According to a new observational study carried out in France, alcohol use disorders are the most important preventable risk factors for the onset of all types of dementia.
Alcohol use disorders are a biggest risk factor for onset of all types of dementia, and especially early-onset dementia. Image credit: Imagens Evangelicas / CC BY 2.0.
Dementia is a clinical syndrome caused by brain damage and characterized by progressive deterioration in cognitive ability and capacity for independent living and functioning. It is a common condition, affecting 5-7% of people aged 60 years and older worldwide, and is a leading cause of disability in people aged 60 years and older.
Several types of dementia exist; Alzheimer’s disease is the most common, followed by vascular dementia and rarer types of dementia, although mixed types of dementia often coexist.
A research team led by Dr. Michaël Schwarzinger of the Translational Health Economics Network aimed to examine the association between alcohol use disorders and dementia risk, with an emphasis on early-onset dementia.
“On average, alcohol use disorders shorten life expectancy by more than 20 years, and dementia is one of the leading causes of death for these people,” said co-author Professor Jürgen Rehm, director of the CAMH Institute for Mental Health Policy Research.
“Our findings indicate that heavy drinking and alcohol use disorders are the most important risk factors for dementia, and especially important for those types of dementia which start before age 65.”
“Alcohol-induced brain damage and dementia are preventable, and known-effective preventive and policy measures can make a dent into premature dementia deaths.”
The study included people who had been diagnosed with mental and behavioral disorders or chronic diseases that were attributable to chronic harmful use of alcohol.
Of the 57,000 cases of early-onset dementia (before the age of 65), the majority (57%) were related to chronic heavy drinking.
For early-onset dementia, there was a significant gender split: while the overall majority of dementia patients were women, almost two-thirds of all early-onset dementia patients (64.9%) were men.
Alcohol use disorders were also associated with all other independent risk factors for dementia onset, such as tobacco smoking, high blood pressure, diabetes, lower education, depression, and hearing loss, among modifiable risk factors.
It suggests that alcohol use disorders may contribute in many ways to the risk of dementia.
“The World Health Organization defines chronic heavy drinking as consuming more than 60 grams pure alcohol on average per day for men and 40 grams per day for women,” the study authors said.
“As a result of the strong association found in the study, we suggest that screening, brief interventions for heavy drinking, and treatment for alcohol use disorders should be implemented to reduce the alcohol-attributable burden of dementia.”
“As a geriatric psychiatrist, I frequently see the effects of alcohol use disorder on dementia, when unfortunately alcohol treatment interventions may be too late to improve cognition,” said co-author Dr. Bruce Pollock, CAMH Vice-President of Research.
“Screening for and reduction of problem drinking, and treatment for alcohol use disorders need to start much earlier in primary care.”
“Only the most severe cases of alcohol use disorder — ones involving hospitalization — were included in the study,” the scientists said.
“This could mean that, because of ongoing stigma regarding the reporting of alcohol-use disorders, the association between chronic heavy drinking and dementia may be even stronger.”
The study was published in the March 2018 issue of the journal Lancet Public Health.
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Michaël Schwarzinger et al. 2018. Contribution of alcohol use disorders to the burden of dementia in France 2008-13: a nationwide retrospective cohort study. Lancet Public Health 3 (3): e124-e132; doi: 10.1016/S2468-2667(18)30022-7
