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Moderate Alcohol Consumption 
Linked to Mixed Effects on Brain

WESTPORT, CT (Reuters Health) Sept 10 - Moderate alcohol consumption evokes complex responses in the brain, resulting in fewer white matter abnormalities but a higher prevalence of brain atrophy, according to a report in the September edition of Stroke.

White matter infarcts and brain atrophy are associated with poorer neurological and cognitive function, as well as greater declines in cognitive function over time, the authors explain. Whether moderate alcohol consumption by elderly individuals brings subclinical MRI findings had not been reported before now.

Dr. Kenneth Mukamal from Beth Israel Deaconess Medical Center in Boston and colleagues studied the relationship between alcohol consumption and MRI findings in 3376 adults aged 65 years and older who participated in the Cardiovascular Health Study.

An inverse relationship emerged between alcohol consumption and white matter infarcts, the authors report, with heavier drinkers (at least 15 drinks a week) facing only 57% of the white matter infarct risk faced by abstainers.

In contrast, alcohol consumption and brain atrophy were linearly related. According to the report, the heaviest drinkers showed brain atrophy scores approximately 0.2 grades higher than those shown by long-term abstainers.

These associations changed little when the groups were stratified by gender, race, HDL level, apoE4 allele status, and type of beverage (beer, wine, or liquor) consumed, the researchers note.

"Alcohol consumption is consistently associated with lower risk of cardiovascular disease, but studies on alcohol use and cerebrovascular disease have been far more mixed," Dr. Mukamal told Reuters Health. "Our findings also show some of this variability — alcohol has substantially different 'dose-response' curves for different types of brain abnormalities."

"I think the final story on alcohol use and brain function hasn't been told yet," Dr. Mukamal said. "Based on studies like ours, as well as the heterogeneity in studies of alcohol use and stroke, how alcohol consumption affects brain structure, function, and blood flow appears to be complex and dependent on a variety of clinical factors."

"This highlights the importance of making individualized recommendations about alcohol use," Dr. Mukamal concluded. "Simple rules about how much alcohol is 'right' to drink, if any, ignore this complexity."

In light of other published reports, notes Dr. Daniel Bereczki from University of Debrecen, Hungary in a related commentary, "it would be worth identifying study participants with really heavy alcohol consumption and reanalyzing the data including this group, after which the implicit suggestion of the paper might (or might not!) change."

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