Alcohol Consumption ~ Good or Bad for Aging?

On 7 June 2017, USA Today featured on page one the headline, “Even moderate drinking is bad for the brain.”  On 23 June, The Week magazine had an article in the section, “Health Scare of the Week,” titled, “Drinking Speeds Mental Decline.”  Both headlines were not truthful, although the content within the articles was accurate, as I found when I accessed the actual journal article.  As my readers know, I dislike newspapers practicing this tactic, as it sensationalizes and cheapens the story. 

First, what is “moderate drinking?”  It depends on where you live, as the guidelines vary by country and the UK recommends lower amount for women than in the USA (IARD, 2017). In the USA, both the NIH (n.d.)  and CDC (2016)  define moderate drinking it as one drink per day for women/two per day for men. Portion sizes are 5 oz. Wine, 1.5 oz distilled liquor, or 12 oz regular beer [not malt liquor].

Both articles featured a recent study published in the British Medical Journal [BMJ] regarding alcohol and older adults.  Anya Topiwals, who was the primary investigator, wanted to know if moderate alcohol consumption was beneficial to brain health or detrimental.  They examined 30 years of records of 527 British civil servants starting at age 43.  The moderate drinkers, defined as consuming 8-12 glasses of wine, beer, or liquor weekly, showed brain structure changes in their MRIs.  Topiwala et al. (2017) found that higher alcohol use was associated with reduced gray matter density, hippocampal atrophy, and reduced white matter microstructural integrity.  The researchers found that drinking alcohol, even in small amounts, may not be beneficial to good brain health as reported in previous studies.   The study was an observational design, and therefore, no cause/effect can be proven.  So the claim cannot be made that moderate drinking destroys the brain.  There were many other confounding variables that could explain the brain shrinkage beyond alcohol consumption.  The researchers recommended that people NOT take up drinking for healthy aging.  They also cautioned that other factors unrelated to alcohol may explain the brain changes.

Conversely, some studies have shown a positive connection between light and moderate alcohol consumption and healthy aging.  In 2014, scientists from the Department of Neuroscience at Uppsala University in Sweden, led by primary investigator P. S. Hogenkamp, examined whether alcohol intake at age 70 is linked to cognitive [brain] functioning.  The participants were 652 men who were assessed at age 70 and 77 and tested to see if drinking impacted performance on assessments of executive functioning.  They found that moderate drinking among the older Swedish men did impact cognitive performance on the brain performance assessments:  They performed better than the abstainers and the heavy drinkers!  They also cautioned that although these findings do not show cause and effect,  Hogenkamp et al. (2013) do not support the view that people should consume moderate amounts of alcohol to slow cognitive decline because other factors may explain their findings. 

Another study conducted in 2017 found light alcohol consumption may be beneficial for heart health.  In a recent research study carried out in Sweden, scientists Susanna C. Larsson, Alice Wallin, and Alicia Wolk wanted to review the scholarly literature to determine if there is an association between alcohol consumption and risk of heart failure.  They carefully analyzed previous scientific studies to learn more about the impact of alcohol on aging.  Larsson et al. (2017)  reviewed 13 different studies that included almost 14,000 cases and 356,000 participants, one of the most comprehensive meta-analysis on the topic to date.  After analyzing the literature and findings, Larsson et al. (2017) determined that light alcohol drinking [up to one drink per day] was associated with a lower risk of heart failure.  The Larsson et al. (2017) has a high rate of validity due to the large volume of previous research evaluated by the team. 

Is light or moderate drinking acceptable for optimum aging?  Should it be avoided altogether, or are there benefits and protective factors?  The experts cannot decide.

References:

CDC, Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention (2016).  Fact Sheets – Moderate Drinking. https://www.cdc.gov/alcohol/fact-sheets/moderate-drinking.htm

Hogenkamp, P. S., Benedict, C., Sjögren, P., Kilander, L., Lind, L., & Schiöth, H. B. (2014). Late-life alcohol consumption and cognitive function in elderly men. Age (Dordrecht, Netherlands), 36(1), 243-249. doi:10.1007/s11357-013-9538-7

International Alliance for Responsible Drinking [IARD], (2017). Drinking Guidelines: General Population.  http://www.iard.org/policy-tables/drinking-guidelines-general-population/

International Alliance for Responsible Drinking [IARD], (2017). National Drinking Guidelines. http://www.iard.org/wp-content/uploads/2016/04/Policy-Review-National-Drinking-Guidelines.pdf

Larsson, S. C., Wallin, A., & Wolk, A. (2017). Alcohol consumption and risk of heart failure: Meta-analysis of 13 prospective studies. Clinical Nutrition (Edinburgh, Scotland), doi:10.1016/j.clnu.2017.05.007

NIH Drinking Levels Defined (n.d.) Appendix 9. Alcohol.    https://www.niaaa.nih.gov/alcohol-health/overview-alcohol-consumption/moderate-binge-drinking

Topiwala, A., Allan, C.L., Valkanova, V., Zsoldos, E., Filippini, N., Sexton, C., Mahmood, A., Fooks, P., Singh-Manoux, A., Mackay, C.E., Kivimaki, M., & Ebmeier, K.P. (2017).  Moderate alcohol consumption as risk factor for adverse brain outcomes and cognitive decline: longitudinal cohort study. BMJ 2017; 357 doi: https://doi.org/10.1136/bmj.j2353 (Published 06 June 2017)Cite this as: BMJ 2017;357:j2353