have always been moderate drinkers, compared to those who refrained from drinking when they were young, then start drinking in the later years.

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I Study Summaries: Research On Drinking And Dementia

Large Studies

Moderate drinking protects older persons from the development of cognitive impairment. Thats the conclusion of researchers who studied 15,807 Italians 65 years of age and older. Among the drinkers, only 19% showed signs of mental impairment. That compared to 29% of the abstainers.1

Other investigators studied 12,480 older women over time. Drinkers were about 20% less likely than abstainers to have poor memory as they aged. The same was true for thinking abilities. The positive effects of different alcoholic beverages were all the same.2

Two large studies in Australia tested people age 20 to 64. They found that moderate drinkers did better than abstainers on all measures of cognitive ability.3

Long Studies

A long-term study of over 6,000 Britons began in 1967. Drinkers did much better on tests of cognitive functioning than teetotalers. For example, abstainers were twice as likely as occasional drinkers to receive the lowest test scores. The beneficial mental effects of alcohol occur when a person drinks up to about 30 drinks per week. It increased with consumption. Researchers did not test higher levels of drinking.4

A study followed 1,018 men and women age 65-79 for an average of 23 years. The subject was drinking and dementia. rinking no alcohol, or too much, increases risk of cognitive impairment.5

Important Fact

Both non-drinkers and heavy drinkers had the lowest CASI scores.7

Specifically Alzheimers

Progression of Dementia


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