January 2002

From Lancet

Moderate alcohol consumption could reduce risk of dementia

N.B. Please note that if you are outside North America the embargo date for Lancet Press material is 0001 hours UK time Friday 25th January 2002.

A Dutch study in this week's issue of THE LANCET suggests that light-to-moderate alcohol consumption could reduce the risk of dementia among older people, regardless of the type of alcoholic drink consumed.

Light-to-moderate alcohol consumption reduces the risk of coronary heart disease and stroke. Because vascular disease is associated with cognitive impairment and dementia, alcohol consumption might also affect the risk of dementia. Monique Breteler and colleagues from Erasmus University Medical School, Rotterdam, Netherlands, examined the relation between alcohol consumption and the risk of dementia in individuals taking part in the Rotterdam Study--a prospective population-based study of around 8000 individuals aged 55 years and older. Participants who did not have dementia at the start of the study (from 1990--93) and who had complete data on alcohol consumption were studied.

Adjusting for age, sex, systolic blood pressure, education, smoking, and body-mass index, the investigators compared the risk of developing dementia between individuals who regularly consumed alcohol with those who did not consume alcohol. The average follow-up was six years. During this period, 197 individuals developed dementia (146 Alzheimer's disease, 29 vascular dementia, 22 other dementia); the average alcohol consumption was 0.29 drinks per day. Light-to-moderate alcohol consumption (1 to 3 drinks per day) was associated with a 42% risk reduction of all dementia, and around a 70% reduction in risk of vascular dementia. Risk reduction was not related to the type of alcoholic drink consumed.

The investigators suggest that several mechanisms could explain the study findings; first, that alcohol might reduce the cardiovascular risk profile--ethanol is known to reduce platelet agregation--or by altering the blood-lipid ratio; second, they suggest that light-to-moderate alcohol intake might have a direct effect on cognition by stimulating the release of acetylcholine in the hippocampus area of the brain (acetylcholine is known to facilitate memory and learning processes; however, high alcohol intake inhibits acetylcholine production).

Monique Breteler comments: "In recent years evidence has been accumulating that vascular factors may be involved in the cause of dementia, both vascular dementia and Alzheimer's disease. Our findings lend further support to the vascular hypothesis of dementia. We saw some indication for a stronger relation with alcohol in persons with a genetically determined susceptibility for Alzheimer's disease. Our findings can help focus research into the specific mechanisms that underlie the development of dementing illnesses." (quote by e-mail; does not appear in published paper).

Contact: Dr Monique Breteler, Department of Epidemiology and Biostatistics, Erasmus University Medical School, PO Box 1738, 3000 DR Rotterdam, Netherlands; T) +31 10 408 7489; F) +31 10 408 9382; E) Breteler@epib.fgg.eur.nl or Fred Balvert, Communication Department, Erasmus University Medical School, T) +31 10 408 8056; F) +31 10 408 9477; E) Balvert@facb.fgg.eur.nl











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