Shaken, Not Stirred: Alcohol Consumption in Older Adults
At my grandfather’s 89th birthday last year, everyone was having a blast, especially since my grandfather made jokes about his aging mind and body constantly. However, the funniest moment of all came when my older sister Liz made him a martini. As a result of poor judgment, she decided to make him a watered-down drink. This did not go over well. When my grandfather took the first sip, he said to my sister, “Elizabeth, I don’t know what this is, but it is not a martini.” The whole family burst out laughing, and my grandfather chastised my sister for trying to trick him. After the situation was ironed out with a real martini or two, the weekend continued without any more hiccups. My grandfather remains very particular about his food and beverages to this day, further proven by the fact that he requested a thirteen layer cake for his 90th birthday this past summer. Fortunately, this year all his drinks were made properly by my uncle, who used to work as a bar tender.
From the experiences with my picky and observant aging grandfather, I have been more and more interested in the role of alcohol in the lives of older adults compared to their younger counterparts. My interest led me to a study that focused on the effects of lifetime alcohol consumption and head circumference on cognition in older adults. This study was done with 1,569 South Koreans by Son, Lee, Oh, and Hong (2011). Son et al. (2011) discussed in their introduction that brain volume can be ascertained from head circumference, and that greater brain volume has been suggested to have protective effects on cognition in an aging adult. Then, Son et al. (2011) explained that excessive alcohol consumption may affect cognition, but low or moderate drinking has also been associated with protective effects on the aging brain. Son et al. (2011) combined the above information to build the hypothesis that adults who had a smaller head circumference and higher alcohol intake would be at a greater risk for negative cognitive effects in old age.
Son et al. (2011) began by doing full physical and mental examinations of all participants. Head circumference was measured by nurses during the physical exam, and they took care to include as little hair as possible. The test for cognition was called the K-MMSE, which is a Korean version of the MMSE, or Mini Mental State Examination. Participants were next asked to report how many alcoholic drinks they had per week, how many years they had been drinking, and what kind of alcohol they drank. Lifetime intake was based off of frequency, duration, and alcohol content. The alcohol content of the three common Korean drinks is as follows: soju (25% alcohol), makgeoli (4.5%), and beer (6%). Son et al. (2011) calculated lifetime alcohol consumption with this equation:
(Bottles per week) x (Alcohol content per bottle) x 52 weeks x (Total drinking duration in years)
Out of all 1,569 participants, 1297 reported being non-drinkers, 134 participants were in the low alcohol intake group, and 138 were in the high alcohol intake group. The high alcohol intake group was also comprised of over 90% men. Three head circumference groups were also formed: Group 1 for ≤ 53.4cm, Group 2 for 53.5cm to 54.9cm, and Group 3 for ≥ 55cm. Participants were almost evenly distributed among the head circumference groups with about 500 people in each group. Most importantly, the results showed that high alcohol intake and smaller head circumference were both associated with lower mean K-MMSE scores and cognitive impairment. However, Son et al. (2011) also found that mean K-MMSE performance of the high alcohol intake group improved as head circumference increased. In fact, those older adults in the high alcohol intake group and Group 3 for head circumference had mean K-MMSE scores similar to non-drinkers in Group 2 and 3. On average, those participants in the low alcohol intake group also performed slightly better in all head circumference groups than the non-drinker group and the high alcohol intake group.
As we all know, some negative effects of alcohol are apparent directly following consumption, but the later effects can vary over the lifetime from person to person due to many factors, as shown by Son et al. (2011). Even if you do have a big head, take into account that heavy drinking is still bad for your body. The emphasis I am intent on making here is that cognition can be seriously impacted by heavy drinking throughout the lifespan. Regardless of al greater head circumference, nobody should expect to be immune to the immediate or delayed impacts of high alcohol consumption.
Reference
Son, S.J., Lee, K.S., Oh, B.H., & Hong, C.H. (2011). The effects of head circumference (HC) and lifetime alcohol consumption (AC) on cognitive function in the elderly. Archives of Gerontology and Geriatrics, 54, 343-347. doi: 10.1016/j.archger.2011.05.025
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This is such an interesting study, especially because, at first, measuring skulls sounds dangerously close to phrenology. I guess it makes sense, though, that greater brain volume can somewhat mediate the effects of high lifetime alcohol intake, and I wonder if this is because the circulatory system has a greater cortical area to cover, or whether there is still damage occurring but it is less behaviorally apparent in participants with greater brain volume. It also surprised me that such a high percentage of the participants considered themselves non-drinkers (almost 83%). Would that skew the results? I think it might be interesting to see if these results can be replicated in a sample where drinking is more prevalent.
I think this is a very interesting study because I have heard conflicting responses to drinking alcohol like what was said in this blog post. Some have told me that it can improve cognitive function and some have told me that it impairs it. I think what Margaret said, is very true. The fact that almost 83 percent said they were non drinkers would change the results. I also think that people reporting how much alcohol they drink could be a skewed number. A person having to report how much alcohol they drink per week and at what alcohol content would be hard to get an accurate representation of if they are a non drinker vs drinker. Also, what is the studies parameters for who is a non drinker, low intake and high intake drinker? This interpretation of how much alcohol a person consumes and what category they go in can be different for different cultures based on how prevalent alcohol is in the society. I think that having more set parameters would be useful to know since it could vary from place to place. Also, people might report less alcohol consumption than what they actual drink. These all would confound the results, so I think that replicating the study with a more accurate representation of drinkers and non drinkers would be really useful as well as having a bigger pool with a larger variety.
I’ve always heard that a glass of wine here and there can result in long-term mental and physical health benefits, but I always assumed this effect was unique to wine (red in particular, not sure why). It’s interesting that regardless of alcohol type, participants in the low intake group performed slightly better than heavy and non-drinkers. Maybe there’s a mediating factor here – perhaps those who drink socially, in moderation, lead generally happier lives. These emotional benefits may then outweigh the physical toll that excess consumption can take on the body. As Margaret noted, I’d like to see a study targeting a sample where the drinking culture is a little bit different (maybe a place where drinking is more prevalent – USA?).
This was a very interesting post, and it is good to know my inconveniently large head may actually be helpful. To echo what Margaret and Sam said, I think it would be interesting to conduct this study in a society that tends to consume more alcohol. Additionally, I think it would be pertinent to see how these health benefits vary between ethnicities. Chartier and Caetano (2010) reported that alcohol tends to have different effects on different races, and people of certain ethnicities (Blacks and Hispanics) are more likely to develop alcohol dependence issues than others (Whites) even when the amount of alcohol consumed remains constant. Furthermore, the prevalence of liver cirrhosis and alcohol-related cancers differs based on race. With the negative effects of alcohol consumption varying between race, it would interesting to take the results of this study and see how the benefits of alcohol consumption vary between race.
References:
Chartier, K., & Caetano, R. (2010). Ethnicity and health disparities in alcohol research. Alcohol research & health: the journal of the National Institute on Alcohol Abuse and Alcoholism, 33(1-2), 152.
The past few comments were my thoughts too. I am skeptical about measuring skulls – what about the differences in race, gender, and consuming any kind of growth supplement? Also, another thing that bothered me about this study was that the alcohol consumption was all self report and that immediately decreases the validity of the result because they might very well be made up or under-reported or over-reported. In addition, very few people can actually account how much alcohol is in each drink. However, I still think that this topic is interesting especially in an American society where drinking is a pretty highly practiced culture.
You raise the important issue of generalizability – clearly a constraint in a vast amount of the research with human participants! An important point in this study is that the participants came from the same ethnic group – thus, the within group differences are what matters. Clearly, a single study cannot generalize to an entire population, but at the same time, it is interesting that they found some reliable effects from such a simple measure. If I’m not mistaken, they also did not ask participants to report on the alcohol content, but they calculated it based on “standard” content (which, I’m guessing, is about the only way to conduct a study of this magnitude!).