Changes in Alcohol Consumption and Risk of Dementia in a Nationwide Cohort in South Korea - PubMed (original) (raw)
Changes in Alcohol Consumption and Risk of Dementia in a Nationwide Cohort in South Korea
Keun Hye Jeon et al. JAMA Netw Open. 2023.
Abstract
Importance: The impact of serial changes in alcohol consumption on dementia risk has rarely been investigated to date.
Objective: To investigate the association of comprehensive patterns of changes in alcohol consumption with the incidence of all-cause dementia, Alzheimer disease (AD), and vascular dementia (VaD).
Design, setting, and participants: This is a retrospective cohort study. Data were obtained from the Korean National Health Insurance Service database. Adults aged 40 years and older underwent 2 health examinations in 2009 and 2011. The cohort was assessed until December 31, 2018, and statistical analysis was performed in December 2021.
Exposures: Alcohol consumption level was categorized into none (0 g per day), mild (<15 g per day), moderate (15-29.9 g per day), and heavy (≥30 g per day) drinking. On the basis of changes in alcohol consumption level from 2009 to 2011, participants were categorized into the following groups: nondrinker, quitter, reducer, sustainer, and increaser.
Main outcomes and measures: The primary outcome was newly diagnosed AD, VaD, or other dementia.
Results: Among 3 933 382 participants (mean [SD] age, 55.0 [9.6] years; 2 037 948 men [51.8%]), during a mean (SD) follow-up of 6.3 (0.7) years, there were 100 282 cases of all-cause dementia, 79 982 cases of AD, and 11 085 cases of VaD. Compared with sustained nondrinking, sustained mild (adjusted hazard ratio [aHR], 0.79; 95% CI, 0.77-0.81) and moderate (aHR, 0.83; 95% CI, 0.79-0.88) drinking were associated with a decreased risk of all-cause dementia, whereas sustained heavy drinking was associated with an increased risk of all-cause dementia (aHR, 1.08; 95% CI, 1.03-1.12). Compared with sustained levels of drinking, reducing alcohol consumption from a heavy to a moderate level (aHR, 0.92; 95% CI, 0.86-0.99) and the initiation of mild alcohol consumption (aHR, 0.93; 95% CI, 0.90-0.96) were associated with a decreased risk of all-cause dementia. Increasers and quitters exhibited an increased risk of all-cause dementia compared with sustainers. The trends in AD and VaD remained consistent.
Conclusions and relevance: In this cohort study of a Korean population, decreased risk of dementia was associated with maintaining mild to moderate alcohol consumption, reducing alcohol consumption from a heavy to a moderate level, and the initiation of mild alcohol consumption, suggesting that the threshold of alcohol consumption for dementia risk reduction is low.
Conflict of interest statement
Conflict of Interest Disclosures: None reported.
Figures
Figure.. Adjusted Hazard Ratios (HRs) and 95% CIs for the Association of Change in Alcohol Consumption Amount With Risk of Dementia
HRs (squares) were adjusted for age, sex, smoking status, regular exercise, area of residence, income, comorbidities (hypertension, diabetes, and dyslipidemia), systolic blood pressure, and laboratory results (fasting glucose levels, total cholesterol, and serum creatinine). Error bars denote 95% CIs.
References
- Alzheimer’s Disease International . World Alzheimer report 2018: the state of the art dementia research—new frontiers. September 21, 2018. Accessed January 4, 2023. https://www.alzint.org/resource/world-alzheimer-report-2018/
MeSH terms
LinkOut - more resources
Full Text Sources
Medical