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Age and Ageing Advance Access originally published online on May 16, 2008
Age and Ageing 2008 37(5):505-512; doi:10.1093/ageing/afn095
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Copyright © The Author 2008. Published by Oxford University Press on behalf of the British Geriatrics Society.

Systematic Review

Alcohol, dementia and cognitive decline in the elderly: a systematic review

Ruth Peters1, Jean Peters2, James Warner3, Nigel Beckett1 and Christopher Bulpitt1

1 Imperial College, London, UK
2 University of Sheffield, School of Health and Related Research, Sheffield, UK
3 St Charles Hospital, London, UK

Address correspondence to: Ruth Peters, Tel: 020 83833959; Fax: 020 83833378. Email: r.peters{at}imperial.ac.uk

Background: 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.

Methods: 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 ≥65, with primary outcomes of incident dementia/cognitive decline.

Results: 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.

Conclusions: 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.

Keywords: elderly, dementia, cognitive decline, alcohol

Received 25 July 2007; accepted in revised form 26 February 2008.


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