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Clinically Recognised Alcohol Use Disorder and Risk of Dementia Subtypes in 1.3 Million Women: A Prospective Cohort Study
Fatih NG, Hippisley-Cox D, Ebmeier KP, Gelernter J, Reeves GK, Floud S, Christodoulou MD, Topiwala A.. medRxiv, 2026-09-29
Topic: Health services, long-term care and technology
Background Alcohol use disorder (AUD) is associated with increased dementia risk, but its long-term relationship with dementia, variation by age and subtype, and how this risk compares with that associated with alcohol consumption remain poorly characterised. We investigated these questions in a large prospective cohort of UK women. Methods We analysed Million Women Study participants recruited aged 50–64 years and followed for more than 20 years through linked health records. Women with hospital-recorded AUD were matched to up to five controls. Cox models estimated associations between time-varying AUD and incident dementia overall, by subtype, attained age, with exposure lags of up to 15 years and competing-risk analyses. Self-reported alcohol consumption was analysed separately. Findings Among 1,288,359 women, 20,070 with AUD were matched to 100,339 controls. Dementia occurred in 3,774 women with AUD and 8,239 matched controls. AUD was associated with all-cause dementia (HR=3·73[95% CI 3·52–3·95]), with strongest associations for mixed (5·03[3·88–6·51]), unspecified (4·29[3·92–4·70]), and vascular dementia (3·96[3·44–4·56]). Associations were substantially stronger before age 70 years (10·68[9·02–12·63]) than at ages 70-79 (3·75[3·47–4·04]) or ≥80 years (2·34[2·11–2·60]). Risk remained elevated with a 15-year lag (2·16[1·81–2·58]) and after accounting for competing mortality. Associations with self-reported alcohol consumption were substantially weaker. Interpretation Clinically recognised AUD identifies women at markedly increased and prolonged dementia risk, particularly at younger ages and for vascular and mixed dementia, not captured by drinking quantity alone. People with AUD should be considered a priority population for earlier dementia prevention and risk reduction. Funding Wellcome Trust Career Development Award to AT (306069/Z/23/Z); NIH grants P50AA012870 and R01DA054869 (JG). The Million Women Study is supported by the UK Medical Research Council (grant number UKRI1464)
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APA 7th
Fatih, N. G., Hippisley-Cox, D., Ebmeier, K. P., Gelernter, J., Reeves, G. K., Floud, S., et al. (2026). Clinically Recognised Alcohol Use Disorder and Risk of Dementia Subtypes in 1.3 Million Women: A Prospective Cohort Study. medRxiv. https://doi.org/10.64898/2026.09.23.26363779
Vancouver
Fatih NG, Hippisley-Cox D, Ebmeier KP, Gelernter J, Reeves GK, Floud S, et al. Clinically Recognised Alcohol Use Disorder and Risk of Dementia Subtypes in 1.3 Million Women: A Prospective Cohort Study. medRxiv. 2026. doi:10.64898/2026.09.23.26363779.
BibTeX
@article{fatih2026-0d5a1594,
author = {Fatih, N. G. and Hippisley-Cox, D. and Ebmeier, K. P. and Gelernter, J. and Reeves, G. K. and Floud, S. and Christodoulou, M. D. and Topiwala, A.},
title = {{Clinically Recognised Alcohol Use Disorder and Risk of Dementia Subtypes in 1.3 Million Women: A Prospective Cohort Study}},
journal = {medRxiv},
year = {2026},
doi = {10.64898/2026.09.23.26363779},
url = {https://doi.org/10.64898/2026.09.23.26363779}
}
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 names 8 authors; APA and Vancouver show the first six, BibTeX and the downloads carry all of them. Check the citation against the original before you use it.
Key findings
- Background Alcohol use disorder (AUD) is associated with increased dementia risk, but its long-term relationship with dementia, variation by age and subtype, and how this risk compares with that associated with alcohol consumption remain poorly characterised.
- Cox models estimated associations between time-varying AUD and incident dementia overall, by subtype, attained age, with exposure lags of up to 15 years and competing-risk analyses.
- AUD was associated with all-cause dementia (HR=3·73[95% CI 3·52–3·95]), with strongest associations for mixed (5·03[3·88–6·51]), unspecified (4·29[3·92–4·70]), and vascular dementia (3·96[3·44–4·56]).
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Study details
- Study designprospective cohort
- Evidence strengthModerate
How this study scored 16/100
Preprint — not yet peer-reviewed. It scored 39 on the same rubric, but non-peer-reviewed sources are capped at 16, so it shows as 16. Scored zero for sample size, effect reported, studied in people and randomised / blinded because the record does not state it. We have no data on times cited, citations per year, impact for its field and year, cited by studies here, still being cited, senior author's track record, institution's track record and multi-centre collaboration, so those were left out: it earned 24 of the 62 points we could judge it on, which is 39 out of 100.
| Component | Points | Why |
|---|---|---|
| Journal tier | 2 / 10 | Tier 4 — not a peer-reviewed journal (medRxiv) |
| Journal's citation record | 0 / 4 | Not a journal article, so the journal's record does not count |
| Study design | 7 / 12 | A prospective cohort study, followed forward from enrollment |
| Strength of evidence | 3 / 5 | Rated “moderate” in our summary |
| Peer-review validation | 4 / 10 | Preprint — not yet peer-reviewed. Hosted on a preprint server. |
| How recent | 5 / 5 | 2026 — within 1 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 | — / 7 | No citation count (not found in OpenAlex) — left out of this score |
| Citations per year | — / 5 | No citation count or no year — left out of this score |
| Impact for its field and year | — / 6 | No field-weighted citation impact (OpenAlex has none yet) — left out of this score |
| Cited by studies here | — / 6 | Not yet checked against this library's citation graph — left out of this score |
| Still being cited | — / 4 | No yearly citation counts — left out of this score |
| Senior author's track record | — / 4 | Senior author's record not available — left out of this score |
| Institution's track record | — / 3 | No institution listed in OpenAlex — left out of this score |
| Multi-centre collaboration | — / 3 | Institutions not listed — left out of this score |
| Indexed in PubMed | 1 / 2 | Not in PubMed, but has a DOI |
| Free to read | 2 / 2 | Free to read |
| Points | 24 / 62 | Scored on 12 of 20 parts. We have no data for the rest, so they are left out: 24 of the 62 points we could judge it on is 39 out of 100. |
| Total | 39 / 100 | Capped to 16 because this is not a peer-reviewed article. |
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