Alcohol Use and Cognitive Impairment in Later Life

Osvaldo P. Almeida, MD, PhD, FRANZCP, FFPOA Professor & Winthrop Chair of Geriatric Psychiatry | School of Psychiatry & Clinical Neurosciences | University of Western Australia. Director of Research | Western Australian Centre for Health & Ageing | Centre for Medical Research | Western Australian Institute for Medical Research. Consultant | Department of Psychiatry | Royal Perth Hospital. Interview with:
Osvaldo P. Almeida, MD, PhD, FRANZCP, FFPOA
Professor & Winthrop Chair of Geriatric Psychiatry | School of Psychiatry & Clinical Neurosciences | University of Western Australia.
Consultant | Department of Psychiatry | Royal Perth Hospital. What are the main findings of this study?

Prof. Almeida: This study used the principles of Mendelian randomisation to clarify whether alcohol use is a direct cause of cognitive impairment in later life. The rationale behind this approach is that the genetic variation associated with lower risk of alcohol abuse or dependence should also be associated with lower risk of cognitive impairment if alcohol misuse is a direct cause cognitive impairment. We found no evidence for such an association. Were any of the findings surprising?

Prof. Almeida: The findings were unexpected, because we know that harmful alcohol use causes numerous other health problems and evidence from observational studies was consistent with the hypothesis that alcohol was a cause of cognitive impairment. Our results show that the association between harmful alcohol use and cognitive impairment is due to confounding factors (e.g., head injury, poor nutrition, deteriorating general health, etc.). What should clinicians and patients take away from this report?

Prof. Almeida: Clinicians should be alerted to the fact that ‘dementia due to alcohol’ is a diagnostic category that is not valid. They should also focus on the numerous other health problems associated with harmful alcohol use as a way of mitigating the risk of future cognitive impairment. The general community should be reminded of the many adverse health consequences associated with harmful alcohol use, and be alerted to the fact that although alcohol is not a direct cause of cognitive impairment, harmful use could lead to cognitive decline indirectly. What future research do you recommend as a result of this study?

Prof. Almeida: Future studies should aim to clarify the mechanisms by which other factors associated with alcohol use lead to cognitive impairment.


Alcohol consumption and cognitive impairment in older men
A mendelian randomization study

  1. Osvaldo P. Almeida, MD, PhD, FRANZCP,
  2. Graeme J. Hankey, MBBS, MD, FRACP, FRCP,
  3. Bu B. Yeap, MBBS, PhD, FRACP,
  4. Jonathan Golledge, BA, MChir, FRCS, FRACS and
  5. Leon Flicker, MBBS, PhD, FRACP

Published online before print February 19, 2014, doi: 10.1212/WNL.0000000000000255 Neurology 10.1212/WNL.0000000000000255