Midlife alcohol consumption and longitudinal brain atrophy: the PREVENT-Dementia study. Michael J. Firbank, John T. O’Brien, Karen Ritchie, Katie Wells, Guy Williams, Li Su & Craig W. Ritchie. Journal of Neurology volume 267, pages3282–3286. June 20 2020. https://link.springer.com/article/10.1007/s00415-020-10000-8
Background and aims: Consensus is lacking on whether light to moderate consumption of alcohol compared to abstinence is neuroprotective. In this study, we investigated the relationship between self-reported alcohol use and brain volume change over 2 years in middle-aged subjects.
Methods: A sample of 162 subjects (aged 40–59 at baseline) from the PREVENT-Dementia programme underwent MRI scans on two separate occasions (mean interval 734 days; SD 42 days). We measured longitudinal rates of brain atrophy using the FSL Siena toolbox, and change in hippocampal volume from segmentation in SPM.
Results: Controlling for age and sex, there were no significant associations of either total brain, ventricular, or hippocampal volume change with alcohol consumption. Adjusting for lifestyle, demographic and vascular risk factors did not alter this.
Conclusions: We did not find any evidence of influence of alcohol consumption on changes in brain volume over a 2-year period in 40–60-year-olds.
Contrary to our hypothesis, we did not observe any significant association between alcohol consumption and longitudinal brain volume changes. Rather, we saw a non-significant trend of 14–21 units of alcohol (vs. abstinence) associated with preserved total brain volume.
Studies of alcohol on cognition or brain structure have confounds due to social and demographic factors, with age, years of education, and social class all being linked to both alcohol consumption and brain volume. Our study, looking at brain volume change over 2 years within individuals overcomes to some extent these confounds, and including the lifestyle, demographic and vascular health factors in our analysis did not change our findings.
Combined with the previous conflicting reports on the benefit or otherwise of mild to moderate alcohol consumption, our data suggest at least that consumption of 7–21 units per week is not associated with marked brain atrophy over a 2-year period in midlife.
Limitations of the study include that alcohol consumption was estimated from subject report, and the relatively short follow-up of 2 years. The participants were mostly female, limiting the extrapolation to the general population.
In summary, we did not find any evidence of influence of alcohol consumption on changes in brain volume over a 2-year period in 40–60-year-olds.