Centre for Healthy Brain Ageing, University of New South Wales, Sydney, Australia.
The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, Australia.
Curr Opin Psychiatry. 2021 Mar 1;34(2):165-170. doi: 10.1097/YCO.0000000000000679.
PURPOSE OF REVIEW: Alcohol is gaining increased recognition as an important risk factor for dementia. This review summarises recent evidence on the relationship between alcohol use and dementia, focusing on studies published from January 2019 to August 2020. RECENT FINDINGS: Epidemiological data continues to yield results consistent with protective effects of low-to-moderate alcohol consumption for dementia and cognitive function. However, recent literature highlights the methodological limitations of existing observational studies. The effects of chronic, heavy alcohol use are clearer, with excessive consumption causing alcohol-related brain damage. Several pathways to this damage have been suggested, including the neurotoxic effects of thiamine deficiency, ethanol and acetaldehyde. SUMMARY: Future research would benefit from greater implementation of analytical and design-based approaches to robustly model the alcohol use-dementia relationship in the general population, and should make use of large, consortia-level data. Early intervention to prevent dementia is critical: thiamine substitution has shown potential but requires more research, and psychosocial interventions to treat harmful alcohol use have proven effective. Finally, diagnostic criteria for alcohol-related dementia require formal validation to ensure usefulness in clinical practice.
目的综述:酒精作为痴呆的一个重要危险因素,其重要性日益得到认可。本综述总结了 2019 年 1 月至 2020 年 8 月期间发表的研究,重点关注酒精使用与痴呆之间关系的最新证据。
最新发现:流行病学数据持续提供结果,一致表明低至中度饮酒对痴呆和认知功能有保护作用。然而,最近的文献强调了现有观察性研究方法上的局限性。慢性、大量饮酒的影响更为明确,过量饮酒会导致与酒精相关的脑损伤。已经提出了几种导致这种损伤的途径,包括硫胺素缺乏、乙醇和乙醛的神经毒性作用。
总结:未来的研究将受益于更广泛地采用分析和基于设计的方法,在一般人群中稳健地模拟酒精使用与痴呆的关系,并应利用大型联盟级别的数据。早期干预以预防痴呆症至关重要:硫胺素替代已显示出潜力,但需要更多的研究,针对有害酒精使用的心理社会干预已被证明是有效的。最后,酒精相关痴呆的诊断标准需要正式验证,以确保在临床实践中的有用性。
Curr Opin Psychiatry. 2021-3-1
Nutr Metab Cardiovasc Dis. 2016-6
Curr Clin Pharmacol. 2015
Pharmacopsychiatry. 2017-9-26
Neurology. 2007-5-22
Evid Based Ment Health. 2017-12-22
Int J Geriatr Psychiatry. 1998-4
Curr Top Behav Neurosci. 2013
Neuropsychiatr Dis Treat. 2025-1-7