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Association Between Alcohol Use Disorders and Dementia in 262,703 Dementia-free Finnish Adults: Is Cardiovascular Disease a Mediator?
Hu Yaoyue, Korhonen Kaarina, Li Peng, Bobak Martin, Martikainen Pekka, Bijlsma Maarten J. The journals of gerontology. Series A, Biological sciences and medical sciences, 2022-12-17
Topic: Risk, prevention and care in population studies
The possible mediating role of cardiovascular disease (CVD) in the relationship between alcohol use disorders (AUD) and the risk of early-onset (<age 65) and late-onset (≥age 65) dementia lacks formal investigation. Using linked Finnish national register data, a population-based cohort study of 262,703 dementia-free Finnish men and women aged 40 + at baseline (December 31, 1999) was established. AUD and CVD in 1988-2014, and incident dementia in 2000-2014 were identified from Finnish Hospital Discharge Register and/or Drug Reimbursement Register. Causal association and mediation were assessed using mediational g-formula. AUD was associated with a substantial increase in the risk of early-onset dementia in both men (hazard ratio: 5.67, 95% confidence interval: 4.37-7.46) and women (6.13, 4.20-8.94) after adjustments for confounding; but the elevated risk for late-onset dementia was smaller (men: 2.01, 1.80-2.25; women: 2.03, 1.71-2.40). Mediational g-formula results showed that these associations were causal in men with no mediation by CVD as the virtually identical total effect of AUD (early-onset: 5.26, 3.48-7.48; late-onset: 2.01, 1.41-2.87) and direct effect of AUD (early-onset: 5.24, 3.38-7.64; late-onset: 2.19, 1.61-2.96) were found with no indirect effect via CVD. In women, the results were similar for late-onset dementia (total effect: 2.80, 1.70-4.31; direct effect: 2.92, 1.86-4.62) but underpowered for early-onset dementia. AUD increased dementia risk, particularly the risk of early-onset dementia. This elevated risk of dementia associated with AUD was not mediated by CVD. Clinicians should consider the increased risk of dementia in the management of middle-aged and older adults with a history and/or current AUD.
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
APA 7th
Yaoyue, H., Kaarina, K., Peng, L., Martin, B., Pekka, M., & Bijlsma Maarten, J. (2023). Association Between Alcohol Use Disorders and Dementia in 262,703 Dementia-free Finnish Adults: Is Cardiovascular Disease a Mediator? The journals of gerontology. Series A, Biological sciences and medical sciences. https://doi.org/10.1093/gerona/glac252
Vancouver
Yaoyue H, Kaarina K, Peng L, Martin B, Pekka M, Bijlsma Maarten J. Association Between Alcohol Use Disorders and Dementia in 262,703 Dementia-free Finnish Adults: Is Cardiovascular Disease a Mediator? The journals of gerontology. Series A, Biological sciences and medical sciences. 2023. doi:10.1093/gerona/glac252. PMID: 36525370.
BibTeX
@article{yaoyue2023-36525370,
author = {Yaoyue, Hu and Kaarina, Korhonen and Peng, Li and Martin, Bobak and Pekka, Martikainen and Bijlsma Maarten, J.},
title = {{Association Between Alcohol Use Disorders and Dementia in 262,703 Dementia-free Finnish Adults: Is Cardiovascular Disease a Mediator?}},
journal = {The journals of gerontology. Series A, Biological sciences and medical sciences},
year = {2023},
doi = {10.1093/gerona/glac252},
pmid = {36525370},
url = {https://doi.org/10.1093/gerona/glac252}
}
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. Check the citation against the original before you use it.
Key findings
- AUD was associated with a substantial increase in the risk of early-onset dementia in both men (hazard ratio: 5.67, 95% confidence interval: 4.37-7.46) and women (6.13, 4.20-8.94) after adjustments for confounding; but the elevated risk for late-onset dementia was smaller (men: 2.01, 1.80-2.25; women: 2.03, 1.71-2.40).
- Mediational g-formula results showed that these associations were causal in men with no mediation by CVD as the virtually identical total effect of AUD (early-onset: 5.26, 3.48-7.48; late-onset: 2.01, 1.41-2.87) and direct effect of AUD (early-onset: 5.24, 3.38-7.64; late-onset: 2.19, 1.61-2.96) were found with no indirect effect via CVD.
- In women, the results were similar for late-onset dementia (total effect: 2.80, 1.70-4.31; direct effect: 2.92, 1.86-4.62) but underpowered for early-onset dementia.
- This elevated risk of dementia associated with AUD was not mediated by CVD.
- Clinicians should consider the increased risk of dementia in the management of middle-aged and older adults with a history and/or current AUD.
Why it matters
This Finnish cohort study found that alcohol use disorders were associated with a substantially increased risk of early-onset dementia and a smaller increased risk of late-onset dementia, with no mediation by cardiovascular disease in men. It identifies alcohol use disorders as a risk factor but does not test any treatment, cure, or prevention for Alzheimer's disease.
Study details
- Study designcohort study
- Evidence strengthModerate
How this study scored 47/100
Published in a peer-reviewed journal, and it is a cohort study following people over time. Scored zero for sample size, effect reported, studied in people and randomised / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (The journals of gerontology. Series A, Biological sciences and medical sciences) |
| Journal's citation record | 3 / 4 | The Journals of Gerontology Series A: journal h-index 274 (OpenAlex, 2026-10-29) |
| Study design | 7 / 12 | A cohort study following people over time |
| Strength of evidence | 3 / 5 | Rated “moderate” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 3 / 5 | 2023 — within 6 year(s) of the newest study here |
| Sample size | 0 / 4 | Participant count not stated — scores zero (not stated in the record — scored 0) |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 0 / 3 | Not stated whether this was studied in people — scores zero (not stated in the record — scored 0) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 2 / 7 | Cited 13 times (OpenAlex, 2026-10-10) |
| Citations per year | 1 / 5 | 2.6 citations a year over 5 year(s) since 2023 |
| Impact for its field and year | 2 / 6 | Cited 1.2× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 1 / 6 | Cited by 1 other studies in this library |
| Still being cited | 1 / 4 | Cited 11 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 1 / 4 | Last-listed author Maarten J. Bijlsma: h-index 16 (OpenAlex, whole career) |
| Institution's track record | 2 / 3 | University College London: institution h-index 2,029 (OpenAlex) |
| Multi-centre collaboration | 2 / 3 | OpenAlex lists 4 institution(s) in 4 countries |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 36525370) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Total | 47 / 100 | — |
What each of these 20 components measures, and what this score is not →
Read the original
- DOI: 10.1093/gerona/glac252
- PubMed: 36525370
- Original source →
- Free full text: UCL Discovery (University College London) →
Full text: free to read — OpenAlex lists this copy as free to read: the link above (checked 6 Feb 1020).
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