History of alcohol use disorders and risk of severe cognitive impairment: a 19-year prospective cohort study

Am J Geriatr Psychiatry. 2014 Oct;22(10):1047-54. doi: 10.1016/j.jagp.2014.06.001. Epub 2014 Jun 6.


Objective: To assess the effects of a history of alcohol use disorders (AUDs) on risk of severe cognitive and memory impairment in later life.

Methods: We 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.

Results: During 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).

Conclusion: Middle-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.

Keywords: Alcohol use disorders; CAGE; cognitive impairment; memory impairment.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Alcohol-Related Disorders / complications
  • Alcohol-Related Disorders / epidemiology*
  • Cognition Disorders / complications
  • Cognition Disorders / epidemiology*
  • Diagnosis, Dual (Psychiatry)
  • Female
  • Humans
  • Incidence
  • Male
  • Memory Disorders / complications
  • Memory Disorders / epidemiology*
  • Middle Aged
  • Prospective Studies
  • Risk Factors
  • United States / epidemiology