Alcohol fuels majority of early onset dementia cases, study finds
Source: The Telegraph
Laura Donnelly
20 FEBRUARY 2018
The majority of cases of early onset dementia are now caused by alcohol, major research suggests.
The study of more than 1 million dementia sufferers, published in the Lancet Public Health Journal, found almost six in ten diagnoses before the age of 65 were linked to heavy drinking.
Experts said the study showed the burden of disease linked to alcohol is “much larger than previously thought”.
They urged GPs to closely question all patients about their drinking habits, and do more to persuade those drinking above recommended levels to cut down.
The study tracked more than 31 million patients discharged from hospitals in France between 2008 and 2013, including 1.1 million cases of dementia. Of those, 57,353 patients received their diagnosis before the age of 65.
Researchers found 39 per cent of cases were found to be suffering from alcohol-related brain damage, while a further 18 per cent of sufferers had already been diagnosed as suffering from an alcohol problem.
Overall, patients diagnosed with an alcohol use disorder had three times the risk of dementia at any age, the research found.
The study by the Translational Health Economics Network in Paris, based at the Sorbonne, did not examine the impact of moderate alcohol intake.
NHS guidance already warns that there is “no safe level of alcohol consumption” when it comes to dementia, with one in three cases of Alzheimer’s disease linked to lifestyle.
But experts said the strength of the association meant far more should be done to tackle drinking levels across the population, with researchers calling for a ban on alcohol advertising.
Researchers said GPs should do far more to encourage patients to open up about their drinking habits, using “motivational interviews” to support changes in habits.
They also said the figures were likely to be an underestimate, given they reflected symptoms severe enough to warrant hospitalisation.
NHS guidance says men and women should drink no more than 14 units of alcohol a week. Until 2016, the limit for men was 21 units.
Chronic heavy drinking is defined by the World health Organisation as consuming far more than that – around five units a day for women (two and a half glasses of wine) or around seven units (three pints of lager) for men.
“Our findings suggest that the burden of dementia attributable to alcohol use disorders is much larger than previously thought, suggesting that heavy drinking should be recognised as a major risk factor for all types of dementia,” the study’s authors said.
Lead researcher Dr Michael Schwarzinger said the increased risk was likely to be explained by the fact alcohol could cause “permanent structural and functional brain damage”.
Family doctors should question all patients about their drinking levels, in an attempt to identify those slipping into habits which could jeopardise their health, he said.
“GPs are the best option to be screening patients to identify those who have alcohol problems,” Dr Schwarzinger said.
“A variety of measures are needed, such as reducing availability, increasing taxation, and banning advertising and marketing of alcohol, alongside early detection and treatment of alcohol use disorders.”
Prof Clive Ballard, of The University of Exeter Medical School, said: “Their study is immensely important and highlights the potential of alcohol use disorders, and possibly alcohol consumption, as modifiable risk factors for dementia prevention.
“In our view, this evidence is robust and we should move forward with clear public health messages about the relationship between both alcohol use disorders and alcohol consumption, respectively, and dementia.”
In total, 6.2 per cent of male patients admitted to hospital suffered from alcohol use disorders, compared with 16.5 per cent of male patients suffering from dementia. While one percent of all female admissions were diagnosed with an alcohol problem, among dementia patients, the figure was 4 per cent.
Dr Sara Imarisio, head of research at Alzheimer’s Research UK, said: “The findings lend even more weight to calls for people to drink within recommended guidelines.
“As this study only looked at the people who had been admitted to hospital due to chronic heavy drinking, it doesn’t reveal the full extent of the link between alcohol use and dementia risk. “Previous research has indicated that even moderate drinking may have a negative impact on brain health and people shouldn’t be under the impression that only drinking to the point of hospitalisation carries a risk,” she added.
“Although there is no sure-fire 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.”
Baby boomers account for 45 per cent of alcohol-related hospital admissions, NHS figures show, with a tripling in cases among those aged between 55 and 74 in the last decade.
Dr Doug Brown, chief policy and research officer at Alzheimer’s Society, said: “We’ve known for a while that heavy drinking can increase your risk of developing dementia. This study suggests that alcohol abuse disorders may be responsible for more cases of early-onset dementia than previously thought.”
He said further research was needed to fully understand how many cases of early onset dementia were caused by excess alcohol.
“The study doesn’t change the advice to stick to no more than 14 units of alcohol a week. Anyone concerned about heavy drinking should visit their GP to discuss ways of cutting down and the support on offer,” he said.