IS THE BOOZE GOOD OR BAD FOR YOUR BRAIN?

The various studies seem to oscillate between condemning and praising alcohol intake. So it is interesting to see an attempt at a systematic literature review designed to see whether it has any effect on your going ga-ga in later life. And the good news for those of us who appreciate the occasional assistance of Mr John Walker of Scotland is that moderate consumption seems to help rather than hinder. See below. I hate to be a spoilsport but I feel obliged to note, however, that the evidence is epidemiological. Moderate drinkers were healthier but moderate drinkers probably engage in safer behaviour in lots of ways (e.g less illegal drug taking). So the booze may have NOTHING to do with their better health. Sad, isn't it?

Alcohol, dementia and cognitive decline in the elderly: a systematic review

By Ruth Peters et al.

Background: dementia and cognitive decline have been linked to cardiovascular risk. Alcohol has known negative effects in large quantities but may be protective for the cardiovascular system in smaller amounts. Effect of alcohol intake may be greater in the elderly and may impact on cognition.

Methods: to evaluate the evidence for any relationship between incident cognitive decline or dementia in the elderly and alcohol consumption, a systematic review and meta-analyses were carried out. Criteria for inclusion were longitudinal studies of subjects aged ~ 65, with primary outcomes of incident dementia/cognitive decline.

Results: 23 studies were identified (20 epidemiological cohort, three retrospective matched case-control nested in a cohort). Meta-analyses suggest that small amounts of alcohol may be protective against dementia (random effects model, risk ratio [RR] 0.63; 95% CI 0.53-0.75) and Alzheimer's disease (RR 0.57; 0.44-0.74) but not for vascular dementia (RR 0.82; 0.50-1.35) or cognitive decline (RR 0.89; 0.67-1.17) However, studies varied, with differing lengths of follow up, measurement of alcohol intake, inclusion of true abstainers and assessment of potential confounders.

Conclusions: because of the heterogeneity in the data these findings should be interpreted with caution. However, there is some evidence to suggest that limited alcohol intake in earlier adult life may be protective against incident dementia later.

Age and Ageing 2008 37(5):505-512.




ANOTHER GREAT THEORY BITES THE DUST

Aspirin seems to loosen up the blood flow generally and that should be a good thing for the restricted bloodflow found in aged brains -- and thus keep the brains concerned a bit younger. So is regular aspirin intake a good thing if you want to avoid going ga-ga? Sorry. No effect! Pesky things, these placebo controls!

Low dose aspirin and cognitive function in middle aged to elderly adults: randomised controlled trial

By Jackie F Price et al.

Objective To determine the effects of low dose aspirin on cognitive function in middle aged to elderly men and women at moderately increased cardiovascular risk.

Design Randomised double blind placebo controlled trial.

Setting Central Scotland.

Participants 3350 men and women aged over 50 participating in the aspirin for asymptomatic atherosclerosis trial.

Intervention Low dose aspirin (100 mg daily) or placebo for five years.

Main outcome measures Tests of memory, executive function, non-verbal reasoning, mental flexibility, and information processing five years after randomisation, with scores used to create a summary cognitive score (general factor).

Results At baseline, mean vocabulary scores (an indicator of previous cognitive ability) were similar in the aspirin (30.9, SD 4.7) and placebo (31.1, SD 4.7) groups. In the primary intention to treat analysis, there was no significant difference at follow-up between the groups in the proportion achieving over the median general factor cognitive score (32.7% and 34.8% respectively, odds ratio 0.91, 95% confidence interval 0.79 to 1.05, P=0.20) or in mean scores on the individual cognitive tests. There were also no significant differences in change in cognitive ability over the five years in a subset of 504 who underwent detailed cognitive testing at baseline.

Conclusion Low dose aspirin does not affect cognitive function in middle aged to elderly people at increased cardiovascular risk.

BMJ 2008;337:a1198.