Intended for healthcare professionals


Lifetime perspective on alcohol and brain health

BMJ 2020; 371 doi: (Published 04 December 2020) Cite this as: BMJ 2020;371:m4691
  1. Louise Mewton, researcher1,
  2. Briana Lees, researcher2,
  3. Rahul Tony Rao, researcher3
  1. 1Centre for Healthy Brain Ageing, University of New South Wales, Sydney, Australia
  2. 2Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, Australia
  3. 3Department of Old Age Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, UK
  4. Correspondence to: L Mewton

Harm prevention policies must take the long view

The maintenance of brain health is central to health and wellbeing across the lifespan.1 Evidence suggests three periods of dynamic brain changes that may be particularly sensitive to the neurotoxic effects of alcohol: gestation (from conception to birth), later adolescence (15-19 years), and older adulthood (over 65 years). Highly prevalent patterns of alcohol use may cause harm during these sensitive periods, including low level prenatal alcohol exposure, adolescent binge drinking, and low-to-moderate alcohol use in older adulthood.2 Although these patterns of alcohol exposure may be associated with less harm to individuals than sustained heavy drinking, the overall burden of harm in populations is likely to be large.

From fetal development to later life, the human brain goes through several periods of dynamic change. The prenatal period is characterised by extensive production, migration, and differentiation of neurons, accompanied by substantial apoptosis.3 Adolescence is …

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