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Research

Alcohol consumption and risk of dementia: 23 year follow-up of Whitehall II cohort study

BMJ 2018; 362 doi: https://doi.org/10.1136/bmj.k2927 (Published 01 August 2018) Cite this as: BMJ 2018;362:k2927

Opinion

The role of health behaviours in cognitive ageing

The alcohol epidemic Re: Alcohol consumption and risk of dementia: 23 year follow-up of Whitehall II cohort study

Once more the alcoholic epidemiological “J Curve” rears its head, this time in relation to dementia. 1

Why are there non-drinkers in societies which see every “Party”, or even a main meal, as a reason for drinking alcohol? By age 35 some people have already drunk more than enough for a lifetime and become members of “Alcoholics Anonymous”. Other non-drinkers have discovered they are alcohol intolerant and some have the auto-brewery syndrome. Ingested sugary foods or drinks turn into alcohol because of increases in fungal or bacterial gut fermentation. Other non-drinkers may have seen the destructive effect of regular alcohol drinking in their families.

As ever more children suffer from autism, hyperactivity, asthma, diabetes and dyslexia, society must take some of the responsibility for encouraging a culture of frequent alcohol drinking. Surely, no amount of pleasure from brain-numbing alcohol can compensate for damaging a child’s health for life. The price of alcohol has become relatively cheaper and alcoholic drinks are a profitable source of revenue for governments and companies but the costs of child care have also increased.

Not drinking any alcohol before or during pregnancy is much more sensible than merely cutting down. One in three pregnancies are unplanned and many women continuing to drink in early pregnancy when most foetal brain development is happening. Alcohol also damages sperm which is simple to monitor with sperm analysis.2 Just one bout of drinking can damage sperm during the three months before conception.

Obad and colleagues concluded that alcohol's action are complex and chronic alcohol consumption can increase the risk of heart disease, brain damage, dementia, neuropathy, metabolic disturbances, nutritional deficiencies, certain cancers, liver, and other faces of morbidity and mortality.3 They highlight the contribution of inflammatory process in alcohol-mediated tissue damage and organ dysfunction. A full understanding of the related cytokine signalling pathways in alcoholic injuries is needed to understand the complex biological effects on alcohol-induced organ damage. The antioxidant effect of bioflavonoids in red wine may not compensate even for an alcohol-induced increased excretion of zinc. I found most women first attending a London hospital migraine clinic had already stopped drinking red wine because it had induced migraine attacks. Red wine can be major cause of migraine and increased risk of cardiovascular diseases.4,5

1 Sabia S, Fayosse A, Dumurgier J et al. Alcohol consumption and risk of dementia: 23 year follow-up of Whitehall II cohort study. BMJ 2018;362:k2927
2 Pajarinen J, Karhunen PJ, Savolainen V et al. Moderate alcohol consumption and disorders of human spermatogenesis. Alcohol Clin Res 1996:20:332-7.
3 Obad A, Peeran A, Little JI, Haddad GE, Tarzami S1 .Alcohol-Mediated Organ Damages: Heart and Brain. Front Pharmacol. 2018 Feb 13;9:81. doi: 10.3389/fphar.2018.00081. eCollection 2018.
4 Grant ECG. Food allergies and migraine. Lancet 1979; 1: 966-69.
5 Kasper A, Komjáthiné Szépligeti S, Holland-Bill L, et al. Migraine and risk of cardiovascular diseases: Danish population based matched cohort study. BMJ 2018; 360 doi: https://doi.org/10.1136/bmj.k96 (Published 31 January 2018) BMJ 2018;360:k96

Competing interests: No competing interests

06 August 2018
Ellen C G Grant
Physician and medical gynaecologist
Retired
Kingston-upon-Thames, Surrey,UK