Alcohol use and dementia: new research directions

Purpose of review Alcohol is gaining increased recognition as an important risk factor for dementia. This review summarises recent evidence on the relationship between alcohol use and dementia, focusing on studies published from January 2019 to August 2020. Recent findings Epidemiological data continues to yield results consistent with protective effects of low-to-moderate alcohol consumption for dementia and cognitive function. However, recent literature highlights the methodological limitations of existing observational studies. The effects of chronic, heavy alcohol use are clearer, with excessive consumption causing alcohol-related brain damage. Several pathways to this damage have been suggested, including the neurotoxic effects of thiamine deficiency, ethanol and acetaldehyde. Future research would benefit from greater implementation of analytical and design-based approaches to robustly model the alcohol use-dementia relationship in the general population, and should make use of large, consortia-level data. Early intervention to prevent dementia is critical: thiamine substitution has shown potential but requires more research, and psychosocial interventions to treat harmful alcohol use have proven effective. Finally, diagnostic criteria for alcohol-related dementia require formal validation to ensure usefulness in clinical practice.

Automated summary

Recent evidence suggests that low-to-moderate alcohol consumption may have protective effects on dementia and cognitive function, but the methodological limitations of existing observational studies have been highlighted. Chronic heavy alcohol use can cause alcohol-related brain damage through various neurotoxic pathways, including thiamine deficiency, ethanol, and acetaldehyde. Future research should focus on robust analytical and design-based approaches to better understand the relationship between alcohol use and dementia in the general population.