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Health See other Health Articles Title: Moderate Drinking Linked to Lower Mortality in Early AD In patients with mild Alzheimer's disease (AD), consumption of moderate amounts of alcohol is associated with a lower risk for death than those who drink only occasionally, a new analysis has shown. The researchers found that those who reported drinking two to three units of alcohol a day had a 77% lower mortality rate compared with those drinking one or less than one drink per day. "That's huge," study author Frans Boch Waldorff, Research Unit for General Practice, Department of Public Health, University of Southern Denmark, Odense C, Denmark, told Medscape Medical News. Still, it's not enough to support a recommendation that patients with AD start drinking alcohol, especially since it's not clear what the impact is on their cognition, said Dr Waldorff. "We don't know how this affects quality of life, or how it affects progression of cognitive decline." The study was published online December 11 in BMJ Open. Because epidemiologic studies have shown that moderate alcohol consumption is associated with decreased mortality in the general population, researchers wanted to test the hypothesis that the same might be true for patients with AD, said Dr Waldorff. They carried out a post hoc analysis of the Danish Alzheimer's Intervention Study (DAISY), a longitudinal multicenter study of the efficacy of a psychosocial counseling and support program in patients with mild AD. The current analysis included 321 patients aged 50 years or older who had a Mini-Mental State Examination score of at least 20, a diagnosis within the past 12 months of probable AD or mixed AD with vascular components, and a primary caregiver willing to participate in the study. These caregivers were asked in a questionnaire to assess the alcohol consumption of the participant: no alcohol; only at parties; 1 unit/day or less (the second and third categories were combined into a single category of "1 or <1 unit/day"); 2 to 3 units/day; and more than 3 units/day. In Denmark, a unit is 12 g/15 mL of pure alcohol. According to Dr Waldorff, this is similar to a standard drink in the United States. The study didn't differentiate the type of alcohol (beer, wine, spirits). Among the study participants, 8% were abstainers, 71% drank occasionally (1 unit/day or less), 17% consumed moderate amounts of alcohol (2 to 3 units/day), and 4% had more than 3 units/day. During the 36-month follow-up, 16.5% of the patients died. Compared with occasional drinkers, patients drinking moderately had a reduced mortality (hazard ratio, 0.23; 95% confidence interval, 0.08 - 0.69; P = .0076). The analysis demonstrated a "U curve," with only those drinking two to three drinks a day having the protective effects. Abstinent patients and those with high alcohol intake had no significant increase or decrease in mortality. To help rule out the possibility that moderate drinkers are healthier, the researchers adjusted for premorbid conditions using the Charlson Comorbidities Index (CCI). Among conditions possibly affecting mortality, the CCI includes depression, which other research has linked to increased risk for death. To account for the possible inaccuracy of caregivers estimating drinking habits of a person they didn't live with, the researchers did an analysis that excluded patients living alone. That analysis showed no different effects on the association between alcohol consumption and mortality. And to adjust for the possibility of reverse causality (reduced intake among patients approaching death, thereby artificially inflating the protective effect), researchers removed the first year of follow-up. This sensitivity analysis retained the conclusion from the original primary analysis. Sex had further differential effect. Researchers don't know how alcohol might extend life, but they speculate it might stem from its positive cardiovascular effects, decreased inflammatory factors, and/or increased insulin sensitivity. It could also be that moderate drinking is associated with social interaction, which improves mortality rates, said Dr Waldorff. The study didn't look at how long a participant had been drinking. Another limitation was the relatively small number of patients in all groups except the reference group of occasional drinkers. As well, the population was selected for an intervention study, so the participants may be better functioning than the general population with AD, said Dr Waldorff. "This was a post hoc analysis, and so we didn't design this study aiming to look at the impact of alcohol consumption on mortality. That's why we have to be cautious about what kind of conclusions we can draw from it." Dr Waldorff sees this study as a "first step" that is "hypothesis-generating." He hopes it will "impact further research in this area." It would be interesting, he added, to design a study that investigates how alcohol intake affects cognitive decline, quality of life, and social networking in patients with AD. Invited to comment on the findings, Heather M Snyder, PhD, senior director, medical & scientific operations, Alzheimer's Association, said it's difficult to "parse out" the effect of alcohol on mortality in patients with AD because other factors, such as management of cardiovascular health and overall heart health, that are also at play. "I don't think from this study that there should be any recommendation, or any change, that people should make in their life." Dr Snyder noted some negative consequences of alcohol consumption in patients with dementia. These include an increased risk for falls, impaired function, and, in those with heavy alcohol use, a concern about neurotoxic effects. But the study does raise awareness about the role of lifestyle factors, she said. "For me, the big picture is that there are factors, things we engage in in our lifestyle and our habits, that may be important in terms of risks." The DAISY study was supported by the National Board of Social Services at the Danish Ministry of Social Affairs, the Danish Ministry of Health, and the Danish Health Foundation. Dr Waldorff has declared no relevant financial relationships. BMJ Open. Published online December 11, 2015. Full text Poster Comment: Should offer old fogies in nursing homes measured quantities of tax-free booze and study outcomes. Post Comment Private Reply Ignore Thread Top • Page Up • Full Thread • Page Down • Bottom/Latest
#1. To: Tatarewicz (#0)
If I had a dollar for every bottle of tequila and case of beer I consumed over the years, I would be wealthy beyond belief. And that does not count the illicit drugs, either. LOL
"When bad men combine, the good must associate; else they will fall, one by one." Edmund Burke
Wow, this stuff IS medicine, ain't it -- "units", I've never heard it called that :-]
Danes like other foreigners have somewhat different ways of speaking, quantifying.
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