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Cited by 46Dementia and Cognitive Impairment ResearchAlcohol Consumption and Health EffectsSubstance Abuse Treatment and Outcomes

Association of Alcohol-Induced Loss of Consciousness and Overall Alcohol Consumption With Risk for Dementia

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Kivimäki, Mika, Singh-Manoux, Archana, Batty, G. David, Sabia, Séverine, Sommerlad, Andrew, Floud, Sarah, Jokela, Markus, Vahtera, Jussi +16 more·2020·JAMA Network Open
DOI 10.1001/jamanetworkopen.2020.16084PMC PMC7489835
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Abstract

Importance: Evidence on alcohol consumption as a risk factor for dementia usually relates to overall consumption. The role of alcohol-induced loss of consciousness is uncertain. Objective: To examine the risk of future dementia associated with overall alcohol consumption and alcohol-induced loss of consciousness in a population of current drinkers. Design, Setting, and Participants: Seven cohort studies from the UK, France, Sweden, and Finland (IPD-Work consortium) including 131 415 participants were examined. At baseline (1986-2012), participants were aged 18 to 77 years, reported alcohol consumption, and were free of diagnosed dementia. Dementia was examined during a mean follow-up of 14.4 years (range, 12.3-30.1). Data analysis was conducted from November 17, 2019, to May 23, 2020. Exposures: Self-reported overall consumption and loss of consciousness due to alcohol consumption were assessed at baseline. Two thresholds were used to define heavy overall consumption: greater than 14 units (U) (UK definition) and greater than 21 U (US definition) per week. Main Outcomes and Measures: Dementia and alcohol-related disorders to 2016 were ascertained from linked electronic health records. Results: Of the 131 415 participants (mean [SD] age, 43.0 [10.4] years; 80 344 [61.1%] women), 1081 individuals (0.8%) developed dementia. After adjustment for potential confounders, the hazard ratio (HR) was 1.16 (95% CI, 0.98-1.37) for consuming greater than 14 vs 1 to 14 U of alcohol per week and 1.22 (95% CI, 1.01-1.48) for greater than 21 vs 1 to 21 U/wk. Of the 96 591 participants with data on loss of consciousness, 10 004 individuals (10.4%) reported having lost consciousness due to alcohol consumption in the past 12 months. The association between loss of consciousness and dementia was observed in men (HR, 2.86; 95% CI, 1.77-4.63) and women (HR, 2.09; 95% CI, 1.34-3.25) during the first 10 years of follow-up (HR, 2.72; 95% CI, 1.78-4.15), after excluding the first 10 years of follow-up (HR, 1.86; 95% CI, 1.16-2.99), and for early-onset (<65 y: HR, 2.21; 95% CI, 1.46-3.34) and late-onset (≥65 y: HR, 2.25; 95% CI, 1.38-3.66) dementia, Alzheimer disease (HR, 1.98; 95% CI, 1.28-3.07), and dementia with features of atherosclerotic cardiovascular disease (HR, 4.18; 95% CI, 1.86-9.37). The association with dementia was not explained by 14 other alcohol-related conditions. With moderate drinkers (1-14 U/wk) who had not lost consciousness as the reference group, the HR for dementia was twice as high in participants who reported having lost consciousness, whether their mean weekly consumption was moderate (HR, 2.19; 95% CI, 1.42-3.37) or heavy (HR, 2.36; 95% CI, 1.57-3.54). Conclusions and Relevance: The findings of this study suggest that alcohol-induced loss of consciousness, irrespective of overall alcohol consumption, is associated with a subsequent increase in the risk of dementia.

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  • Heavier drinking (>21 units/week) in midlife compared to lighter drinking is associated with increased risk of dementia (HR 1.22, 95% CI 1.01-1.48).

    “Similarly, a subsequent individual participant meta-analysis of 131,415 participants from France, UK, Sweden and Finland found, after adjusting for confounders, heavier drinking ( &gt; 21 units/week) in midlife, compared to lighter drinking, was associated with an increased risk of dementia (HR 1.22, 1.01-1.48).(205)”

    From Dementia prevention, intervention, and care: 2024 report of the Lancet standing Commission (2024) · cites this paper as [205]

  • Alcohol-induced loss of consciousness increases dementia risk in those with either moderate or heavy consumption.

    “Alcohol-induced loss of consciousness increased dementia risk in those with either moderate or heavy consumption. (205)”

    From Dementia prevention, intervention, and care: 2024 report of the Lancet standing Commission (2024) · cites this paper as [205]

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Authors
Kivimäki, M., Singh-Manoux, A., Batty, G. D., Sabia, S., Sommerlad, A., Floud, S., Jokela, M., Vahtera, J., Beydoun, M. A., Suominen, S. B., Koskinen, A., Väänänen, A., Goldberg, M., Zins, M., Alfredsson, L., Westerholm, P. J. M., Knutsson, A., Nyberg, S. T., Sipilä, P. N., Lindbohm, J. V., Pentti, J., Livingston, G., Ferrie, J. E., & Strandberg, T.
Affiliations
  • Department of Epidemiology and Public Health, University College London, London, United Kingdom
  • Oregon State University (US)
  • Epidemiology of Ageing and Neurodegenerative Diseases, INSERM U1153, Université de Paris, Paris, France
  • University College London (GB)
  • University of Oxford (GB)
  • University of Helsinki (FI)
  • University of Turku (FI)
  • National Institutes of Health (US)
  • Finnish Institute of Occupational Health (FI)
  • Inserm (FR)
  • Region Stockholm (SE)
  • Uppsala University (SE)
  • Mid Sweden University (SE)
  • University of Bristol (GB)
ORCID
Venue
JAMA Network Open
Publisher
American Medical Association (AMA)
Published
2020-09-09
Volume
3
Issue
9
Pages
e2016084
ISSN
2574-3805 (ISSN-L)
DOI
10.1001/jamanetworkopen.2020.16084
PMC
PMC7489835
OpenAlex
W3084022305
Cited by
46
References
7
Citations by year
2026: 7 · 2025: 9 · 2024: 9 · 2023: 5 · 2022: 9 · 2021: 4 · 2020: 2
FWCI
3.65
Type
journal article
Language
en
Open access
Licence
cc-by
Locations
  • JAMA Network Open (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • Bristol Research (University of Bristol) (publishedVersion, cc-by)
  • HRB National Drugs Library (Health Research Board) (submittedVersion)
  • UTUPub (University of Turku) (submittedVersion)
  • KTH Publication Database DiVA (KTH Royal Institute of Technology) (submittedVersion, other-oa)
  • Publications (Mid Sweden University) (submittedVersion, other-oa)
  • UCL Discovery (University College London) (submittedVersion)
  • Työväentutkimus Vuosikirja (submittedVersion)
  • Explore Bristol Research (submittedVersion, cc-by)
Funders
  • Academy of Finland (RF1AG062553, 311492)
  • NordForsk (RF1AG062553, 70521, 75021, 311492)
  • Medical Research Council (S011676, MR/S011676/1, MR/R024227/1, RF1AG062553, 311492, MRC S011676)
  • National Institute on Aging (RF1AG062553, R01AG056477, R01AG056477, RF1AG062553, 311492)
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
  • Health Sciences › Medicine › Pathology and Forensic Medicine › Alcohol Consumption and Health Effects
  • Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
Keywords
alcohol consumption, dementia risk, heavy drinking, alcohol-related disorders, sex differences, alcohol consumption thresholds, cohort studies, alcohol-related memory impairment, alcohol-related depression, alcoholic liver disease, alcohol-related cancer, alcohol-related violence, alcohol-related accidents, alcohol-related social problems
MeSH terms
Adolescent, Adult, Aged, Ethanol, Alcoholism, Dementia, Female, Finland, France, United Kingdom, Humans, Male, Middle Aged, Risk Factors, Sweden, Unconsciousness, Cohort Studies, Proportional Hazards Models

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