Evidence map›Paper›PMID 30068508›Full record

ArticleBMJ (Clinical research ed.)2018

Alcohol consumption and risk of dementia: 23 year follow-up of Whitehall II cohort study.

Séverine Sabia, Aurore Fayosse, Julien Dumurgier, Aline Dugravot, Tasnime Akbaraly, Annie Britton, Mika Kivimäki, Archana Singh-Manoux

Open access · hybridAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMJ (Clinical research ed.), 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 149 papers, 7 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
149citing papers in PubMed, 7 pooled it
15.3field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

149 citing papers in PubMed, 7 syntheses or guidelines pooled it, 277 citations in OpenAlex.

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89 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

8 authors at 3 institutions in 2 countries.

Séverine SabiaInserm, U1018, Centre for Research in Epidemiology and Population Health, Université Paris-Saclay, France; Hôpital Paul Brousse, Bât 15/16, Villejuif Cedex, France severine.sabia@inserm.fr.ORCID 0000-0003-3109-9720
Aurore FayosseInserm, U1018, Centre for Research in Epidemiology and Population Health, Université Paris-Saclay, France; Hôpital Paul Brousse, Bât 15/16, Villejuif Cedex, France.
Julien DumurgierCognitive Neurology Center, Lariboisière-Fernand Widal hospital, AP-HP, Université Paris Diderot, Sorbonne Paris Cité, Paris, France.
Aline DugravotInserm, U1018, Centre for Research in Epidemiology and Population Health, Université Paris-Saclay, France; Hôpital Paul Brousse, Bât 15/16, Villejuif Cedex, France.
Tasnime AkbaralyDepartment of Epidemiology and Public Health, University College London, UK.
Annie BrittonDepartment of Epidemiology and Public Health, University College London, UK.
Mika KivimäkiDepartment of Epidemiology and Public Health, University College London, UK.
Archana Singh-ManouxInserm, U1018, Centre for Research in Epidemiology and Population Health, Université Paris-Saclay, France; Hôpital Paul Brousse, Bât 15/16, Villejuif Cedex, France.
Inserm · FRUniversity College London · GBDélégation Paris 7 · FR

Funding

Socio-economic status and heterogeneity in agingR01AG013196 · NIA · UNIVERSITY OF LONDON INST OF NEUROLOGY · PI MARMOT, MICHAEL G, SINGH-MANOUX, ARCHANA · 1996 to 2013
$3.5M
Education, socioeconomic status and Aging: transitions from multimorbidity to functional limitations and mortalityR01AG056477 · NIA · UNIVERSITY COLLEGE LONDON · PI KIVIMAKI, MIKA J, SINGH-MANOUX, ARCHANA · 2018 to 2022
$2.8M
Health behaviors over the adult lifecourse and cognitive agingR01AG034454 · NIA · UNIVERSITY COLLEGE LONDON · PI KIVIMAKI, MIKA J, SINGH-MANOUX, ARCHANA · 2009 to 2013
$1.5M
British Heart Foundation RG/16/11/32334Medical Research Council MR/K013351/1Medical Research Council MR/M006638/1Medical Research Council MR/R024227/1NIA NIH HHS R01 AG013196NIA NIH HHS R01 AG034454NIA NIH HHS R01 AG056477
6 · The paper itself

Abstract

objectiveTo examine the association between alcohol consumption and risk of dementia.

designProspective cohort study.

settingCivil service departments in London (Whitehall II study).

participants9087 participants aged 35-55 years at study inception (1985/88).

main outcome measuresIncident dementia, identified through linkage to hospital, mental health services, and mortality registers until 2017. Measures of alcohol consumption were the mean from three assessments between 1985/88 and 1991/93 (midlife), categorised as abstinence, 1-14 units/week, and >14 units/week; 17 year trajectories of alcohol consumption based on five assessments of alcohol consumption between 1985/88 and 2002/04; CAGE questionnaire for alcohol dependence assessed in 1991/93; and hospital admission for alcohol related chronic diseases between 1991 and 2017.

results397 cases of dementia were recorded over a mean follow-up of 23 years. Abstinence in midlife was associated with a higher risk of dementia (hazard ratio 1.47, 95% confidence interval 1.15 to 1.89) compared with consumption of 1-14 units/week. Among those drinking >14 units/week, a 7 unit increase in alcohol consumption was associated with a 17% (95% confidence interval 4% to 32%) increase in risk of dementia. CAGE score >2 (hazard ratio 2.19, 1.29 to 3.71) and alcohol related hospital admission (4.28, 2.72 to 6.73) were also associated with an increased risk of dementia. Alcohol consumption trajectories from midlife to early old age showed long term abstinence (1.74, 1.31 to 2.30), decrease in consumption (1.55, 1.08 to 2.22), and long term consumption >14 units/week (1.40, 1.02 to 1.93) to be associated with a higher risk of dementia compared with long term consumption of 1-14 units/week. Analysis using multistate models suggested that the excess risk of dementia associated with abstinence in midlife was partly explained by cardiometabolic disease over the follow-up as the hazard ratio of dementia in abstainers without cardiometabolic disease was 1.33 (0.88 to 2.02) compared with 1.47 (1.15 to 1.89) in the entire population.

conclusionThe risk of dementia was increased in people who abstained from alcohol in midlife or consumed >14 units/week. In several countries, guidelines define thresholds for harmful alcohol consumption much higher than 14 units/week. The present findings encourage the downward revision of such guidelines to promote cognitive health at older ages.

Indexed as

AdultAgedAlcohol DrinkingAlcohol-Related DisordersDementiaFemaleFollow-Up StudiesHumansLondonLongitudinal StudiesMaleMental Health ServicesMiddle AgedProspective StudiesRisk Factors

Identifiers

PMID30068508
PMCPMC6066998
OpenAlexW2886976326

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.