Peters Ruth, Peters Jean, Warner James, Beckett Nigel, Bulpitt Christopher
Imperial College, London, UK.
Age Ageing. 2008 Sep;37(5):505-12. doi: 10.1093/ageing/afn095. Epub 2008 May 16.
dementia and cognitive decline have been linked to cardiovascular risk. Alcohol has known negative effects in large quantities but may be protective for the cardiovascular system in smaller amounts. Effect of alcohol intake may be greater in the elderly and may impact on cognition.
to evaluate the evidence for any relationship between incident cognitive decline or dementia in the elderly and alcohol consumption, a systematic review and meta-analyses were carried out. Criteria for inclusion were longitudinal studies of subjects aged >or=65, with primary outcomes of incident dementia/cognitive decline.
23 studies were identified (20 epidemiological cohort, three retrospective matched case-control nested in a cohort). Meta-analyses suggest that small amounts of alcohol may be protective against dementia (random effects model, risk ratio [RR] 0.63; 95% CI 0.53-0.75) and Alzheimer's disease (RR 0.57; 0.44-0.74) but not for vascular dementia (RR 0.82; 0.50-1.35) or cognitive decline (RR 0.89; 0.67-1.17) However, studies varied, with differing lengths of follow up, measurement of alcohol intake, inclusion of true abstainers and assessment of potential confounders.
because of the heterogeneity in the data these findings should be interpreted with caution. However, there is some evidence to suggest that limited alcohol intake in earlier adult life may be protective against incident dementia later.
痴呆和认知功能衰退与心血管风险相关。大量饮酒已知具有负面影响，但少量饮酒可能对心血管系统具有保护作用。饮酒的影响在老年人中可能更大，且可能影响认知。
为评估老年人新发认知功能衰退或痴呆与饮酒之间的关系，进行了一项系统评价和荟萃分析。纳入标准为年龄≥65岁受试者的纵向研究，主要结局为新发痴呆/认知功能衰退。
共纳入23项研究（20项流行病学队列研究，3项队列研究中的回顾性匹配病例对照研究）。荟萃分析表明，少量饮酒可能对痴呆（随机效应模型，风险比[RR]0.63；95%CI 0.53 - 0.75）和阿尔茨海默病（RR 0.57；0.44 - 0.74）具有保护作用，但对血管性痴呆（RR 0.82；0.50 - 1.35）或认知功能衰退（RR 0.89；0.67 - 1.17）无保护作用。然而，各研究存在差异，随访时间长短不同、饮酒量测量方法不同、是否纳入真正戒酒者以及潜在混杂因素评估方法不同。
由于数据的异质性，这些研究结果应谨慎解读。然而，有证据表明，成年早期有限的酒精摄入量可能对后期新发痴呆具有保护作用。
