Will drinking alcohol reduce your risk of dementia?

Glasses of wine and beer

People who don’t drink any alcohol in middle age may be at a greater risk of dementia later in their life, research has suggested. But will drinking alcohol reduce your risk of dementia? We look behind the headlines.

3rd August 2018

Researchers have found that not drinking alcohol in mid-life is associated with a higher risk of dementia.

The study, published in the British Medical Journal, found that abstinence in middle age was associated with a 45 per cent higher risk of dementia later in life compared with people who consumed between one and 14 units of alcohol per week.

The current government guidelines say men and women should drink no more than 14 units a week

The researchers looked at the health of more than 9,000 civil servants in London over an average of 23 years. They used data from the long-running Whitehall II study, which is funded by the British Heart Foundation among others. 

They also found that excessive drinkers, who drank more than 14 units per week, had a heightened risk of dementia. This risk increased the more that a person drank. With every seven-unit-per-week increase there was a 17 per cent rise in dementia risk.

The current government guidelines say men and women should drink no more than 14 units a week — equal to six pints of 4 per cent alcohol lager or ale, or six 175ml glasses of 13 per cent alcohol wine. This research supports that recommendation.

Alcohol consumption was measured during assessments between 1985 and 1993, when the participants were, on average, 50 years old.

There were 397 recorded cases of dementia, which were identified through hospital, mental health service and mortality records. The mean age at dementia diagnosis was 76 in the non-drinking group, 76 for the 1-14 units a week group, and 74 in the more than 14 units group.

How good was this research?

The researchers, from Université Paris-Saclay in France and University College London, mentioned that, although they took into account people's social and health background, this could still have affected the results.

They said this ‘cannot be excluded as an explanation for the higher risk of dementia among abstainers.’ In other words, it’s possible that people who don’t drink have stopped drinking because of existing health problems, which could have raised their risk of dementia.

They also noted that not drinking is associated with a higher risk of diabetes and cardiovascular disease, which might increase the risk of dementia.

A key limitation is that the research relied on people accurately reporting the amount of alcohol they drank.

The study also didn’t take into account how much people drank before they gave up alcohol.

A strength of the research is that more than 9,000 of the 10,231 participants had at least two measurements of alcohol consumption. The study also had a long follow up period (23 years) so the researchers could create a comprehensive assessment of the association between alcohol consumption and dementia.

A key limitation is that the research relied on people accurately reporting the amount of alcohol they drank. 

A recent study has also found that milder cases of dementia are often missing from hospital records. The study overcame this by using other sources for dementia diagnosis, such as the UK mental health database, as well as hospital records.

But a further difficulty that the researchers note is that people could have developed dementia and then died between the two assessments, preventing them from being categorised as having dementia.

The BHF view

Julie Ward, senior cardiac nurse at the BHF, says: “These findings should not be seen as an excuse to drink alcohol excessively. There are many other risks associated with alcohol consumption. There is a very clear link between regularly drinking too much alcohol and having high blood pressure.

"Over time, high blood pressure (hypertension) puts strain on the heart muscle and can lead to cardiovascular disease (CVD), which increases your risk of heart attack and stroke. Stroke and mini strokes can then cause vascular dementia, where a lack of blood supply to your brain causes the surrounding cells to die.

These findings should not be seen as an excuse to drink alcohol excessively

“It’s also essential to remember that alcohol also contributes to many other diseases, such as cancer, and dramatically raises our risk of a drink-related accident. Experts agree that any small benefits of drinking alcohol are outweighed by these risks.”

The coverage

The story got a lot of media coverage, including The Sun, Daily Mail, Telegraph, and the Guardian.

The coverage was generally accurate, with papers such as the Daily Mail being careful to avoid encouraging people who don’t drink to drink an unhealthy amount. For example, in the headline ‘How just a few drinks could help stave off dementia’ they say ‘just a few drinks’.

Other news outlets strongly encouraged people to drink, for example The Sun’s headline was ‘BOOZE BENEFITS: Drinking six pints of beer or glasses of wine a week could save you from deadly dementia’.

This could be misleading as the researchers were looking at participants’ risk of developing dementia, not their risk of dying from it. Similarly the units of alcohol could vary hugely depending on what percentage of beer you drink, or how big the glass of wine, but this is not mentioned in the article.

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