Investigação da relação do uso de álcool com desempenho cognitivo e funcional em uma amostra populacional de idosos com 75 anos: estudo Pietá

Abstract

Background: The relationship between alcohol and cognition is difficult to understand. This is due to inconsistency of the existing data, as well as to limitations inherent of observational studies. Many authors suggest a J- or U-shaped relationship, in which a lower risk of dementia or cognitive decline would be associated with mild to moderate alcohol consumption compared to abstinence or heavy consumption. Objective: To investigate the association of alcohol consumption with cognitive impairment, functionality, psychiatric and neurological diagnoses. Methodology: Cross-sectional population-based study, conducted in the city of Caeté (MG, Brazil). Overall, 639 elderly people, aged 75+ years, were evaluated in three phases: general health questionnaire (phase 1), clinical, neurological, cognitive, psychiatric and functional assessments (phase 2), neuropsychological assessment, laboratory tests and magnetic resonance imaging (phase 3). The general health questionnaire included information on current and previous alcohol consumption (quantity, frequency and type of alcoholic beverage). Participants were categorized according to the number of alcoholic beverages consumed per week: zero (abstainers); 0.1 to 7 doses per week (light consumption); 7.1 to 14 doses per week (moderate consumption); more than 14 doses per week (heavy consumption). The three phases allowed the establishment of cognitive diagnoses: dementia, cognitive impairment no dementia (CIND) and without cognitive impairment. Using the ordinal logistic regression model, the chance of dementia was estimated according to previous and current alcohol consumption. Results: Data from 602 participants were analyzed, with mean age of 81.12 years, mean education of 2.68 years, 383 (63.6%) were female and 219 (36.4%) were male. The prevalence of previous alcohol consumption was 34.6% (208) and current consumption, 12.3% (74). Current alcohol abuse was diagnosed through the Mini International Neuropsychiatric Interview in 11 participants (1.8%). There was no association between cognitive profile and the categories (abstainers, light, moderate and heavy consumption) of current or previous alcohol consumption, after multivariate analysis. When previous alcohol consumption was treated as a dichotomous variable, there was also no association with the cognitive profile (p = 0.109). As for the current habit of alcohol intake, when treated as a dichotomous variable, the absence of alcohol consumption was associated with the diagnosis of dementia (OR = 2.34; 95%CI: 1.39- 3.90), stroke (p = 0,014), current major depression (p = 0,013), parkinsonism (p = 0,041) and worse functionality (p = 0.001). The consumption of cachaça increased by 2.52 (95%CI: 1.25-5.04) times the individual's chance of being in the dementia group in relation to CIND and without cognitive impairment. There was a statistically significant association between heavy drinking and traumatic brain injury (p = 0.026). No interaction was found between current or previous alcohol consumption and the presence of the ε4 allele of apolipoprotein E in the cognitive profile. Conclusion: Absence of current alcohol consumption, in oldest-old individuals, was associated with diagnosis of dementia, stroke, major depression, parkinsonism and worse functionality. There was an association between heavy drinking and traumatic brain injury.