You are leaving Medscape Education
Cancel Continue
Log in to save activities Your saved activities will show here so that you can easily access them whenever you're ready. Log in here CME & Education Log in to keep track of your credits.


Light to Moderate Alcohol Use Protective Against Dementia in Older Adults

  • Authors: News Author: Megan Brooks
    CME Author: Désirée Lie, MD, MSEd
  • CME Released: 3/11/2011
  • Valid for credit through: 3/11/2012, 11:59 PM EST
Start Activity

Target Audience and Goal Statement

This article is intended for primary care clinicians, geriatricians, and other specialists who care for older patients.

The goal of this activity is to provide medical news to primary care clinicians and other healthcare professionals in order to enhance patient care.

Upon completion of this activity, participants will be able to:

  1. Describe the quantity and type of alcohol consumed by individuals 75 years and older and factors associated with alcohol consumption.
  2. Describe the association between alcohol consumption and dementia in adults 75 years and older.


As an organization accredited by the ACCME, Medscape, LLC, requires everyone who is in a position to control the content of an education activity to disclose all relevant financial relationships with any commercial interest. The ACCME defines "relevant financial relationships" as financial relationships in any amount, occurring within the past 12 months, including financial relationships of a spouse or life partner, that could create a conflict of interest.

Medscape, LLC, encourages Authors to identify investigational products or off-label uses of products regulated by the US Food and Drug Administration, at first mention and where appropriate in the content.


  • Megan Brooks

    Megan Brooks is a freelance writer for Medscape.


    Disclosure: Megan Brooks has disclosed no relevant financial relationships.


  • Brande Nicole Martin

    CME Clinical Editor, Medscape, LLC


    Disclosure: Brande Nicole Martin has disclosed no relevant financial relationships.

CME Author(s)

  • Désirée Lie, MD, MSEd

    Clinical Professor; Director of Research and Faculty Development, Department of Family Medicine, University of California, Irvine at Orange


    Disclosure: Désirée Lie, MD, MSEd, has disclosed the following relevant financial relationship:
    Served as a nonproduct speaker for: "Topics in Health" for Merck Speaker Services

CME Reviewer(s)

  • Sarah Fleischman

    CME Program Manager, Medscape, LLC


    Disclosure: Sarah Fleischman has disclosed no relevant financial relationships.

Accreditation Statements

    For Physicians

  • Medscape, LLC is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

    Medscape, LLC designates this educational activity for a maximum of 0.25 AMA PRA Category 1 Credit(s)™ . Physicians should only claim credit commensurate with the extent of their participation in the activity.

    This activity, Medscape Education Clinical Briefs has been reviewed and is acceptable for up to 300 Prescribed credits by the American Academy of Family Physicians. AAFP accreditation begins September 1, 2010. Term of approval is for 1 year from this date. Each issue is approved for .25 Prescribed credits. Credit may be claimed for 1 year from the date of this issue.

    Note: Total credit is subject to change based on topic selection and article length.

    Medscape, LLC staff have disclosed that they have no relevant financial relationships.

    AAFP Accreditation Questions

    Contact This Provider

For questions regarding the content of this activity, contact the accredited provider for this CME/CE activity noted above. For technical assistance, contact [email protected]

Instructions for Participation and Credit

There are no fees for participating in or receiving credit for this online educational activity. For information on applicability and acceptance of continuing education credit for this activity, please consult your professional licensing board.

This activity is designed to be completed within the time designated on the title page; physicians should claim only those credits that reflect the time actually spent in the activity. To successfully earn credit, participants must complete the activity online during the valid credit period that is noted on the title page.

Follow these steps to earn CME/CE credit*:

  1. Read the target audience, learning objectives, and author disclosures.
  2. Study the educational content online or printed out.
  3. Online, choose the best answer to each test question. To receive a certificate, you must receive a passing score as designated at the top of the test. Medscape Education encourages you to complete the Activity Evaluation to provide feedback for future programming.

You may now view or print the certificate from your CME/CE Tracker. You may print the certificate but you cannot alter it. Credits will be tallied in your CME/CE Tracker and archived for 6 years; at any point within this time period you can print out the tally as well as the certificates by accessing "Edit Your Profile" at the top of your Medscape homepage.

*The credit that you receive is based on your user profile.



Light to Moderate Alcohol Use Protective Against Dementia in Older Adults

Authors: News Author: Megan Brooks CME Author: Désirée Lie, MD, MSEdFaculty and Disclosures

CME Released: 3/11/2011

Valid for credit through: 3/11/2012, 11:59 PM EST


March 11, 2011 — Mirroring findings in younger adults, a new study of adults 75 years and older at baseline suggests that drinking light to moderate amounts of alcohol may help protect against the development of dementia.

"There is strong evidence from previous longitudinal studies that [drinking] a small amount of alcohol is associated with lower incidence of overall dementia and Alzheimer dementia," Professor Siegfried Weyerer, PhD, from the Central Institute of Mental Health in Mannheim, Germany, said.

"Unique in our study," he told Medscape Medical News, "is that this result was also found among a large population [75 years and older at baseline] where the mean age was, at 80.2 years, much higher than that in previous studies."

The study was published online March 2 in Age and Ageing.

Drinkers Outnumber Teetotalers

Dr. Siegfried Weyerer
Dr. Siegfried Weyerer

Included in the study were 3202 elderly German individuals free of dementia at baseline who were followed up 1.5 years and 3 years later by means of structured clinical interviews, including detailed assessment of current alcohol consumption and dementia diagnoses.

On the basis of alcohol consumption information available for 3180 of the subjects, 50.0% were abstinent, 24.8% consumed fewer than 1 drink daily (10 g/day), 12.8% drank 1 to 2 drinks daily (10 – 19 g/day), and 12.4% consumed 2 or more drinks daily (≥20 g/day). A small group of 25 participants met criteria for harmful drinking (>60 g/day for men and >40 g/day for women).

Among alcohol drinkers, nearly half (48.6%) drank wine only, 29.0% drank beer only, and 22.4% drank wine, beer, or spirits.

During an average of 3 years, 217 of the 3202 subjects (6.8%) developed dementia; 111 of these subjects (3.5%) developed Alzheimer dementia.

Compared with teetotalers, subjects consuming alcohol were 29% less likely to develop dementia (adjusted hazard ratio [aHR], 0.71; 95% confidence interval [CI], 0.53 – 0.96; P = .0028) and 42% were less likely to develop Alzheimer dementia (aHR, 0.58; 95% CI, 0.38 – 0.89; P = .013).

The protective effect of mild/moderate alcohol consumption on incident dementia was found after controlling for several social factors, such as education, physical and mental health problems including functional impairment or depression, lifestyle factors, or ApoE4 status factors, which have a significant impact on dementia, said Dr. Weyerer.

With regard to quantity of alcohol consumed, the researchers reported all hazard ratios were lower than 1. However, a statistically significant association was found only for subjects consuming between 20 and 29 g of alcohol per day.

A lower risk for incident dementia was found for all types of alcohol, with statistically significant hazard ratios found among those drinking mixed alcoholic beverages.

"In agreement with meta-analyses that include younger age groups, our study suggests that light-to-moderate alcohol consumption is inversely related to incident dementia, also among individuals aged 75 years and older," the study authors conclude.

"People should be aware that we are talking about mild/moderate consumption of alcohol. There is no doubt that long-term alcohol abuse is detrimental to memory function and can cause neurodegenerative disease," said Dr. Weyerer.

Experts Weigh In

Medscape Medical News asked the International Scientific Forum on Alcohol Research to weigh in on the study in relation to prior studies. The forum is a joint undertaking of the Institute on Lifestyle & Health of Boston University School of Medicine in Massachusetts and Alcohol in Moderation of the United Kingdom. Forum members are not paid; members are researchers who share their knowledge and expertise and put recent research into context with other studies.

A statement from the forum provided to Medscape Medical News notes that during the past 31 years (1980-2011), the association between moderate alcohol intake and cognitive function has been investigated in 71 studies comprising 153,856 men and women from various populations with various drinking patterns.

"Most studies showed an association between light to moderate alcohol consumption and better cognitive function and reduced risk of dementia, including vascular dementia and Alzheimer dementia," according to the forum.

However, forum member Erik Skovenborg, MD, of the Scandinavian Medical Alcohol Board and Practitioner, from Aarhus, Denmark, made the point that "since a randomized, controlled study of alcohol consumption and risk of dementia has not been done [and would not be feasible], the jury is still out concerning the importance of confounding."

Dr. Skovenborg noted that "happy people with many friends have the most opportunities for social drinking and in the [current] study alcohol consumption was significantly associated with factors that are protective for the development of dementia: better education, not living alone, and absence of depression.

"However, even after controlling for these and several other factors, the risk for incident dementia was still significantly lower among light-to-moderate alcohol consumers. Even so, it may still be a part of the explanation that old German men and women, who drank alcohol sensibly in old age, also have a healthier lifestyle in terms of physical, dietary, and mental perspectives," Dr. Skovenborg said.

Forum member Roger Corder, PhD, MRPharmS, from the William Harvey Research Institute, Queen Mary University of London, United Kingdom, agrees that "it is very difficult to separate alcohol consumption from other healthy lifestyle factors in populations where moderate drinking is commonplace.

"In this respect," he said, "the [current] study doesn’t correct for a healthy diet, which is also likely very important, as a poor diet is associated with increased risk of dementia due to deficiencies such as low omega-3 fat intake, inadequate vitamin B12, etc. However, it is also known that improved vascular function in alcohol drinkers could account for some element of reduced dementia risk."

Forum member Harvey Finkel, MD, of Boston University Medical Center in Massachusetts, said, although he believes that one "should not start to drink just because one has attained seniority, neither must one stop. Elderly folks handle alcohol with more responsibility than do the young, and they may derive greater health benefits from moderate drinking. Age is not a reason for abstinence," Dr. Finkel said.

The study was funded by the German Federal Ministry of Education and Research. Dr. Weyerer and colleagues have disclosed no relevant financial relationships.

Age Ageing. Published online March 2, 2011. Abstract

Clinical Context

Long-term alcohol abuse is associated with memory function, and alcohol-related dementia accounts for approximately 10% of all dementia. However, it is unclear if current alcohol consumption in older adults is associated with incident dementia because there is evidence that light to moderate alcohol consumption may decrease the risk for cognitive decline or dementia.

This is a longitudinal study of primary care participants 75 years and older without dementia who were observed to determine incident rates of overall dementia and Alzheimer's dementia.

Study Highlights

  • Included were 3327 patients (age ≥ 75 years) from 138 general practice settings.
  • General practitioners used a screening instrument to screen for dementia at baseline.
  • Patients were interviewed at home and were reassessed 1.5 and 3 years later.
  • Among those interviewed at baseline, 84.8% were interviewed 1.5 years later and 73.9% at 3 years later.
  • For assessment of current use of alcohol, participants were asked how many days of the week they drank alcohol. Those who consumed alcohol were asked how much they drank on average.
  • Frequency of alcohol consumption and amounts of beer, wine, and liquor consumed were assessed.
  • Quantity of alcohol consumption was classified as abstinent, 1 to 9 g, 10 to 19 g, 20 to 29 g, 30 to 39 g, and 40 or more g.
  • Type of alcohol was classified as abstinent, wine only, beer only, and mixed wine and beer and other (ie, spirits).
  • Nicotine consumption was also assessed.
  • Diagnosis of dementia was based on the Structured Interview for Diagnosis of Dementia of Alzheimer type.
  • Other dementias were diagnosed according to Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, and International Classification of Diseases, 10th Revision, codes.
  • Depressive symptoms were assessed by means of the 15-item short version of the Geriatric Depression Scale.
  • Mild cognitive impairment was diagnosed by the International Working Group on Mild Cognitive Impairment criteria.
  • An 8-item scale was used to measure Instrumental Activities of Daily Living.
  • Comorbidity was reported by the general practitioner.
  • Cox proportional hazard regression models were used to examine the relationship between alcohol consumption and incident overall dementia and Alzheimer's dementia.
  • At baseline, there were 3202 persons without dementia.
  • Information on current alcohol consumption was available for 3180 participants: 50% were abstinent, 24.8% consumed less than 1 drink (10 g of alcohol) per day, 12.8% consumed 10 to 19 g per day, and 12.4% consumed 20 g or more per day.
  • Overall, 50% consumed any alcohol, most less than 2 drinks a day.
  • 48.6% drank wine only, 29.0% drank beer only, and 22.4% drank mixed alcoholic beverages (wine, beer, or spirits).
  • Alcohol consumption was significantly associated with male sex, younger age, higher level of education, not living alone, and not being depressed.
  • No association was found between alcohol consumption and functional impairment, somatic comorbidity, smoking, mild cognitive impairment, or ApoE4 status.
  • At 3 years of follow-up, there were 6.8% of cases of dementia and 3.5% of cases of Alzheimer's dementia.
  • Alcohol consumption was associated with a lower incidence of overall dementia and Alzheimer's dementia.
  • There was a 29% decrease in overall dementia and a 42% decrease in Alzheimer's dementia.
  • All HRs were lower than 1.0 for quantity of alcohol consumed, but only the quantity of 20 to 29 g of alcohol per day was significant.
  • The authors concluded that consumption of alcohol among adults 75 years and older was light to moderate and that consumption of 20 to 29 g per day was associated with a reduced incidence of both overall dementia and Alzheimer's dementia.

Clinical Implications

  • A total of 50% of adults 75 years and older consume alcohol, most less than 2 drinks (mainly wine) per day. In this age group, alcohol consumption is significantly associated with male sex, younger age, higher level of education, not living alone, and not being depressed.
  • Light to moderate alcohol consumption among adults 75 years and older is associated with lower risks for overall dementia and Alzheimer's dementia.

CME Test

  • Print