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Alcohol-dementia link far bigger than thought

Heavy alcohol drinking is linked to 57% of cases of early-onset dementia, according to a new study, far more than most experts had guessed.

“Our findings suggest that the burden of dementia attributable to alcohol use disorders is much larger than previously thought,” says lead author Dr Michaël Schwarzinger of the Translational Health Economics Network.

“While it is widely recognised that heavy drinking can have detrimental physical effects, we have not tended to think about these in terms of brain functioning. This research suggests we should focus more of our attention in that direction,” says James Nicholls of Alcohol Research UK.

Alcohol use disorders were associated with three-times the risk of all types of dementia, making it the strongest modifiable risk factor for dementia onset. The paper suggests reducing dementia cases by having screening, interventions and treatment for heavy drinking.

The alcohol-dementia link may be stronger even than this study implies because alcohol problems are underdiagnosed. The French study made the link by looking at diagnoses of mental and behavioural disorders attributed to alcohol use or and alcohol-related liver disease.

The finding is “immensely important” according to Professor Clive Ballard of the University of Exeter. “We should move forward with clear public health messages about the relationship between both alcohol use disorders and alcohol consumption, respectively, and dementia.”

“The link between dementia and alcohol use disorders needs further research, but is likely a result of alcohol leading to permanent structural and functional brain damage,” says Dr Schwarzinger. He also recommends cutting availability, increasing tax and banning advertising.

Of the 57,000 early onset dementia cases examined, 18% came alongside a diagnosis of alcohol use disorder, in addition to the 39% of cases which were already recognised as being alcohol-related. Early onset dementia is dementia diagnosed before we are 65.

The association between heavy drinking and dementia onset has been poorly measured. This is a reason why it was not included in the modifiable risk factors included in the Lancet commission on dementia prevention last year, says Dr Schwarzinger.

Drinking consistently less than 14 UK units (140ml) of alcohol a week is reckoned to mean dementia risk is low. Alcohol is not a medicine or health tonic.


We can avoid alcohol’s mental health icebergs


Alcohol Companion Newsletter 52, February 17th 2018

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Special: Alcohol industry legal threats have now definitely scuppered a Canadian cancer warning label trial
News: Overwhelming support for better labelling in NE England; Alcohol linked to a third of UK child death and neglect cases; Pre-birth alcohol exposure may affect a fifth of US children; Heineken cashes-in on demand for lower strength beer.
Studies: Alzheimer’s drug repairs damage from teenage binging; Partners’ alcohol risks significantly linked; Cues create glutamate shift in people with alcohol abuse disorder
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Legal threats scupper Canadian alcohol cancer warning trial

Yukon’s abandoned labels

Legal threats have scuppered hopes for the resumption of a Canadian trial of labels warning that drinking alcohol increases the risk of cancer, putting a question mark over plans to inform consumers elsewhere.

Ireland and Australia are both considering labels warning that alcohol increases the risk of cancer, with Ireland’s lower house debating the move this week.

The UK’s Royal Society for Public Health proposed labels last month which include a warning that alcohol is proven to increase the risk of cancer (left). Alcohol producers quietly lowered their voluntary labelling standard last year.

The Canadian study was abruptly halted at the end of December after receiving a range of legal threats, including that it might be guilty of defamation and trademark infringement. Experts say those seeking to obstruct cancer labelling have a wide range of legal options.

The legal threats have not stopped the evaluation of labels not mentioning the increased cancer risk of drinking alcohol: one showing a standard drink size and another the low-risk drinking guidelines. Results are expected in June.

The trial is part of the second phase of the Northern Territories Alcohol Study led by researchers from Public Health Ontario and the Canadian Institute for Substance Use Research at the University of Victoria.

Yukon’s 34,000 people have the highest alcohol sales per head in Canada. ■

Track your drinking days and days off…

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Alcohol Companion Newsletter 51, February 9th 2018

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Specials: Alcohol is not a proven “brain cleaner”, as widely reported
Notable: Alcohol-free craft beer is the next Big Thing; A drug reverses rodent alcohol-induced deficits; The Mayor of Shropshire helps fund alcohol treatment …
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Rolling news


[review] Citizen Clem: A Biography of Attlee, by John Bew

Clement Attlee was a man whose life was shaped by world events dwarfing those of our own time, World Wars 1 and 2 and their aftermath, the Russian Revolution and the Great Depression. And, in his own quiet, methodical way, he also helped shaped them. Shy, privately-schooled, cricket-loving, he put himself into the public eye to fulfil a Victorian sense of patriotism and selfless public duty which seem foreign today. His mission all began by living and working in London’s hard up East End. He was a spitting image for Lenin, though he rejecting bolshevism in favour of the separate stream of British socialism. He was, with his homegrown creed, able to work effectively alongside the aristocratic and bombastic Winston Churchill in the national government of World War 2, only to trounce him with a radical plan to create the welfare state once it was over. And yet the two remained on good terms. His natural reticence and his role in unifying a fractious Labour party perhaps mean he is, as a man and as a politician, destined to remain frustratingly elusive. But this portrait of a life lived on the front line in tumultuous times, from being shot in the bum in the Mesopotamia campaign to facing the threat of the nuclear age, while providing universal healthcare and homes for heroes and starting the dismantling of the British Empire, is no less breathtaking for it. ■

Alcohol is not a human “brain cleaner”

Recent headlines saying alcohol drinking “cleans brains” should not persuade humans to drink more.

“It is by no means a green light for people to drink more alcohol,” says Dr Claire Walton, research manager at the UK’s Alzheimer’s Society, about a study on mice which has triggered coverage hinting otherwise.

Mammal brains

It is a “big leap” to take a research finding for mice and apply it to people, she said. “There are just too many differences between mice and people to do this.” Drinking more than 14 UK units (140ml) of alcohol a week, meanwhile, definitely increases human alcohol-related dementia risk.

The study investigated the mouse’s brain waste-disposal system which might play a role in the development of Alzheimer’s disease. “This is a relatively new area of research, where there is a lot still to be learned.”

Alcohol had a long history of use as a medicine, but it has since been found to be counterproductive in all cases and fraught with other risks. It is no longer put to any medical use other than as a sterilising fluid because of its ability to kill cells.

Dubious ideas that alcohol drinking can have health benefits can help support our decisions to drink, in what is known by health professionals as alcohol’s false “health halo”. ■

Alcohol Companion Newsletter 50, February 2nd 2018

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Specials: Dry January brings us valuable insight; Alcohol vendors hope to stop governments informing their citizens of alcohol’s health risks
Notable: A public health champion has proposed information labels in the UK; Doctors offer a three-point plan for a healthier relationship with alcohol
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Alcohol labellers face legal “domino effect”

Jurisdictions trying to introduce health warning labels on alcoholic drinks face a daunting battery of legal challenges intended to discourage them and others, say experts.

Hardly any country or province currently provides labels warning people that drinking alcohol increases the risk of a range of mental, physical and social problems, including cancer, heart disease, birth defects, anxiety and depression.

Jurisdictions which try to change this face the threat of being hit by “legal big guns”, according to analysis published last week.* The most recent case was in the sparsely-populated Yukon territory in Canada which halted a trial in December after receiving worrisome legal warnings.

“The raising of legal doubts, threats of litigation and the actual commencement of litigation have the potential to sway all but the most resolute and well-resourced governments from prioritising public health over industry interests,” the paper says.

The law allows the alcohol industry to make legal challenges at the national, supranational or international courts, as well as tribunals. Australia’s defence of plain tobacco packaging, the paper says, drawing a comparison, has been costly and time-consuming, although it seems set to be successful.

Thailand was the first to hear the drumbeat of possible litigation from the alcohol industry after proposing graphic warning labels in 2010. It planned to introduce labels warning that drinking alcohol causes liver cirrhosis and can undermine sexual performance.

But Thailand’s labels never appeared after they were discussed in the World Trade Organisation’s Technical Barriers to Trade Committee, a diplomatic forum. Concerns raised by the EU, US, Australia and New Zealand may have been taken as the signs of impending legal action.

Jurisdictions can have some confidence courts will take their side when their labels are designed to reflect “good scientific evidence”, the paper explains, but opponents can play on nagging doubts by introducing the prospect of long and expensive litigation.

The alcohol industry may, the paper argues, be looking for a “domino effect” in which governments lose their resolve to introduce alcohol labels. Dr Margaret Chan, a former director-general of the World Health Organisation, described the tobacco industry using this strategy in 2015.

The alcohol industry will be “extremely pleased” to halt the Yukon trial (pictured), says Professor Robin Room of Melbourne University, one of the authors of the paper. It also saw the disappearance of a label in place for 27 years warning that drinking while pregnant can cause birth defects.

“We are still a little hopeful that our study may resume in some capacity,” Erin Hobin, a researcher on the trial, told Alcohol Companion. Supporters of plans for health labels in Australia and Ireland, meanwhile, say they are undaunted by Yukon’s legal difficulties.

Continuing to use trade and investment treaties to launch legal action, the paper says, would be “substantially against the public interest and public health”. With overwhelming public support for health labels, the dominos could yet fall the other way.

*Paula O’Brien, Deborah Gleeson, Robin Room, Claire Wilkinson; Commentary on ‘Communicating Messages About Drinking’: Using the ‘Big Legal Guns’ to Block Alcohol Health Warning Labels, Alcohol and Alcoholism,

Alcohol Companion Newsletter 49, January 20th 2018

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Special: Drinking more than a small amount of alcohol is again linked to cognitive decline in middle- and old-age
In the media: An international “task force” is set up to cut the burden of alcohol and other products; Scotland’s Nicola Sturgeon is part of the team; Ireland produces two new alcohol-free drinks in a week; Sri Lankan women work to overturn a sexist alcohol ban
Perspectives: Alcohol producers may be poised to use international law to block warning labels; Why the Sri Lankan government flip-flopped on lifting its sexist alcohol ban
Studies find: More hippocampus research may unlock the secrets of blackouts
Diary: Events in London and Cardiff


In the media


Studies find