Estudios científicos
Alcohol consumption and risk of dementia: 23 year follow-up of Whitehall II cohort study
Abstract:
Objective: To examine the association between alcohol consumption and risk of dementia.
Design: Prospective cohort study.
Setting: Civil service departments in London (Whitehall II study).
Participants: 9087 participants aged 35-55 years at study inception (1985/88).
Main outcome measures: Incident dementia, identified through linkage to hospital, mental health services, and mortality registers until 2017. Measures of alcohol consumption were the mean from three assessments between 1985/88 and 1991/93 (midlife), categorised as abstinence, 1-14 units/week, and >14 units/week; 17 year trajectories of alcohol consumption based on five assessments of alcohol consumption between 1985/88 and 2002/04; CAGE questionnaire for alcohol dependence assessed in 1991/93; and hospital admission for alcohol related chronic diseases between 1991 and 2017.
Results: 397 cases of dementia were recorded over a mean follow-up of 23 years. Abstinence in midlife was associated with a higher risk of dementia (hazard ratio 1.47, 95% confidence interval 1.15 to 1.89) compared with consumption of 1-14 units/week. Among those drinking >14 units/week, a 7 unit increase in alcohol consumption was associated with a 17% (95% confidence interval 4% to 32%) increase in risk of dementia. CAGE score >2 (hazard ratio 2.19, 1.29 to 3.71) and alcohol related hospital admission (4.28, 2.72 to 6.73) were also associated with an increased risk of dementia. Alcohol consumption trajectories from midlife to early old age showed long term abstinence (1.74, 1.31 to 2.30), decrease in consumption (1.55, 1.08 to 2.22), and long term consumption >14 units/week (1.40, 1.02 to 1.93) to be associated with a higher risk of dementia compared with long term consumption of 1-14 units/week. Analysis using multistate models suggested that the excess risk of dementia associated with abstinence in midlife was partly explained by cardiometabolic disease over the follow-up as the hazard ratio of dementia in abstainers without cardiometabolic disease was 1.33 (0.88 to 2.02) compared with 1.47 (1.15 to 1.89) in the entire population.
Conclusion: The risk of dementia was increased in people who abstained from alcohol in midlife or consumed >14 units/week. In several countries, guidelines define thresholds for harmful alcohol consumption much higher than 14 units/week. The present findings encourage the downward revision of such guidelines to promote cognitive health at older ages.
Comentarios divulgativos:
Los resultados de este estudio ponen de manifiesto nuevas evidencias entre el consumo moderado de alcohol durante la mediana edad y una menor probabilidad de desarrollar demencia en la edad adulta.
Los hallazgos se basan en datos del estudio Whitehall II, un proyecto en curso que rastrea la salud de los funcionarios y funcionarias británicas. El equipo de investigadores franceses y británicos reunió 23 años de datos de seguimiento de 9.087 participantes de Whitehall II, incluidos los registros hospitalarios y los niveles autoinformados de consumo de alcohol.
El estudio concluyó que de los 397 casos totales de demencia reportados por el hospital, los abstemios y los bebedores mostraron un riesgo más alto de desarrollar demencia. El riesgo más bajo de padecer demencia, se encontró en el grupo que durante el periodo de evaluación mantuvo un consumo moderado menor a 14 unidades semanales.