title: History of alcohol use disorders and risk of severe cognitive impairment: a 19-year prospective cohort study.
abstract: 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).
  
  
  CONCLUSIONS
  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.
authors.affiliation: University of Exeter Medical School, Exeter, United Kingdom; National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care for the South West Peninsula (NIHR PenCLAHRC), Leeds, United Kingdom.
authors.forename: Elżbieta
authors.initials: E
authors.lastname: Kuźma
authors.affiliation: University of Exeter Medical School, Exeter, United Kingdom; National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care for the South West Peninsula (NIHR PenCLAHRC), Leeds, United Kingdom.
authors.forename: David J
authors.initials: DJ
authors.lastname: Llewellyn
authors.affiliation: University of Michigan and Veterans Affairs Center for Clinical Management Research, Ann Arbor, MI.
authors.forename: Kenneth M
authors.initials: KM
authors.lastname: Langa
authors.affiliation: College of Public Health, University of Iowa, Iowa City, IA.
authors.forename: Robert B
authors.initials: RB
authors.lastname: Wallace
authors.affiliation: University of Exeter Medical School, Exeter, United Kingdom; National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care for the South West Peninsula (NIHR PenCLAHRC), Leeds, United Kingdom; University of Michigan and Veterans Affairs Center for Clinical Management Research, Ann Arbor, MI. Electronic address: I.Lang@exeter.ac.uk.
authors.forename: Iain A
authors.initials: IA
authors.lastname: Lang
mesh_terms: D019973:Alcohol-Related Disorders / Q000150:complications / Q000453:epidemiology*; D003072:Cognition Disorders / Q000150:complications / Q000453:epidemiology*; D017831:Diagnosis, Dual (Psychiatry); D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008569:Memory Disorders / Q000150:complications / Q000453:epidemiology*; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D014481:United States / Q000453:epidemiology
keywords: Alcohol use disorders; CAGE; cognitive impairment; memory impairment
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