Tag Archives: Alcohol

Even moderate alcohol consumption increases risk of cognitive decline

30 Jun

This month The British Medical Journal published a paper titled : “Moderate alcohol consumption as risk factor for adverse brain outcomes and cognitive decline: longitudinal cohort study.” Here is the abstract:

Objectives To investigate whether moderate alcohol consumption has a favourable or adverse association or no association with brain structure and function.

Design Observational cohort study with weekly alcohol intake and cognitive performance measured repeatedly over 30 years (1985-2015). Multimodal magnetic resonance imaging (MRI) was performed at study endpoint (2012-15).

Setting Community dwelling adults enrolled in the Whitehall II cohort based in the UK (the Whitehall II imaging substudy).

Participants 550 men and women with mean age 43.0 (SD 5.4) at study baseline, none were “alcohol dependent” according to the CAGE screening questionnaire, and all safe to undergo MRI of the brain at follow-up. Twenty three were excluded because of incomplete or poor quality imaging data or gross structural abnormality (such as a brain cyst) or incomplete alcohol use, sociodemographic, health, or cognitive data.

Main outcome measures Structural brain measures included hippocampal atrophy, grey matter density, and white matter microstructure. Functional measures included cognitive decline over the study and cross sectional cognitive performance at the time of scanning.

Results Higher alcohol consumption over the 30 year follow-up was associated with increased odds of hippocampal atrophy in a dose dependent fashion. While those consuming over 30 units a week were at the highest risk compared with abstainers (odds ratio 5.8, 95% confidence interval 1.8 to 18.6; P≤0.001), even those drinking moderately (14-21 units/week) had three times the odds of right sided hippocampal atrophy (3.4, 1.4 to 8.1; P=0.007). There was no protective effect of light drinking (1-<7 units/week) over abstinence. Higher alcohol use was also associated with differences in corpus callosum microstructure and faster decline in lexical fluency. No association was found with cross sectional cognitive performance or longitudinal changes in semantic fluency or word recall.

Conclusions Alcohol consumption, even at moderate levels, is associated with adverse brain outcomes including hippocampal atrophy. These results support the recent reduction in alcohol guidance in the UK and question the current limits recommended in the US.

There is a good account in The Washington Post

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The Alcohol Harm Paradox

15 May

I had not heard of this relationship before and thought my readers might be interested. The alcohol harm paradox refers to the fact that “that people with low individual or neighbourhood socioeconomic status (SES) show a greater susceptibility to the harmful effects of alcohol”

For example, in England:

Lower SES is associated with an almost two fold greater risk of alcohol related death compared with individuals in higher SES classifications.
Relative to high SES, low SES is associated with an increased risk of head and neck cancers, strokes, hypertension, liver disease and pre-term birth. These findings are independent of a number of other known risk factors for these conditions such as diet and smoking.

Here is a large study of the effect. It concludes:

Different SES measures appear to influence whether the Alcohol Harm Paradox is observed as a linear trend across SES groups or a phenomenon associated particularly with the most disadvantaged. The paradox also appears more concentrated in men and younger age groups

It would not surprise anyone that greater wealth affords greater protection from the vicissitudes of life, but other variables may play a role, such as class differences in the patterns of drinking behavior and the beverages consumed.

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Testing a hypothesis: Over 21 edition

24 Apr

Tonight, I am going to lecture about hypothesis testing. I plan to show my students this video I found on BoingBoing:

The question for the students: was this a fair test?

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“Do ‘Moderate’ Drinkers Have Reduced Mortality Risk?”

30 Mar

Not according to this meta-analysis published in  The Journal of Studies on Alcohol and Drugs.

“In summary, analyses of groups of higher quality studies free from abstainer biases were less likely to find evidence of reduced risk of mortality (i.e., health benefits) at low levels of alcohol consumption. Rather, the pattern of results is more consistent with a linear dose response than a J-shaped curve describing the risk relationships between level of alcohol consumption and all-cause mortality.”

 

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IQ and Alcohol Consumption

1 Mar

A paper published in Alcoholism: Clinical and Experimental Research:

“Background
Studies of the association between IQ and alcohol consumption have shown conflicting results. The aim of this study was to investigate the association between IQ test results and alcohol consumption, measured as both total alcohol intake and pattern of alcohol use.

Methods
The study population consists of 49,321 Swedish males born 1949 to 1951 who were conscripted for Swedish military service 1969 to 1970. IQ test results were available from tests performed at conscription. Questionnaires performed at conscription provided data on total alcohol intake (consumed grams of alcohol/wk) and pattern of drinking. Multinomial and binomial logistic regressions were performed on the cross-sectional data to estimate odds ratios (ORs) with 95% confidence intervals (CIs). Adjustments were made for socioeconomic position as a child, psychiatric symptoms and emotional stability, and father’s alcohol habits.

Results
We found an increased OR of 1.20 (1.17 to 1.23) for every step decrease on the stanine scale to be a high consumer versus a light consumer of alcohol. For binge drinking, an increased OR of 1.09 (95% CI = 1.08 to 1.11) was estimated for every step decrease on the stanine scale. Adjustment for confounders attenuated the associations. Also, IQ in adolescence was found to be inversely associated with moderate/high alcohol consumption measured in middle age.

Conclusions
We found that lower results on IQ tests are associated with higher consumption of alcohol measured in terms of both total alcohol intake and binge drinking in Swedish adolescent men.”

Ironically the account of this study in The Telegraph linked to this story:

Starbucks to offer wine and beer in evenings

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How effective is Alcoholics Anonymous?

26 Dec

Researchers have long questioned the effectiveness of Alcoholics Anonymous. Most of the claims made on its behalf are anecdotal and, thus, of little scientific value. Research has been hampered by the lack of randomized control trials. This type of analysis is especially important. Without it, one could not rule out the possibility that people who have had success with AA were self selected and it was some characteristic of those individuals that caused their success and not the AA program.

Recent research, however, casts new light on AA and suggests that the program itself might be effective. Here is a summary by Keith Humphreys. And here is his paper. From its conclusion:

“For most individuals seeking help for alcohol problems, increasing AA attendanceleads to short- and long-term decreases in alcohol consumption that cannot be attributed to self-selec-tion. However, for populations with high preexisting AA involvement, further increases in AA atten-dance may have little impact.”

Humphreys also has this piece in The Washington Post:

‘Studies such as these dramatically reduced the ranks of AA critics among scientists. AA’s value is still questioned in a few quarters, but as Harvard Professor of Psychiatry John Kelly notes, this is becoming less true as the years go by: “The stronger scientific evidence supporting the effectiveness of AA is relatively new. It takes time for evidence to disseminate into clinical practice as well as into broader society.”’

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Ten percent of drinkers consume more than half of all alcohol

29 Oct

Alcohol is America’s most serious drug problem. Contrary to industry propaganda, there is no known safe level of alcohol consumption. The health benefits claimed for alcohol do not survive critical scrutiny.

The Washington Post reports

“the top 10 percent of drinkers account for well over half of the alcohol consumed in any given year.”

According to Stanford researcher Philip J. Cook:

“One consequence is that the heaviest drinkers are of greatly disproportionate importance to the sales and profitability of the alcoholic-beverage industry,” he writes writes. “If the top decile somehow could be induced to curb their consumption level to that of the next lower group (the ninth decile), then total ethanol sales would fall by 60 percent.”

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Hat tip to BoingBoing.

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