Shimizu Yoko, Sawada Norie, Ihira Hikaru, Abe Sarah Krull, Inoue Manami, Yasuda Nobufumi, Yamagishi Kazumasa, Iwasaki Motoki, Tsugane Shoichiro
Division of Epidemiology, National Cancer Center Institute for Cancer Control, Tokyo, Japan.
Division of Cohort Research, National Cancer Center Institute for Cancer Control, Tokyo, Japan.
Int J Geriatr Psychiatry. 2023 Mar;38(3):e5896. doi: 10.1002/gps.5896.
The association between alcohol consumption and dementia in Japanese is poorly understood, and use of single-point alcohol assessment may cause measurement error. We explored this association in Japanese using repeated alcohol assessments.
Participants in the Japan Public Health Center-based Prospective Study (JPHC Study) since 1990 and who were alive in 2006 were followed from 2006 until 2016 for dementia ascertainment. Disabling dementia was identified through long-term care insurance records. Alcohol consumption was assessed at the 5-year questionnaire survey (1995-1999) and drinking patterns were assessed on repeated follow-up (2000-2003). We performed Cox proportional hazards models with age as the time-scale with adjustment for various lifestyle factors and medical history using light consumption (<75 g ethanol/week, hereinafter "g") as reference. Analysis considering death as a competing risk was also conducted.
Among 42,870 participants aged 54-84 years, 4802 cases of disabling dementia were newly diagnosed. Average years from alcohol assessment until dementia incidence was 14.9 years. Non-drinkers and regular drinkers with ≥450 g at 5 years had adjusted HRs (95% CI) of 1.29 (1.12-1.47) and 1.34 (1.12-1.60). Patterns of long-term abstinence, former drinking, and regular heavy weekly consumption of ≥450 g showed increased adjusted HRs of 1.61 (1.28-2.03), 2.54 (1.93-3.35), and 1.96 (1.49-2.59), respectively. Competing risk analysis yielded similar results.
In Japanese, non-drinking and regular weekly consumption of ≥450 g from midlife were associated with high risk of disabling dementia compared with light drinking.
人们对日本人群中饮酒与痴呆症之间的关联了解甚少，而且使用单点酒精评估可能会导致测量误差。我们通过重复酒精评估来探究日本人群中的这种关联。
自1990年起参与日本公共卫生中心前瞻性研究（JPHC研究）且在2006年仍在世的参与者，于2006年至2016年期间接受痴呆症确诊随访。通过长期护理保险记录确定失能性痴呆症。在5年问卷调查（1995 - 1999年）中评估酒精摄入量，并在重复随访（2000 - 2003年）中评估饮酒模式。我们以年龄为时间尺度进行Cox比例风险模型分析，对各种生活方式因素和病史进行调整，以轻度饮酒（<75克乙醇/周，以下简称“克”）作为参照。还进行了将死亡视为竞争风险的分析。
在42,870名年龄在54 - 84岁的参与者中，新确诊了4802例失能性痴呆症病例。从酒精评估到痴呆症发病的平均年限为14.9年。不饮酒者以及5年时每周饮酒量≥450克的经常饮酒者的调整后风险比（95%置信区间）分别为1.29（1.12 - 1.47）和1.34（1.12 - 1.60）。长期戒酒、既往饮酒以及每周规律大量饮酒≥450克的模式显示调整后风险比分别增加至1.61（1.28 - 2.03）、2.54（1.93 - 3.35）和1.96（1.49 - 2.59）。竞争风险分析得出了类似结果。
在日本人群中，与轻度饮酒相比，中年时期不饮酒以及每周规律饮酒量≥450克与失能性痴呆症的高风险相关。
