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Changes in Alcohol Consumption and Risk of Dementia in a Nationwide Cohort in South Korea
Jeon KH, Han K, Jeong SM, Park J, Yoo JE, Yoo J, et al.. JAMA Network Open, 2023-02-01
Topic: Risk, prevention and care in population studies
Importance The impact of serial changes in alcohol consumption on dementia risk has rarely been investigated to date. Objective To investigate the association of comprehensive patterns of changes in alcohol consumption with the incidence of all-cause dementia, Alzheimer disease (AD), and vascular dementia (VaD). Design, setting, and participants This is a retrospective cohort study. Data were obtained from the Korean National Health Insurance Service database. Adults aged 40 years and older underwent 2 health examinations in 2009 and 2011. The cohort was assessed until December 31, 2018, and statistical analysis was performed in December 2021. Exposures Alcohol consumption level was categorized into none (0 g per day), mild ( Main outcomes and measures The primary outcome was newly diagnosed AD, VaD, or other dementia. Results Among 3 933 382 participants (mean [SD] age, 55.0 [9.6] years; 2 037 948 men [51.8%]), during a mean (SD) follow-up of 6.3 (0.7) years, there were 100 282 cases of all-cause dementia, 79 982 cases of AD, and 11 085 cases of VaD. Compared with sustained nondrinking, sustained mild (adjusted hazard ratio [aHR], 0.79; 95% CI, 0.77-0.81) and moderate (aHR, 0.83; 95% CI, 0.79-0.88) drinking were associated with a decreased risk of all-cause dementia, whereas sustained heavy drinking was associated with an increased risk of all-cause dementia (aHR, 1.08; 95% CI, 1.03-1.12). Compared with sustained levels of drinking, reducing alcohol consumption from a heavy to a moderate level (aHR, 0.92; 95% CI, 0.86-0.99) and the initiation of mild alcohol consumption (aHR, 0.93; 95% CI, 0.90-0.96) were associated with a decreased risk of all-cause dementia. Increasers and quitters exhibited an increased risk of all-cause dementia compared with sustainers. The trends in AD and VaD remained consistent. Conclusions and relevance In this cohort study of a Korean population, decreased risk of dementia was associated with maintaining mild to moderate alcohol consumption, reducing alcohol consumption from a heavy to a moderate level, and the initiation of mild alcohol consumption, suggesting that the threshold of alcohol consumption for dementia risk reduction is low.
Key findings
- Results Among 3 933 382 participants (mean [SD] age, 55.0 [9.6] years; 2 037 948 men [51.8%]), during a mean (SD) follow-up of 6.3 (0.7) years, there were 100 282 cases of all-cause dementia, 79 982 cases of AD, and 11 085 cases of VaD.
- Compared with sustained nondrinking, sustained mild (adjusted hazard ratio [aHR], 0.79; 95% CI, 0.77-0.81) and moderate (aHR, 0.83; 95% CI, 0.79-0.88) drinking were associated with a decreased risk of all-cause dementia, whereas sustained heavy drinking was associated with an increased risk of all-cause dementia (aHR, 1.08; 95% CI, 1.03-1.12).
- Compared with sustained levels of drinking, reducing alcohol consumption from a heavy to a moderate level (aHR, 0.92; 95% CI, 0.86-0.99) and the initiation of mild alcohol consumption (aHR, 0.93; 95% CI, 0.90-0.96) were associated with a decreased risk of all-cause dementia.
- Increasers and quitters exhibited an increased risk of all-cause dementia compared with sustainers.
- Conclusions and relevance In this cohort study of a Korean population, decreased risk of dementia was associated with maintaining mild to moderate alcohol consumption, reducing alcohol consumption from a heavy to a moderate level, and the initiation of mild alcohol consumption, suggesting that the threshold of alcohol consumption for dementia risk reduction is low.
Why it matters
This South Korean cohort found that sustained mild or moderate drinking was linked to lower dementia risk, while sustained heavy drinking was linked to higher risk. It is observational, so it cannot prove that drinking protects against or causes dementia.
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Study details
- Study designcohort
- Participants3,933,382
- Effect sizeSustained heavy drinking aHR 1.08 (95% CI 1.03-1.12); heavy-to-moderate reduction aHR 0.92 (0.86-0.99)
- Evidence strengthModerate
Limitations
Observational with self-reported drinking; quitters may have stopped because of ill health (reverse causation); Korean population and drinking thresholds may not generalise.
How this study scored 73/100
Published in a leading specialty journal, and it is a cohort study following people over time. Scored zero for randomised / blinded because the record does not state it. We have no data on free to read, so that was left out: it earned 72 of the 98 points we could judge it on, which is 73 out of 100.
| Component | Points | Why |
|---|---|---|
| Journal tier | 9 / 10 | Tier 2 — leading specialty journal (JAMA Network Open) |
| Journal's citation record | 2 / 4 | JAMA Network Open: journal h-index 235 (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 | 4 / 4 | 3,933,382 participants |
| Effect reported | 3 / 3 | Effect reported with a statistic (interval, p-value, ratio or similar) |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 5 / 7 | Cited 101 times (OpenAlex, 2026-10-10) |
| Citations per year | 4 / 5 | 20.2 citations a year over 5 year(s) since 2023 |
| Impact for its field and year | 4 / 6 | Cited 18.2× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 2 / 6 | Cited by 6 other studies in this library |
| Still being cited | 3 / 4 | Cited 86 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 3 / 4 | Last-listed author Dong Wook Shin: h-index 57 (OpenAlex, whole career) |
| Institution's track record | 2 / 3 | University of Southern California: institution h-index 1,521 (OpenAlex) |
| Multi-centre collaboration | 3 / 3 | OpenAlex lists 11 institution(s) in 2 countries |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 36745453) |
| Free to read | — / 2 | Access not recorded — left out of this score |
| Points | 72 / 98 | Scored on 19 of 20 parts. We have no data for the rest, so they are left out: 72 of the 98 points we could judge it on is 73 out of 100. |
| Total | 73 / 100 | — |
What each of these 20 components measures, and what this score is not →
Read the original
- DOI: 10.1001/jamanetworkopen.2022.54771
- PubMed: 36745453
- Original source →
- Free full text: PubMed Central →
Full text: free to read — PubMed Central lists this copy as free to read: the link above (checked 10 Oct 2026).
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. The record's author list ends in “et al.”, so not every author is named. Check the citation against the original before you use it.
APA 7th
Jeon, K. H., Han, K., Jeong, S. M., Park, J., Yoo, J. E., Yoo, J., et al. (2023). Changes in Alcohol Consumption and Risk of Dementia in a Nationwide Cohort in South Korea. JAMA Network Open. https://doi.org/10.1001/jamanetworkopen.2022.54771
Vancouver
Jeon KH, Han K, Jeong SM, Park J, Yoo JE, Yoo J, et al. Changes in Alcohol Consumption and Risk of Dementia in a Nationwide Cohort in South Korea. JAMA Network Open. 2023. doi:10.1001/jamanetworkopen.2022.54771. PMID: 36745453.
BibTeX
@article{jeon2023-36745453,
author = {Jeon, K. H. and Han, K. and Jeong, S. M. and Park, J. and Yoo, J. E. and Yoo, J. and others},
title = {{Changes in Alcohol Consumption and Risk of Dementia in a Nationwide Cohort in South Korea}},
journal = {JAMA Network Open},
year = {2023},
doi = {10.1001/jamanetworkopen.2022.54771},
pmid = {36745453},
url = {https://doi.org/10.1001/jamanetworkopen.2022.54771}
}
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