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Heavy Drinking Increases Risks for Dementia

Alcohol use disorder is the current accepted term for the diagnosis of two drinking-related conditions: alcohol abuse and alcoholism. Excessive alcohol consumption is widely acknowledged as an important factor in a number of damaging changes in human mental and physical health. In a study slated for publication in 2014 in The American Journal of Geriatric Psychiatry, a team of British and American researchers explored a previously unconsidered impact of alcohol use disorder in middle-aged adults: an increased chance of developing serious, potentially dementia-promoting memory problems in later life.

Alcohol Use Disorder

Under guidelines established in 2013 by the American Psychiatric Association, alcohol use disorder is defined by one of three things: isolated symptoms of a damaging pattern of alcohol abuse, isolated symptoms of physically dependent alcoholism or combined symptoms of both alcohol abuse and alcoholism. To receive a diagnosis, an affected person must have at least two out of 11 specifically designated symptoms of alcohol abuse or alcoholism. Examples of the potential symptoms include an inability to keep alcohol consumption within self-defined limits, a recurring or ongoing urge to drink more alcohol, repeated use of alcohol in clearly dangerous circumstances, rising tolerance to the effects of alcohol, continued alcohol intake after exposure to seriously negative drinking-related outcomes, and the onset of alcohol withdrawal when intake of the substance stops or quickly drops. The alcohol use disorder diagnosis was created, in part, because issues of alcohol abuse and alcoholism are frequently interconnected.

Alcohol and Memory

Researchers, public health officials and addiction specialists already know that excessive alcohol consumption has negative influences on our ability to store and recall memories. For example, binge drinkers and other excessive alcohol consumers are fairly likely to experience “blackouts” while in a heavily intoxicated state. People in the midst of a blackout retain the ability to recall their moment-to-moment actions, but partially or fully lose the ability to recall those actions when they’re no longer intoxicated. Even in people who don’t experience blackouts, alcohol consumption above moderate levels can interfere with the ability to translate relatively unstable short-term memories into lasting long-term memories. Part of this effect stems from alcohol’s ability to alter normal function in a brain structure called the hippocampus, which plays a crucial role in our capacity to make, store and recall memories. When present in excessive amounts, the substance can also alter basic function in other brain structures that contribute to memory capacity.

Impact on Late-Life Memory Problems

In the study scheduled for publication in The American Journal of Geriatric Psychiatry, researchers from the University of Michigan, the University of Iowa and the United Kingdom’s University of Exeter Medical School used a two-decade examination of 6,542 adults to determine the connection between a history of alcohol use disorder in middle age and the odds of developing severe memory problems as a senior citizen. All of these adults were born between 1931 and 1941 and participated in an American project called the Health and Retirement Study. In 1992, each participant underwent an assessment for alcohol use disorder commonly known as the CAGE questionnaire. In addition, all participants underwent an assessment designed to detect memory problems and declines in mental function. Additional assessments were conducted at two-year intervals between 1996 and 2010.

In middle age, some of the study participants qualified for a preliminary assessment of alcohol use disorder at some point in their lifetimes, while others did not. The researchers concluded that, among the participants currently or previously affected by alcohol use disorder, the rate of severe memory impairment in later life was more than 100 percent higher than the rate found in the participants who were never affected by serious alcohol problems. They also linked a middle-age history of alcohol use disorder to other declines in mental function, although these declines were not deemed statistically significant in comparison to the declines experienced by those individuals with no history of alcohol use disorder.

The study’s authors believe that the amount of memory impairment they identified in the participants with a history of alcohol use disorder may be enough to increase the odds of eventually receiving a diagnosis for some form of dementia. They also believe that this previously unnoticed link highlights the importance of considering all of the alcohol-related factors that can contribute to long-term changes in human health.

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