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January 20, 2015; 84 (3) ArticleOpen Access

Alcohol consumption, drinking patterns, and cognitive function in older Eastern European adults

Pia Horvat, Marcus Richards, Ruzena Kubinova, Andrzej Pajak, Sofia Malyutina, Sergey Shishkin, Hynek Pikhart, Anne Peasey, M.G. Marmot, Archana Singh-Manoux, Martin Bobak
First published December 12, 2014, DOI: https://doi.org/10.1212/WNL.0000000000001164
Pia Horvat
From the Department of Epidemiology & Public Health (P.H., H.P., A. Peasey, M.G.M., A.S.-M., M.B.), and MRC Unit for Lifelong Health and Ageing at UCL (M.R.), University College London, UK; National Institute of Public Health (R.K.), Prague, Czech Republic; Department of Epidemiology and Population Studies (A. Pajak), Jagellonian University Collegium Medicum, Krakow, Poland; Institute of Internal and Preventive Medicine Siberian Branch under the Russian Academy of Medical Sciences (S.M., S.S.), Novosibirsk; Novosibirsk State Medical University (S.M.), Novosibirsk, Russia; and INSERM (A.S.-M.), U1018, Hopital Paul Brousse, Villejuif, France.
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Marcus Richards
From the Department of Epidemiology & Public Health (P.H., H.P., A. Peasey, M.G.M., A.S.-M., M.B.), and MRC Unit for Lifelong Health and Ageing at UCL (M.R.), University College London, UK; National Institute of Public Health (R.K.), Prague, Czech Republic; Department of Epidemiology and Population Studies (A. Pajak), Jagellonian University Collegium Medicum, Krakow, Poland; Institute of Internal and Preventive Medicine Siberian Branch under the Russian Academy of Medical Sciences (S.M., S.S.), Novosibirsk; Novosibirsk State Medical University (S.M.), Novosibirsk, Russia; and INSERM (A.S.-M.), U1018, Hopital Paul Brousse, Villejuif, France.
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Ruzena Kubinova
From the Department of Epidemiology & Public Health (P.H., H.P., A. Peasey, M.G.M., A.S.-M., M.B.), and MRC Unit for Lifelong Health and Ageing at UCL (M.R.), University College London, UK; National Institute of Public Health (R.K.), Prague, Czech Republic; Department of Epidemiology and Population Studies (A. Pajak), Jagellonian University Collegium Medicum, Krakow, Poland; Institute of Internal and Preventive Medicine Siberian Branch under the Russian Academy of Medical Sciences (S.M., S.S.), Novosibirsk; Novosibirsk State Medical University (S.M.), Novosibirsk, Russia; and INSERM (A.S.-M.), U1018, Hopital Paul Brousse, Villejuif, France.
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Andrzej Pajak
From the Department of Epidemiology & Public Health (P.H., H.P., A. Peasey, M.G.M., A.S.-M., M.B.), and MRC Unit for Lifelong Health and Ageing at UCL (M.R.), University College London, UK; National Institute of Public Health (R.K.), Prague, Czech Republic; Department of Epidemiology and Population Studies (A. Pajak), Jagellonian University Collegium Medicum, Krakow, Poland; Institute of Internal and Preventive Medicine Siberian Branch under the Russian Academy of Medical Sciences (S.M., S.S.), Novosibirsk; Novosibirsk State Medical University (S.M.), Novosibirsk, Russia; and INSERM (A.S.-M.), U1018, Hopital Paul Brousse, Villejuif, France.
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Sofia Malyutina
From the Department of Epidemiology & Public Health (P.H., H.P., A. Peasey, M.G.M., A.S.-M., M.B.), and MRC Unit for Lifelong Health and Ageing at UCL (M.R.), University College London, UK; National Institute of Public Health (R.K.), Prague, Czech Republic; Department of Epidemiology and Population Studies (A. Pajak), Jagellonian University Collegium Medicum, Krakow, Poland; Institute of Internal and Preventive Medicine Siberian Branch under the Russian Academy of Medical Sciences (S.M., S.S.), Novosibirsk; Novosibirsk State Medical University (S.M.), Novosibirsk, Russia; and INSERM (A.S.-M.), U1018, Hopital Paul Brousse, Villejuif, France.
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Sergey Shishkin
From the Department of Epidemiology & Public Health (P.H., H.P., A. Peasey, M.G.M., A.S.-M., M.B.), and MRC Unit for Lifelong Health and Ageing at UCL (M.R.), University College London, UK; National Institute of Public Health (R.K.), Prague, Czech Republic; Department of Epidemiology and Population Studies (A. Pajak), Jagellonian University Collegium Medicum, Krakow, Poland; Institute of Internal and Preventive Medicine Siberian Branch under the Russian Academy of Medical Sciences (S.M., S.S.), Novosibirsk; Novosibirsk State Medical University (S.M.), Novosibirsk, Russia; and INSERM (A.S.-M.), U1018, Hopital Paul Brousse, Villejuif, France.
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Hynek Pikhart
From the Department of Epidemiology & Public Health (P.H., H.P., A. Peasey, M.G.M., A.S.-M., M.B.), and MRC Unit for Lifelong Health and Ageing at UCL (M.R.), University College London, UK; National Institute of Public Health (R.K.), Prague, Czech Republic; Department of Epidemiology and Population Studies (A. Pajak), Jagellonian University Collegium Medicum, Krakow, Poland; Institute of Internal and Preventive Medicine Siberian Branch under the Russian Academy of Medical Sciences (S.M., S.S.), Novosibirsk; Novosibirsk State Medical University (S.M.), Novosibirsk, Russia; and INSERM (A.S.-M.), U1018, Hopital Paul Brousse, Villejuif, France.
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Anne Peasey
From the Department of Epidemiology & Public Health (P.H., H.P., A. Peasey, M.G.M., A.S.-M., M.B.), and MRC Unit for Lifelong Health and Ageing at UCL (M.R.), University College London, UK; National Institute of Public Health (R.K.), Prague, Czech Republic; Department of Epidemiology and Population Studies (A. Pajak), Jagellonian University Collegium Medicum, Krakow, Poland; Institute of Internal and Preventive Medicine Siberian Branch under the Russian Academy of Medical Sciences (S.M., S.S.), Novosibirsk; Novosibirsk State Medical University (S.M.), Novosibirsk, Russia; and INSERM (A.S.-M.), U1018, Hopital Paul Brousse, Villejuif, France.
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M.G. Marmot
From the Department of Epidemiology & Public Health (P.H., H.P., A. Peasey, M.G.M., A.S.-M., M.B.), and MRC Unit for Lifelong Health and Ageing at UCL (M.R.), University College London, UK; National Institute of Public Health (R.K.), Prague, Czech Republic; Department of Epidemiology and Population Studies (A. Pajak), Jagellonian University Collegium Medicum, Krakow, Poland; Institute of Internal and Preventive Medicine Siberian Branch under the Russian Academy of Medical Sciences (S.M., S.S.), Novosibirsk; Novosibirsk State Medical University (S.M.), Novosibirsk, Russia; and INSERM (A.S.-M.), U1018, Hopital Paul Brousse, Villejuif, France.
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Archana Singh-Manoux
From the Department of Epidemiology & Public Health (P.H., H.P., A. Peasey, M.G.M., A.S.-M., M.B.), and MRC Unit for Lifelong Health and Ageing at UCL (M.R.), University College London, UK; National Institute of Public Health (R.K.), Prague, Czech Republic; Department of Epidemiology and Population Studies (A. Pajak), Jagellonian University Collegium Medicum, Krakow, Poland; Institute of Internal and Preventive Medicine Siberian Branch under the Russian Academy of Medical Sciences (S.M., S.S.), Novosibirsk; Novosibirsk State Medical University (S.M.), Novosibirsk, Russia; and INSERM (A.S.-M.), U1018, Hopital Paul Brousse, Villejuif, France.
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Martin Bobak
From the Department of Epidemiology & Public Health (P.H., H.P., A. Peasey, M.G.M., A.S.-M., M.B.), and MRC Unit for Lifelong Health and Ageing at UCL (M.R.), University College London, UK; National Institute of Public Health (R.K.), Prague, Czech Republic; Department of Epidemiology and Population Studies (A. Pajak), Jagellonian University Collegium Medicum, Krakow, Poland; Institute of Internal and Preventive Medicine Siberian Branch under the Russian Academy of Medical Sciences (S.M., S.S.), Novosibirsk; Novosibirsk State Medical University (S.M.), Novosibirsk, Russia; and INSERM (A.S.-M.), U1018, Hopital Paul Brousse, Villejuif, France.
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Citation
Alcohol consumption, drinking patterns, and cognitive function in older Eastern European adults
Pia Horvat, Marcus Richards, Ruzena Kubinova, Andrzej Pajak, Sofia Malyutina, Sergey Shishkin, Hynek Pikhart, Anne Peasey, M.G. Marmot, Archana Singh-Manoux, Martin Bobak
Neurology Jan 2015, 84 (3) 287-295; DOI: 10.1212/WNL.0000000000001164

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Abstract

Objective: To investigate associations of frequency, quantity, binge, and problem drinking with cognitive function in older Eastern European adults.

Methods: The investigation included 14,575 participants, aged 47 to 78 years at cognitive assessment in 2006–2008 from Novosibirsk (Russia), Krakow (Poland), and 6 Czech towns participating in the HAPIEE (Health, Alcohol, and Psychosocial Factors in Eastern Europe) prospective cohort study. Average response rates were 59% at baseline (2002–2005) and 63% in 2006–2008. Alcohol consumption was assessed at baseline and in 2006–2008. Cognitive tests included immediate and delayed word recall, semantic fluency (animal naming), and letter cancellation. Associations between alcohol indices and cognitive scores were analyzed cross-sectionally (all measures from 2006 to 2008) and prospectively (alcohol and covariates from 2002 to 2005 and cognition from 2006 to 2008).

Results: In cross-sectional analyses, nondrinkers had lower cognitive scores and female moderate drinkers had better cognitive performance than light drinkers. Heavy, binge, and problem drinking were not consistently associated with cognitive function. Few associations were replicated in prospective analyses. Participants who stopped drinking during follow-up had worse cognition than stable drinkers; in men, regression coefficients (95% confidence interval) ranged from −0.26 (−0.36, −0.16) for immediate recall to −0.14 (−0.24, −0.04) for fluency.

Conclusion: Regular and episodic heavy drinking were not consistently associated with cognitive function. Worse cognition in participants who stopped drinking during follow-up suggests that inclusion of less healthy ex-drinkers may partly explain poorer cognition in nondrinkers.

GLOSSARY

CAGE=
cutting down, annoyance by criticism, guilty feeling, and eye-openers;
CVD=
cardiovascular disease;
GFQ=
graduated frequency questionnaire;
HAPIEE=
Health, Alcohol, and Psychosocial Factors in Eastern Europe

Footnotes

  • Go to Neurology.org for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article. The Article Processing Charge was paid by Wellcome Trust.

  • Supplemental data at Neurology.org

  • Received July 10, 2014.
  • Accepted in final form September 24, 2014.
  • © 2014 American Academy of Neurology

This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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