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New study - alcohol and dementia risk

Posted: Mon Oct 21, 2019 1:59 pm
by frankiesfriend
Alcohol Consumption and Risk of Dementia and Cognitive Decline Among Older Adults With or Without Mild Cognitive Impairment
JAMA Network Open, September 27, 2019 - Koch, Manja, et al.

(Article is open to the public, but I could not get a hyperlink to work.)

This study extracted data from the Gingko Evaluation of Memory Study conducted between 2000-2008 on 3021 U.S. participants averaging 78 yrs. Participants were free of dementia at the start of the study, and were followed for 6 years. Some participants had MCI. Alcohol use was self-reported.

The goal of the study was to examine the effect of alcohol use on development of dementia, and to see if either MCI or APOE status would affect the results. When dementia was plotted against 4 categories of weekly alcohol use (#drinks = none, 0.1–0.9, 1-7, 7-14, 14+), a U-shaped curve was noted for those without MCI. The lowest point on the risk curve was at 9 drinks/week.

General conclusion:
Low daily or weekly alcohol use correlates with lower risk of dementia in this group of participants. “In this study, complete abstention and consuming more than 14.0 drinks per week (compared with drinking <1.0 drink per week) were associated with lower cognitive scores among participants aged 72 years and older. [However], particular caution is needed among individuals with MCI who continue to drink alcohol.” Participants with MCI who drank more than 14 drinks per week experienced the greatest risk of dementia of any of the subgroups during the study period.

There were 571 APOE4 carriers and 1845 noncarriers. Compared to the reference group of less than one drink per week (0.1-0.9 drinks), participants who consumed zero alcohol or more than 14 drinks/week were at higher risk of dementia in the APOE4 non-carriers, but not in APOE4 carriers. There was no association of alcohol use with dementia risk in APOE4 carriers…in fact the risk ratio was nearly flat across the 4 categories of alcohol intake. Curious.

Hazard Ratios:

# drinks/week none…..0.1-0.9…..1-7…..7.1-14…..14+
APOE E4 + 0.93……ref=1…….0.74…...0.77…...0.77
APOE E4 - 1.27……ref=1…….1.05…..0.93……1.45

They include a pretty long paragraph of study limitations worth noting, among which is lack of information on lifestyle specifics and comorbidities, although they did control for some factors like smoking and diabetes. Further, the variation of risk within in each number reported above as the "average" was wide.

Re: New study - alcohol and dementia risk

Posted: Mon Oct 21, 2019 3:27 pm
by cdamaden
frankiesfriend wrote: There was no association of alcohol use with dementia risk in APOE4 carriers…in fact the risk ratio was nearly flat across the 4 categories of alcohol intake. Curious.

Hazard Ratios:

# drinks/week none…..0.1-0.9…..1-7…..7.1-14…..14+
APOE E4 + 0.93……ref=1…….0.74…...0.77…...0.77
APOE E4 - 1.27……ref=1…….1.05…..0.93……1.45
.

Thank you, frankiesfriend. What is the significance of the HRs being one or less for APO E4s? Does that indicate drinking could be protective for us?
Chris

Re: New study - alcohol and dementia risk

Posted: Mon Oct 21, 2019 6:22 pm
by TelopeaBlue
cdamaden wrote:
frankiesfriend wrote: There was no association of alcohol use with dementia risk in APOE4 carriers…in fact the risk ratio was nearly flat across the 4 categories of alcohol intake. Curious.

Hazard Ratios:

# drinks/week none…..0.1-0.9…..1-7…..7.1-14…..14+
APOE E4 + 0.93……ref=1…….0.74…...0.77…...0.77
APOE E4 - 1.27……ref=1…….1.05…..0.93……1.45
.

Thank you, frankiesfriend. What is the significance of the HRs being one or less for APO E4s? Does that indicate drinking could be protective for us?
Chris


Nice try, Chris :D I'd like to think that too, but the CIs spanned 1 in all categories, so my read is that alcohol has little effect regardless of APOE4 status (click on the attached image)

Re: New study - alcohol and dementia risk

Posted: Tue Oct 22, 2019 4:59 am
by slacker
Here is the link to the article; free pdf as of now.