Journal scan

Moderate alcohol consumption linked to decline in brain health

Review of Topiwala A, Allan C, Valkanova V et al (2017) Moderate alcohol consumption as risk factor for adverse brain outcomes and cognitive decline: longitudinal cohort study. BMJ. 357:j2353. 

Review of Topiwala A, Allan C, Valkanova V et al (2017) Moderate alcohol consumption as risk factor for adverse brain outcomes and cognitive decline: longitudinal cohort study. BMJ. 357:j2353. 

Senior_Alcohol
Picture: iStock

Alcohol has historically been regarded as harmless when taken in moderation. However, brain imaging studies have shown that, in older people, even moderate alcohol consumption is associated with reduced brain total volume, increased ventricle size, and reduced grey matter in the frontal and parietal lobes.

Heavy drinking is known to be associated with Korsakoff’s syndrome, alcoholic dementia and widespread brain atrophy. Light drinking has been associated with an increase in oropharyngeal, oesophageal and breast cancer, but was previously thought to be protective against cognitive decline. This study throws doubt on this protective mechanism, suggesting that previous research was flawed because education levels and social class had not been taken into account.

The study followed 1,380 randomly selected individuals and assessed levels of drinking and cognitive function over a 30-year period. Findings showed an association between intake of alcohol and atrophy in the hippocampus, and altered structure of white matter in the brain, even in moderate drinkers. The damage was worst in those who drank most, but there was no evidence of a protective effect of light drinking. Cognitive decline was particularly noticeable in the reduction in vocabulary and use of language.

The findings support the recent reduction in UK safe limits and suggest that alcohol intake might represent a modifiable risk factor for cognitive decline.


Reviewed by Ruth Sander, independent consultant in care of the older person

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