Binge drinkers' dementia risk

Behind the Headlines

Monday November 3 2008

Binge drinking is on the increase

“Binge drinkers are putting themselves at risk of Alzheimer's in later life”, warns the Daily Mail Today. Worse, there could be an “epidemic” in the number of people suffering from alcohol-related dementia in the near future, the newspaper reported.

This news story is based on an article in the British Journal of Psychiatry and is largely correct. The authors say alcohol-related dementia is under-recognised and may account for up to 10% of all dementia cases – around 70,000 people in the UK. They warn of a “silent epidemic” and call for more research into the problem.

Where did the story come from?

What counts as binge drinking?

  • Binge drinking is defined by the NHS as drinking double the daily recommended units in one session.
  • Recommended daily amounts are two to three units per day for women, and three to four units for men.
  • A unit is the equivalent of 8g of alcohol (the amount of alcohol found in half a pint of lager, or in less than one small glass of red wine).

Dr Susham Gupta, a specialist registrar in adult and old age psychiatry from Chelsea and Westminster Hospital and James Warner, a consultant in older adult psychiatry in north-west London wrote this editorial for the British Journal of Psychiatry. There is no indication of external support for this particular article and no conflicts of interest.

What kind of scientific study was this?

In this independent editorial, the authors review existing evidence and present their view on the evidence assessing the effects of alcohol on the brain and how attitudes and consumption of alcohol is changing, mainly in the UK. The researchers drew on their own expert knowledge and have reviewed the reported changes in alcohol consumption over time as well as the harmful effects of heavy drinking and how brain changes caused by alcohol are defined and classified.

What were the results of the study?

The editorial includes 20 references to other research and policy documents. The authors discuss changes in alcohol consumption in the UK since the 1960s, saying that the price of alcohol has halved and consumption has doubled. They say that research on the link between alcohol and cognitive performance has found that light to moderate alcohol intake is associated with a slight reduction in the risk of dementia, but there is a higher risk of dementia in heavy drinkers.

The authors discuss the burden of dementia in the UK, saying that the Alzheimer’s Society estimates that there are 700,000 people in the UK currently suffering from the condition. They warn that while Alzheimer’s disease, and vascular and Lewy body dementia are considered to be the main causes of dementia, ‘alcohol-related dementia’ is often overlooked.

The authors also acknowledge there is limited research into alcohol-related dementia and there may be problems with under-recognition and under-diagnosis. They say that some studies suggest that alcohol related dementia may account for 10% of all dementia cases.

What interpretations did the researchers draw from these results?

The authors conclude that the ‘neurotoxic effects of alcohol’ and the increase in consumption may mean that future generations will see an increase in alcohol-related dementia. They warn this may be compounded by the effects of recreational drug use (such as ecstasy). They call for the development of tools to assess alcohol-related cognitive impairment and for public health initiatives to educate people about the risks to their cognitive performance. This may need “similar legislation to that used in the fight against tobacco-related health problems”.

What does the NHS Knowledge Service make of this study?

This editorial puts forward the case for more research into alcohol and cognitive problems in later life and the extent of the problem in the UK. The publication is not a systematic review of the literature and has therefore not identified all the studies assessing this link. The suggestion that “future generations may see an increase in alcohol-related dementia” is a serious one that requires more investigation. A systematic review of studies that have assessed the link between alcohol consumption and cognitive performance would provide more robust evidence on the contribution of alcohol to dementia.

More work needs to be done to establish the proportion of diagnosed dementia cases in the UK that are alcohol-related. Only then can the potential burden of disease be determined and the truth behind these authors’ opinions and recommendations be fully investigated.

The underlying message is clear, heavy drinking is associated with short and long-term health problems. People who consume alcohol should try not to exceed the maximum recommended amounts and avoid binge drinking.

 

Sir Muir Gray adds...

I would not call this new knowledge, heavy drinking batters the brain.

 

Analysis by Bazian

Edited by NHS Choices

Links to the headlines

Alcohol consumption doubles since the 1960s. The Daily Telegraph, November 01 2008

Risk of dementia 'epidemic' from drinking culture. Financial Times, November 01 2008

Drink memory timebomb. Daily Mirror, November 01 2008

Binge drinkers face increased risk of dementia. The Times, November 01 2008

Binge-drinkers 'risking dementia'. BBC News, November 01 2008

Binge-drinking culture may cause dementia epidemic, experts warn. The Independent, November 01 2008

The dementia timebomb facing binge drinkers, as doctors call for warning labels on bottles. Daily Mail, November 01 2008

Links to the science

Gupta S, and Warner J. Alcohol-related dementia: a 21st-century silent epidemic? The British Journal of Psychiatry 2008; 193: 351-353

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