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ASSOCIATION BETWEEN ALCOHOL CONSUMPTION AND COGNITIVE IMPAIRMENT IN CHINESE OLDER ADULTS ( Chu LW, Chan KKK, Chiu KC). Prof. Leung-Wing Chu MD, FRCP (Edin. & Glas.) , FHKCP, FHKAM (Medicine) Honorary Clinical Professor, Department of Medicine,,
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ASSOCIATION BETWEEN ALCOHOL CONSUMPTION AND COGNITIVE IMPAIRMENT IN CHINESE OLDER ADULTS(Chu LW, Chan KKK, Chiu KC) Prof. Leung-Wing ChuMD, FRCP (Edin. & Glas.), FHKCP, FHKAM (Medicine) Honorary Clinical Professor, Department of Medicine,, LKS Faculty of Medicine, The University of Hong Kong Chief, Division of Geriatrics, Queen Mary Hospital OC051 March 28, 2011
Conflict of Interest • All authors • Chu LW, Chan KKK, Chiu KC • Has no real or apparent conflicts of interest to report OC051
Introduction • Alcohol consumption - diverse effects on heart & brain health • Coronary heart diseases, • Moderate consumption beneficial effects in heart diseases; possibly too for vascular dementia • Brain’s cognitive functioning: Previous studies • light to moderate alcohol consumption (up to 3 glasses of wine daily) lower risks of cognitive impairment (CI) & dementia vs. non-drinker (Ruitenberg et al, 2002, Rotterdam study & several other Western studies) 38% reduced risk of CI in a systematic review (Peters et al, 2008) • MCI (mild cognitive impairment): Light alcohol consumption of up to one drink/day decrease progression from MCI to dementia (Solfrizzi, 2007)
Introduction • Very limited data reported fron Chinese populations • Only 2 studies from mid-China provinces • But with different findings • Alcohol increased the risk of dementia in a dose-related manner (Zhou et al, 2003) • Light-moderate alcohol intake 50% reduction in dementia (both VaD & AD) (Deng et al, 2006) • No Chinese study from Southern part of China
Objective of the study • To investigate the association between alcohol consumption and the risk of cognitive impairment in Southern Chinese older adults in Hong Kong.
Methods • Design: A a cross-sectional study • Setting: Geriatric Clinics of Queen Mary Hospital and Grantham Hospital, The University of Hong Kong, Hong Kong SAR ( a southern city in China). • Subjects’ inclusion criteria:- • Chinese ethnicity, aged 65 years old or over, and written informed consent • Exclusion criteria:- • visual and hearing impairment, end-stage liver, heart or lung disease, active cancer, language or other communication barriers
Methods • Face-to-face interviews: Participants’ socio-demographic, co-morbid diseases, alcohol drinking habits and Mini-Mental State Examination (MMSE) for cognitive function were obtained • Alcohol drinking • Alcohol drinking habit and pattern were assessed by a modified version of the Canada Alcohol and Drug Survey (Statistics Canada, 1994) • The amounts of alcohol consumption in the participants were converted into grams of weekly pure ethanol intake from alcohol units (1unit = 8 g. or 10 ml of alcohol) (Huang et al, 2002; Deng et al, 2006). • The amount of ethanol contained in a particular type of alcoholic beverages in a typical week was calculated • volume of the alcoholic beverage × the percentage of ethanol contained in the beverage, • then converted into grams of ethanol, using the formula: Concentration of alcohol (%) x Alcohol Volume (ml) x alcohol unit (g/%ml). • Then, the average weekly alcohol consumption was calculated by multiplying the frequency of consumption in a typical week by the amount of ethanol in the consumed beverage (Janghorbani et al, 2003; Solfrizzi et al, 2007).
Methods • Seven main types of alcoholic beverages were encountered • Western alcohol drinks • Chinese alcohol drinks
Methods *Gaziano & Hennekens,1995; Janghorbani et al, 2003 • Alcohol Consumption per week: Categorized into 4 groups* • 1) non-drinker (abstainers) - did not drink; • 2) light drinkers - drink <168g for men and <112g for women; • 3) moderate drinkers - drink 400g or less but 168g or more for men and 280g or less but 112g or more for women; • 4) heavy drinkers - drink >400g for men and >280g for women
Methods Outcome measure: MMSE • Participants were categorized into • normal cognitive and • cognitively impaired groups • by education-adjusted MMSE cut-off scores (validated previously for Hong Kong Chinese older adults*) • *MMSE cut-offs for cognitive impairment were • less than 23 for those with middle/secondary school or higher education, • less than 21 for those with primary school education, and • less than 19 for those with no education (Chiu et al, 1998).
Results • 314 Chinese older adults • Cognitively normal, n=150 • Cognitively impairment, n=164 • Mean age 79.9 years (SD 6.5) • Females, 52.2%
Bivariate analyses:Risk factors of cognitive impairment • Co-morbid diseases not associated with CI, including • stroke (p=0.736), • hypertension (p=0.791), • heart diseases (coronary heart diseases, myocardial infarction, ischemic heart diseases, etc) (p=0.743), heart failures (p=0.336) • cataracts (p=0.279), • diabetes mellitus (p=0.244), • COPD (p=0.920), • hyperlipidemia (p=0.732), • parkinsonism (p=0.202), • osteoporosis (p=0.226)
Bivariate analyses:Risk factors of cognitive impairment • The average weekly alcohol consumption in the cognitively impaired group was significantly higher than that of the normal cognition group • CI: mean (SD): 861.89 (673.03) grams per week • Normal cognition: 241.21 (276.26) ( p<0.001, t-test) • Drinkers with light to moderate alcohol consumption were associated with higher MMSE scores • than non-drinkers and heavy drinkers.
Logistic regression analyses:Independent risk factors of CI *Education, marital status, social class, family members, drinking red wine, waist circumference, were statistically non-significant
Conclusion • Heavy alcohol consumption is associated with an increased risk of cognitive impairment • while light to moderate alcohol consumption is associated with reduced risk in Chinese older adults
