History of Alcohol Use Disorders and Risk of Severe Cognitive Impairment: A 19-Year Prospective Cohort Study

ObjectiveTo assess the effects of a history of alcohol use disorders (AUDs) on risk of severe cognitive and memory impairment in later life.MethodsWe studied the association between history of AUDs and the onset of severe cognitive and memory impairment in 6,542 middle-aged adults born 1931 through 1941 who participated in the Health and Retirement Study, a prospective nationally representative U.S. cohort. Participants were assessed at 1992 baseline and follow-up cognitive assessments were conducted biannually from 1996 through 2010. History of AUDs was identified using the three-item modified CAGE questionnaire. Cognitive outcomes were assessed using the 35-item modified Telephone Interview for Cognitive Status at last follow-up with incident severe cognitive impairment defined as a score ≤8, and incident severe memory impairment defined as a score ≤1 on a 20-item memory subscale.ResultsDuring up to 19 years of follow-up (mean: 16.7 years, standard deviation: 3.0, range: 3.5–19.1 years), 90 participants experienced severe cognitive impairment and 74 participants experienced severe memory impairment. History of AUDs more than doubled the odds of severe memory impairment (odds ratio [OR] = 2.21, 95% confidence interval [CI] = 1.27–3.85, t = 2.88, df = 52, p = 0.01). The association with severe cognitive impairment was statistically non-significant but in the same direction (OR = 1.80, 95% CI = 0.97–3.33, t = 1.92, df = 52, p = 0.06).ConclusionMiddle-aged adults with a history of AUDs have increased odds of developing severe memory impairment later in life. These results reinforce the need to consider the relationship between alcohol consumption and cognition from a multifactorial lifespan perspective