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The adverse effects of excess alcohol intake on cognitive function are well established, but the effect of moderate consumption is uncertain. Between 1995 and 2001, we evaluated cognitive function in 12,480 participants in the Nurses' Health Study who were 70 to 81 years old, with follow-up assessments in 11,102 two years later. The level of alcohol consumption was ascertained regularly beginning in 1980. We calculated multivariate-adjusted mean cognitive scores and multivariate-adjusted risks of cognitive impairment (defined as the lowest 10 percent of the scores) and a substantial decline in cognitive function over time (defined as a change that was in the worst 10 percent of the distribution of the decline). We also stratified analyses according to the apolipoprotein E genotype in a subgroup of women. After multivariate adjustment, moderate drinkers (those who consumed less than 15.0 g of alcohol per day [about one drink]) had better mean cognitive scores than nondrinkers. Among moderate drinkers, as compared with nondrinkers, the relative risk of impairment was 0.77 on our test of general cognition (95 percent confidence interval, 0.67 to 0.88) and 0.81 on the basis of a global cognitive score combining the results of all tests (95 percent confidence interval, 0.70 to 0.93). The results for cognitive decline were similar; for example, on our test of general cognition, the relative risk of a substantial decline in performance over a two-year period was 0.85 (95 percent confidence interval, 0.74 to 0.98) among moderate drinkers, as compared with nondrinkers. There were no significant associations between higher levels of drinking (15.0 to 30.0 g per day) and the risk of cognitive impairment or decline. There were no significant differences in risks according to the beverage (e.g., wine or beer) and no interaction with the apolipoprotein E genotype. Our data suggest that in women, up to one drink per day does not impair cognitive function and may actually decrease the risk of cognitive decline. Copyright 2005 Massachusetts Medical Society.
This longitudinal study examined the influence of alcohol advertising and promotions on the initiation of alcohol use. A measure of receptivity to alcohol marketing was developed from research about tobacco marketing. Recall and recognition of alcohol brand names were also examined. Data were obtained from in-class surveys of sixth, seventh, and eighth graders at baseline and 12-month follow-up. Participants who were classified as never drinkers at baseline (n = 1,080) comprised the analysis sample. Logistic regression models examined the association of advertising receptivity at baseline with any alcohol use and current drinking at follow-up, adjusting for multiple risk factors, including peer alcohol use, school performance, risk taking, and demographics. At baseline, 29% of never drinkers either owned or wanted to use an alcohol branded promotional item (high receptivity), 12% students named the brand of their favorite alcohol ad (moderate receptivity), and 59% were not receptive to alcohol marketing. Approximately 29% of adolescents reported any alcohol use at follow-up; 13% reported drinking at least 1 or 2 days in the past month. Never drinkers who reported high receptivity to alcohol marketing at baseline were 77% more likely to initiate drinking by follow-up than those were not receptive. Smaller increases in the odds of alcohol use at follow-up were associated with better recall and recognition of alcohol brand names at baseline. Alcohol advertising and promotions are associated with the uptake of drinking. Prevention programs may reduce adolescents' receptivity to alcohol marketing by limiting their exposure to alcohol ads and promotions and by increasing their skepticism about the sponsors' marketing tactics.
A review of the literature on the positive psychological benefits of light and moderate alcohol consumption suggests the following: (1) Alcohol in moderate amounts is effective in reducing stress. This has been found in both physiologic and self-report measures. (2) Low and moderate doses of alcohol have been reported to increase overall affective expression, happiness, euphoria, conviviality and pleasant and carefree feelings. Tension, depression and self-consciousness have been reported to decrease with equal doses. (3) Low alcohol doses have been found to improve certain types of cognitive performance. Included here are problem-solving and short-term memory. (4) Heavy drinkers and abstainers have higher rates of clinical depression than do regular moderate drinkers. (5) Alcohol in low and moderate doses has been effective in the treatment of geropsychiatric problems. As indicated in the text, results from many of the studies reviewed suggest that light or moderate drinking may be beneficial to psychological well-being. Liber (N. Engl. J. Med., 310(13) (1984) 846) has commented that the subject of control of alcohol intake evokes strong emotional responses, which can overshadow a logical assessment of whether or not to include 'healthy' drinking in a dietary plan. It is hoped that this review of data from available research can help provide a basis for making such an assessment.
