As of 2019, an estimated 57.4 million people worldwide were living with dementia, and it is predicted that the number of cases will almost triple in the next three decades [1]. With increasing life expectancy, dementia is becoming one of the most prevalent and serious diseases among the elderly. Several modifiable risk factors have been identified and were estimated to explain about 40% in dementia outcomes [2]. These modifiable risk factors include high-risk alcohol use (i.e., weekly consumption of more than 168 g of pure alcohol).
Various systematic reviews and meta-analyses have been published so far suggesting a link between high levels of alcohol use and dementia (e.g., [3,4,5]). In a recent systematic review of 28 systematic reviews [3], high levels of alcohol use were found to be a risk factor for dementia as well as for structural and functional changes in the brain. Several pathways were suggested to contribute to elevated risk levels, including the neurotoxicity of the ethanol metabolite acetaldehyde, the detrimental effect of alcohol on cardiovascular disease and consequently vascular forms of dementia, thiamine deficiency, and alcohol-related brain injuries. There is also some evidence that moderate levels of alcohol use might be protective for dementia development, however, plausible biological explanations for such a link, except for a potential beneficial effect of ischemic disease [6], are lacking (see also [5]). The consideration of the apolipoprotein ɛ4 (APOE4) genotype may explain some of the discrepancies observed, yet inconsistent findings exist on the interaction of alcohol use and carriers of the APOE4 allele (e.g., [7,8,9,10]).
Bạn đang xem: Alcohol use, dementia risk, and sex: a systematic review and assessment of alcohol-attributable dementia cases in Europe
Another obstacle to understanding the link between alcohol use and dementia is due to a number of methodological limitations frequently observed when using case-control or cohort studies to identify risk factors (see [3, 11, 12]). These limitations concern the underestimation of alcohol use relative to per capita consumption [13, 14], inconsistent definitions of alcohol consumption patterns and abstinence [15], regression dilution bias due to measurement error when alcohol use is surveyed only once [12], and missing consideration of confounders, such as APOE4 genotype, education, and other known dementia risk factors such as smoking and physical inactivity [2]. Perhaps most importantly, many studies lack the consideration of sex. However, both alcohol use [16] and the risk of developing a dementia are known to vary by sex [17, 18]. Finally, age also seems to factor into the alcohol-dementia link, as alcohol use disorder has been found to be a risk factor for an early onset of dementia in particular [19]. For populations aged 65 and older, the impact of alcohol might be masked by an increasing dementia and mortality risk driven by other factors.
Xem thêm : Kingston Auto Insurance | NXG Insurance Agency Group in Kingston, New York
While there is a solid evidence base suggesting high-risk alcohol use is causally linked to dementia, in particular for early-onset dementia, this relationship is not considered in global comparative risk assessments of the Global Burden of Disease study or of the World Health Organization (for a comparison, see [20]). To the best of our knowledge, the only available estimates were performed as part of an assessment of multiple risk factors with alcohol exposure data drawn from an English survey [2].
Against this backdrop, our systematic review will be the first taking a sex-specific perspective to investigate the association between different levels of alcohol use and dementia risk, accounting for the age of dementia onset. In addition, we will estimate the sex-specific contribution of alcohol to incident dementia cases in selected European countries in 2019.
Nguồn: https://buycookiesonline.eu
Danh mục: Info
This post was last modified on December 12, 2024 3:22 am