Alcohol use and cognitive performance: a comparison between Greece and the United States

Abstract Objectives To examine associations between alcohol use and cognitive performance among older adults in Greece and the United States, and assess potential differences due to differing drinking practices in the two countries. Methods Data came from Hellenic Longitudinal Investigation of Aging and Diet (HELIAD) and National Alzheimer’s Coordinating Center Uniform Dataset (NACC). We examined those aged 65–90 years at baseline who had no cognitive impairment and complete data for cognitive and alcohol use variables (N = 1110 from HELIAD; N = 2455 from NACC). We examined associations between current alcohol use and frequency of such use with cognitive performance on various cognitive tasks stratified by gender. Results In NACC, use of alcohol was associated with better cognitive performance. Men drinkers performed better than non-drinkers on Trail A (standardized mean 0.07 vs. −0.24, p<.001), Trail B (0.06 vs. −0.19, p=.001), and women drinkers performed better on Trail A (0.04 vs. −0.09, p=.016), Trail B (0.04 vs. −0.10, p=.005), verbal fluency (Animals: 0.05 vs. −0.13, p<.001; Vegetables: 0.04 vs. −0.09, p=.027), and MoCA (0.03 vs. −0.08, p=.039). In HELIAD, fewer differences were seen with only women drinkers exhibiting better performance than non-drinkers on the Boston Naming Task (0.11 vs. −0.05, p=.016). In general, more frequent drinkers performed better on cognitive tasks than less frequent drinkers, although this was only statistically significant in the NACC dataset. Conclusion While drinking alcohol may be associated with better cognitive performance across both the US and Greece, more research is needed to assess the cultural factors that may modify this association.

[1]  K. Katsouyanni,et al.  Long-Term Trends (1994–2011) and Predictors of Total Alcohol and Alcoholic Beverages Consumption: The EPIC Greece Cohort , 2021, Nutrients.

[2]  U. Staudinger,et al.  Cross-country differences in age trends in alcohol consumption among older adults: a cross-sectional study of individuals aged 50 years and older in 22 countries. , 2020, Addiction.

[3]  Changwei Li,et al.  Association of Low to Moderate Alcohol Drinking With Cognitive Functions From Middle to Older Age Among US Adults , 2020, JAMA network open.

[4]  P. Petrikis,et al.  Prevalence of Alcohol Use Disorders and Their Association with Sociodemographic Determinants and Depression/Anxiety Disorders in a Representative Sample of the Greek General Population , 2020, Psychiatry journal.

[5]  J. Rehm,et al.  Alcohol use and dementia: a systematic scoping review , 2019, Alzheimer's Research & Therapy.

[6]  Dan J Stein,et al.  Alcohol use and burden for 195 countries and territories, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016 , 2018, Lancet.

[7]  D. Paulson,et al.  Moderate alcohol use and apolipoprotein E-4 (ApoE-4): Independent effects on cognitive outcomes in later life , 2018, Journal of clinical and experimental neuropsychology.

[8]  Lei Wu,et al.  Adherence to Mediterranean diet and risk of developing cognitive disorders: An updated systematic review and meta-analysis of prospective cohort studies , 2017, Scientific Reports.

[9]  B. Grant,et al.  Religiosity, race/ethnicity, and alcohol use behaviors in the United States , 2016, Psychological Medicine.

[10]  E. Philippou,et al.  Mediterranean Diet, Cognitive Function, and Dementia: A Systematic Review of the Evidence. , 2016, Advances in nutrition.

[11]  Emilie T. Reas,et al.  Moderate, Regular Alcohol Consumption is Associated with Higher Cognitive Function in Older Community-Dwelling Adults. , 2016, The journal of prevention of Alzheimer's disease.

[12]  N. Scarmeas,et al.  The Hellenic Longitudinal Investigation of Aging and Diet (HELIAD): Rationale, Study Design, and Cohort Description , 2014, Neuroepidemiology.

[13]  S. Mednick,et al.  Religious factors associated with alcohol involvement: results from the Mauritian Joint Child Health Project. , 2014, Drug and alcohol dependence.

[14]  Bruce L. Miller,et al.  Distinct neuroanatomical substrates and cognitive mechanisms of figure copy performance in Alzheimer's disease and behavioral variant frontotemporal dementia , 2011, Neuropsychologia.

[15]  K. Tsapkini,et al.  Adaptation and Validation of Standardized Aphasia Tests in Different Languages: Lessons from the Boston Diagnostic Aphasia Examination–Short Form in Greek , 2010, Behavioural neurology.

[16]  F. Clavel-Chapelon,et al.  Alcohol consumption patterns, diet and body weight in 10 European countries , 2009, European Journal of Clinical Nutrition.

[17]  B. Booth,et al.  Rural, suburban, and urban variations in alcohol consumption in the United States: findings from the National Epidemiologic Survey on Alcohol and Related Conditions. , 2007, The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association.

[18]  G. Casazza,et al.  Socio-demographic status and alcohol drinking patterns among Greek healthy adults. , 2006, Central European journal of public health.

[19]  Ulrike Grittner,et al.  Drinking patterns and their gender differences in Europe. , 2006, Alcohol and alcoholism (Oxford, Oxfordshire). Supplement.

[20]  J. Morris,et al.  The Uniform Data Set (UDS): Clinical and Cognitive Variables and Descriptive Data From Alzheimer Disease Centers , 2006, Alzheimer disease and associated disorders.

[21]  M. Holmila,et al.  Gender differences in drinking: why do they still exist? , 2005, Addiction.

[22]  H. Dodge,et al.  Alcohol consumption and cognitive function in late life , 2005, Neurology.

[23]  J. Cummings,et al.  The Montreal Cognitive Assessment, MoCA: A Brief Screening Tool For Mild Cognitive Impairment , 2005, Journal of the American Geriatrics Society.

[24]  F. Grodstein,et al.  Effects of moderate alcohol consumption on cognitive function in women. , 2005, The New England journal of medicine.

[25]  L. Kuller,et al.  Prospective study of alcohol consumption and risk of dementia in older adults. , 2003, JAMA.

[26]  A. Miller,et al.  Patterns of alcohol consumption in 10 European countries participating in the European Prospective Investigation into Cancer and Nutrition (EPIC) project , 2002, Public Health Nutrition.

[27]  J. Jolles,et al.  Cigarette smoking and alcohol consumption in relation to cognitive performance in middle age. , 2002, American journal of epidemiology.

[28]  R. D'Agostino,et al.  Alcohol consumption and cognitive performance in the Framingham Heart Study. , 1999, American journal of epidemiology.

[29]  C. Stefanis,et al.  Alcohol consumption and rates of alcoholism in Greece. , 1980, Drug and alcohol dependence.

[30]  S. Folstein,et al.  "Mini-mental state". A practical method for grading the cognitive state of patients for the clinician. , 1975, Journal of psychiatric research.

[31]  R. Caetano,et al.  Drinking, Alcohol Use Disorder, and Treatment Access and Utilization Among U.S. Racial/Ethnic Groups. , 2017, Alcoholism, clinical and experimental research.

[32]  L. McEvoy,et al.  Alcohol Intake and Cognitively Healthy Longevity in Community-Dwelling Adults: The Rancho Bernardo Study. , 2017, Journal of Alzheimer's disease : JAD.

[33]  M. Sudhinaraset,et al.  Social and Cultural Contexts of Alcohol Use , 2016, Alcohol research : current reviews.

[34]  Thomas M. Brown,et al.  Alcohol Use , 2018, Annals of Internal Medicine.

[35]  E. Goyder,et al.  Alcohol consumption among the over 50s: international comparisons. , 2015, Alcohol and alcoholism.

[36]  D. Heim,et al.  Rethinking drinking cultures: a review of drinking cultures and a reconstructed dimensional approach. , 2012, Public health.