AIM: This study aimed to investigate the association between alcohol consumption and the risk of Alzheimer's disease (AD). METHODS: PubMed and Web of Science databases were systematically searched as of 1 September 2019. Relative risk and 95% CI were used to evaluate the association between alcohol consumption and AD risk. Subgroup analyses based on the type of alcohol, ethnicity, study design and sex were carried out. An alcohol dose-response meta-analysis was carried out. RESULTS: A total of 13 studies were included in the quantitative synthesis, and six were used in the dose-response meta-analysis. Compared with non-drinkers, individuals who drank had a lower risk of AD (relative risk 0.68, 95% CI 0.53-0.87; I(2) = 87.9%, P < 0.001). In subgroup analyses, drinking wine was found to reduce the occurrence of AD (relative risk 0.71, 95% CI 0.51-0.96). When stratified by ethnicity, sex and study design, no association was seen between AD risk and alcohol use. There was an overall non-linear, but not significant, association between alcohol intake dose and AD risk. A significant non-linear association was observed between excess AD risk and alcohol intake dose in men (overall P = 0.023; P for non-linearity = 0.025) starting from 14.8 drinks per week. Women's alcohol intake dose <16.9 drinks per week showed a significant non-linear association with decreased AD risk (overall P = 0.002; P for non-linearity = 0.019). CONCLUSIONS: Drinking alcohol could reduce the risk of AD. Alcohol dose had a non-linear, but non-significant, relationship with the development of AD. The amount of alcohol consumption showed significant sex-specific effects on AD. Geriatr Gerontol Int 2022; 22: 278-285.
BACKGROUND: Observational studies have documented lower risks of coronary heart disease and diabetes among moderate alcohol consumers relative to abstainers, but only a randomized clinical trial can provide conclusive evidence for or against these associations. AIM: The purpose of this study was to describe the rationale and design of the Moderate Alcohol and Cardiovascular Health Trial, aimed to assess the cardiometabolic effects of one alcoholic drink daily over an average of six years among adults 50 years or older. METHODS: This multicenter, parallel-arm randomized trial was designed to compare the effects of one standard serving ( approximately 11-15 g) daily of a preferred alcoholic beverage to abstention. The trial aimed to enroll 7800 people at high risk of cardiovascular disease. The primary composite endpoint comprised time to the first occurrence of non-fatal myocardial infarction, non-fatal ischemic stroke, hospitalized angina, coronary/carotid revascularization, or total mortality. The trial was designed to provide >80% power to detect a 15% reduction in the risk of the primary outcome. Secondary outcomes included diabetes. Adverse effects of special interest included injuries, congestive heart failure, alcohol use disorders, and cancer. RESULTS: We describe the design, governance, masking issues, and data handling. In three months of field center activity until termination by the funder, the trial randomized 32 participants, successfully screened another 70, and identified approximately 400 additional interested individuals. CONCLUSIONS: We describe a feasible design for a long-term randomized trial of moderate alcohol consumption. Such a study will provide the highest level of evidence for the effects of moderate alcohol consumption on cardiovascular disease and diabetes, and will directly inform clinical and public health guidelines.
This paper reviews the evidence for the effectiveness and cost-effectiveness of policies to reduce alcohol-related harm. Policies focus on price, marketing, availability, information and education, the drinking environment, drink-driving, and brief interventions and treatment. Although there is variability in research design and measured outcomes, evidence supports the effectiveness and cost-effectiveness of policies that address affordability and marketing. An adequate reduction in temporal availability, particularly late night on-sale availability, is effective and cost-effective. Individually-directed interventions delivered to at-risk drinkers and enforced legislative measures are also effective. Providing information and education increases awareness, but is not sufficient to produce long-lasting changes in behaviour. At best, interventions enacted in and around the drinking environment lead to small reductions in acute alcohol-related harm. Overall, there is a rich evidence base to support the decisions of policy makers in implementing the most effective and cost-effective policies to reduce alcohol-related harm.
OBJECTIVE: Observational studies indicate that moderate levels of alcohol consumption may reduce the risk of type 2 diabetes. In addition to providing an updated summary of the existing literature, this meta-analysis explored whether reductions in risk may be the product of misclassification bias. RESEARCH DESIGN AND METHODS: A systematic search was undertaken, identifying studies that reported a temporal association between alcohol consumption and the risk of type 2 diabetes. No restrictions were placed upon the language or date of publication. Non-English publications were, where necessary, translated using online translation tools. Models were constructed using fractional polynomial regression to determine the best-fitting dose-response relationship between alcohol intake and type 2 diabetes, with a priori testing of sex and referent group interactions. RESULTS: Thirty-eight studies met the selection criteria, representing 1,902,605 participants and 125,926 cases of type 2 diabetes. A conventional noncurrent drinking category was reported by 33 studies, while five reported a never-drinking category. Relative to combined abstainers, reductions in the risk of type 2 diabetes were present at all levels of alcohol intake <63 g/day, with risks increasing above this threshold. Peak risk reduction was present between 10-14 g/day at an 18% decrease in hazards. Stratification of available data revealed that reductions in risk may be specific to women only and absent in studies that adopted a never-drinking abstention category or sampled an Asian population region. CONCLUSIONS: Reductions in risk among moderate alcohol drinkers may be confined to women and non-Asian populations. Although based on a minority of studies, there is also the possibility that reductions in risk may have been overestimated by studies using a referent group contaminated by less healthy former drinkers