Three More Ways to Reduce Dementia Risk | Alcohol Consumption Part 2

Alcohol consumption, air pollution, and traumatic brain injury have been added to the list of modifiable lifestyle factors–others include a healthy diet, quit smoking, adequate sleep, and regular exercise–that can prevent dementia by up to 40 percent (updated from 35 percent). The research was reported at this summer’s virtual Alzheimer’s Association International Conference (AAIC).

In this three-part blog, we focus on each of the factors and learn how we can change our behaviors to decrease cognitive decline. Part 2 focuses on alcohol consumption.

Alcohol Consumption and Global Impact

A mojito to wind down a long hard week at work, a couple of beers to chug with friends while watching a sports event, or a glass of wine to go with Thanksgiving dinner – most of us celebrate with an alcoholic beverage every now and again.

While the occasional libation is fine, excess alcohol consumption can have a dire health impact. Alcohol is third on the list of preventable causes of death in the United States after tobacco and poor diet, and lack of physical activity. And according to the World Health Organization, alcohol causes 3 million deaths globally every year, that’s 5.3 percent of all deaths.

Alcohol and Dementia

At AAIC 2020, it was reported that more than 21 units of alcohol per week increase the risk of dementia.

As defined by the report:

  • A unit is 10 mL (0.34 oz) of pure alcohol, not a single alcoholic drink
  • In the United States, a 12 oz beer at 5 percent alcohol contains 1.775 units
  • A large glass of 12 percent wine contains about three units

According to the study, led by Michaël Schwarzinger, President of Translational Health Economics Network (THEN), Paris, of more than 30.5 million people, it was found that “for both women and men, alcohol abuse more than tripled the risk for dementia, and emerged as the strongest modifiable risk factor for the disease, beating out smoking, obesity, high blood pressure, and diabetes.” Additionally, 56 percent of early-onset sporadic dementia cases were found to be alcohol-related. The study, published by Lancet Public Health, also showed that the damage of heavy drinking on the brain are lifelong even after a period of abstinence.

Wait, Isn’t Red Wine Good for the Brain?

There are many research studies that suggest red wine is linked to a lower risk of dementia. Red wine contains resveratrol, a polyphenol in the skin of grapes, which has shown to protect the brain’s neurons.

“We have shown for the first time that low doses of alcohol are potentially beneficial to brain health, namely it improves the brain’s ability to remove waste,” said Maiken Nedergaard, M.D., D.M.Sc., co-director of the Center for Translational Neuromedicine at the University of Rochester Medical Center (URMC), lead author of the 2018 study.

In another study, low amounts of red wine consumption showed the reduction of cognitive decline by 23 percent compared to those who didn’t consume it.

How to Reduce or Quit Alcohol Consumption

It is important to remember that reducing the risk of dementia isn’t just based on changing one lifestyle factor.

“Although there is no surefire way to completely prevent dementia, the best current evidence indicates that as well as only drinking in moderation, staying physically and mentally active, eating a healthy balanced diet, not smoking, and keeping weight, cholesterol and blood pressure in check are all good ways to support a healthy brain as we age,” said Dr Sara Imarisio, head of research at Alzheimer’s Research UK.

If you choose to reduce or quit your alcohol consumption, here are some tips to do so.

Reduce the accessibility

  • Reduce the temptation, don’t buy alcohol for the house
  • Place a pitcher of water instead of a bottle of wine at the dinner table. If you’re having a glass, pour the wine, and put it away.

Out with the old, in with the new

  • Understand why you are drinking, is it out of boredom, a habit, or because you’re depressed? Find a brain-healthy activity to replace drinking, such as hiking or take a walk around the block when you crave one.
  • Don’t drink when you’re depressed or feeling sad. Talk to someone instead or go out for some fresh air and exercise.
  • Avoid going to bars with friends. Suggest another activity such as playing a sport or volunteering to help others.

Write it down

  • Alcohol consumption can get expensive. Keep track of your expenses and how much you are spending, and how much you can save if you cut the habit.
  • Keep a diary of when, where, and how much you drink. After a few weeks, review and make changes to reduce consumption.

Get support

  • Tell your friends and family you’re quitting or reducing your alcohol consumption and get their support. Learn to say no when you are offered a drink.
  • Talk to your physician about ways you can cut it out.

Drink in moderation

  • Sip your drink slowly and alternate your alcoholic drink with a glass of water
  • Don’t drink on an empty stomach
  • Try diluting your drink with a spritzer
  • Instead of an alcoholic beverage try a mocktail or a spritzer with lemon

Test Your Cognition

According to Clive Ballard at the University of Exeter Medical School, U.K., alcohol consumption is often accompanied by poor diet and lifestyle, smoking, cardiovascular disease, depression, failure to comply with medical treatments, and social isolation – all of which also increase the risk of dementia.

Population attributable fraction of potentially modifiable risk factors for dementia. Source: Lancet Commission.Ballard wrote, “Understanding the pathways of risk in people with alcohol use disorders will help us to model the attributable risk more accurately and to develop better prevention strategies.”

And, one preventative strategy is to take regular cognitive assessments to establish a baseline for the brain. Cognitive health should be considered as the fifth vital sign. Just as we monitor blood pressure for our cardiovascular health, taking regular cognitive assessments are just as important. By doing so, any signs of cognitive decline can be addressed and its progression decelerated.

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References

Global Information System on Alcohol and Health. (n.d.). World Health Organization. Retrieved from https://www.who.int/gho/alcohol/en/

Schwarzinger, M., Pollock, B. G., Hasan, O., Dufouil, C., Rehm, J., & QalyDays Study Group (2018). Contribution of alcohol use disorders to the burden of dementia in France 2008-13: a nationwide retrospective cohort study. The Lancet. Public health, 3(3), e124–e132. https://doi.org/10.1016/S2468-2667(18)30022-7

Livingston, G., Huntley, J., Sommerlad, A., Ames, D., Ballard, C., Banerjee, S., Brayne, C., Burns, A., Cohen-Mansfield, J., Cooper, C., Costafreda, S. G., Dias, A., Fox, N., Gitlin, L. N., Howard, R., Kales, H. C., Kivimäki, M., Larson, E. B., Ogunniyi, A., Orgeta, V., … Mukadam, N. (2020). Dementia prevention, intervention, and care: 2020 report of the Lancet Commission. Lancet (London, England), 396(10248), 413–446. https://doi.org/10.1016/S0140-6736(20)30367-6

11 Ways to Curb Your Drinking. (n.d.). Harvard Health Publishing Harvard Medical School. Retrieved from https://www.health.harvard.edu/diseases-and-conditions/11-ways-to-curb-your-drinking

Iben Lundgaard, Wei Wang, Allison Eberhardt, Hanna Sophia Vinitsky, Benjamin Cameron Reeves, Sisi Peng, Nanhong Lou, Rashad Hussain, Maiken Nedergaard. Beneficial effects of low alcohol exposure, but adverse effects of high alcohol intake on glymphatic function. Scientific Reports, 2018; 8 (1) DOI: 10.1038/s41598-018-20424-y

University of Rochester Medical Center. (2018, February 2). Low levels of alcohol good for the brain, study shows. ScienceDaily. Retrieved November 13, 2020 from www.sciencedaily.com/releases/2018/02/180202085241.htm

Alcohol misuse linked to increased dementia risk. (2018, February 20). Alzheimer’s Research UK. Retrieved from https://www.alzheimersresearchuk.org/alcohol-misuse-linked-increased-dementia-risk/

Lundgaard, I., Wang, W., Eberhardt, A. et al. Beneficial effects of low alcohol exposure, but adverse effects of high alcohol intake on glymphatic function. (2018). Sci Rep 8, 2246. https://doi.org/10.1038/s41598-018-20424-y

Neafsey, E. J., & Collins, M. A. (2011). Moderate alcohol consumption and cognitive risk. Neuropsychiatric disease and treatment, 7, 465–484. https://doi.org/10.2147/NDT.S23159