alcoholanddementia-alz：酒精和痴呆-公司.ppt

1,ASSOCIATION BETWEEN ALCOHOL CONSUMPTION AND COGNITIVE IMPAIRMENT IN CHINESE OLDER ADULTS (Chu LW, Chan KKK, Chiu KC),Prof. Leung-Wing Chu MD, FRCP (Edin. & Glas.), FHKCP, FHKAM (Medicine) Honorary Clinical Professor, Department of Medicine,, LKS Faculty of Medicine, The University of Hong Kong Chief, Division of Geriatrics, Queen Mary Hospital,OC051 March 28, 2011,2,Conflict of Interest,All authors Chu LW, Chan KKK, Chiu KC Has no real or apparent conflicts of interest to report,OC051,3,Introduction,Alcohol consumption - diverse effects on heart possibly too for vascular dementia Brain’s cognitive functioning: Previous studies light to moderate alcohol consumption (up to 3 glasses of wine daily)  lower risks of cognitive impairment (CI) & dementia vs. non-drinker (Ruitenberg et al, 2002, Rotterdam study & several other Western studies)  38% reduced risk of CI in a systematic review (Peters et al, 2008) MCI (mild cognitive impairment): Light alcohol consumption of up to one drink/day  decrease progression from MCI to dementia (Solfrizzi, 2007),4,Introduction,Very limited data reported fron Chinese populations Only 2 studies from mid-China provinces But with different findings Alcohol increased the risk of dementia in a dose-related manner (Zhou et al, 2003) Light-moderate alcohol intake  50% reduction in dementia (both VaD & AD) (Deng et al, 2006) No Chinese study from Southern part of China,5,Objective of the study,To investigate the association between alcohol consumption and the risk of cognitive impairment in Southern Chinese older adults in Hong Kong.,6,Methods,Design: A a cross-sectional study Setting: Geriatric Clinics of Queen Mary Hospital and Grantham Hospital, The University of Hong Kong, Hong Kong SAR ( a southern city in China). Subjects’ inclusion criteria:- Chinese ethnicity, aged 65 years old or over, and written informed consent Exclusion criteria:- visual and hearing impairment, end-stage liver, heart or lung disease, active cancer, language or other communication barriers,7,Methods,Face-to-face interviews: Participants’ socio-demographic, co-morbid diseases, alcohol drinking habits and Mini-Mental State Examination (MMSE) for cognitive function were obtained Alcohol drinking Alcohol drinking habit and pattern were assessed by a modified version of the Canada Alcohol and Drug Survey (Statistics Canada, 1994) The amounts of alcohol consumption in the participants were converted into grams of weekly pure ethanol intake from alcohol units (1unit = 8 g. or 10 ml of alcohol) (Huang et al, 2002; Deng et al, 2006). The amount of ethanol contained in a particular type of alcoholic beverages in a typical week was calculated volume of the alcoholic beverage × the percentage of ethanol contained in the beverage, then converted into grams of ethanol, using the formula: Concentration of alcohol (%) x Alcohol Volume (ml) x alcohol unit (g/%ml). Then, the average weekly alcohol consumption was calculated by multiplying the frequency of consumption in a typical week by the amount of ethanol in the consumed beverage (Janghorbani et al, 2003; Solfrizzi et al, 2007).,8,Methods,Seven main types of alcoholic beverages were encountered Western alcohol drinks Chinese alcohol drinks,9,Methods,Alcohol Consumption per week: Categorized into 4 groups* 1) non-drinker (abstainers) - did not drink; 2) light drinkers - drink 400g for men and 280g for women,*Gaziano Janghorbani et al, 2003,10,Methods,Outcome measure: MMSE Participants were categorized into normal cognitive and cognitively impaired groups by education-adjusted MMSE cut-off scores (validated previously for Hong Kong Chinese older adults*),*MMSE cut-offs for cognitive impairment were less than 23 for those with middle/secondary school or higher education, less than 21 for those with primary school education, and less than 19 for those with no education (Chiu et al, 1998).,11,Results,314 Chinese older adults Cognitively normal, n=150 Cognitively impairment, n=164 Mean age 79.9 years (SD 6.5) Females, 52.2%,12,Bivariate analyses: Risk factors of cognitive impairment,13,Bivariate analyses: Risk factors of cognitive impairment,Co-morbid diseases not associated with CI, including stroke (p=0.736), hypertension (p=0.791), heart diseases (coronary heart diseases, myocardial infarction, ischemic heart diseases, etc) (p=0.743), heart failures (p=0.336) cataracts (p=0.279), diabetes mellitus (p=0.244), COPD (p=0.920), hyperlipidemia (p=0.732), parkinsonism (p=0.202), osteoporosis (p=0.226),14,Bivariate analyses: Risk factors of cognitive impairment,15,Bivariate analyses: Risk factors of cognitive impairment,The average weekly alcohol consumption in the cognitively impaired group was significantly higher than that of the normal cognition group CI: mean (SD): 861.89 (673.03) grams per week Normal cognition: 241.21 (276.26) ( p0.001, t-test) Drinkers with light to moderate alcohol consumption were associated with higher MMSE scores than non-drinkers and heavy dri。