Have a drink a day and enhance cognition? NOT

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Here's more news from a new study published in the New England Journal of Medicine Volume 352:245-253 January 20, 2005, which the media happily grabbed, and that the public will love to hear.  Have that glass (or two) of booze every day and you might get less brain deterioration.  Too bad medical science tells us the opposite.

In this study, apparently 12,000 nurses over 70 were accessed for cognitive skills using the TICS test

http://findarticles.com/p/articles/mi_m0689/is_n2_v44/ai_19181947

This is a 10 minute test which can be given over the telephone as a quick accessment of cognition when other tests are not feasible and includes questions like "where do you live" and subtract from 100 by 7's, as well as giving the subject a list of ten words to remember and spit back at the proctor (how many of us could do that all the time?) etc. and is similar to the "Mini Mental State Examination form". Below is a modified version from a blog. Apparently this test is less used to diagnose dementia than in times of yore.

1) Orientation
What is the (year) (season) (date) (day) (month)? (5 points)
Where are we (province) (country) (town) (street) (unit)? (5 points)

2) Registration
(Name three objects: ie- pen, apple, candy -using one second to say each. Then ask the patient all three after you have said them. Give one point for each correct answer. If you cant remember the three objects, the tester will repeat them again, but no score will be given on second tries. Try to remember the three objects as you will be asked to recall them later again.) (3 points)

3) Attention and Calculation
Two tests are given, the best of the two scores are used in the final scoring.
a) Count backwards from a given number by subtracting sevens. Give one point for each correct answer; stop after five counts. One point is given for each correct subtraction. (5 points)
b) Spell "world" backwards. (5 points)

4) Recall
Name the three objects learned above. One point for each correct answer.

5) Language
a) The person being tested is shown two everyday items - a hammer and a crayon, for example - and asked to name them. 1 point for each correct answer. (2 points)
b) Repeat the following: "No ifs, ands, or buts." One point for the correct repetition of the sentence. (1 point)
c) You will be given a piece of paper, and you will be asked to perform the following: i) hold the paper in your right hand (1 point) ii) fold the paper in half (1 point) iii) Put the paper on the floor (1 point)
d) Read and obey the following: "clap your hands) (1 point)
e) Write a sentence. (the sentence has to make sense to gain 1 point)
f) Copy a design of two intersecting shapes. One point is awarded for correctly copying it. All angles on both figures must be present, and the figures must have one overlapping angle. (1 point)

The test has a maximum score of thirty. People with Alzheimer's usually score 26 points or less. The test questions should be given in the above order, no questions should be skipped or changed.

 

What hits me immediately, is many folks are not comfortable over the phone, may not hear the questioner well but be too proud to ask for assistance. I know at times when I am trying to remember some silly thing like my phone number under pressure, my mind can go blank but cognition is so much more than memory so the accessment itself is likely quite flawed. 

According to the researchers their study "had several limitations" (to put it mildly - I love how these researchers tend to understate)

1. alcohol usage was self reported (by the nurse herself) so if she was senile, would she remember if she drank or not?

2. There is a DISTINCT probability that alcohol usage declined or ceased when senility hit - the typical "which came first, the chicken or the egg" scenario.

3. Moderate drinkers may have been healthier to begin with, more active.  (Heavy drinkers were excluded from the study)

4. The nurses over 70 were only accessed during a period of two years so those suffering senility who may have stopped drinking might have been registered as "non drinkers"

 

I would add this - The amount of exercise which is AN IMPORTANT FACTOR in the health of everyone regardless of drinking habits, weight etc was NOT AT ALL, it seems, taken in consideration but there again, a high percentage of people who after the age of 70 are still drinking moderately, may be exercising which would be an important factor in cognition (cardio significantly enhances cognitive ability).

The bottom line is, of course, the study is junk science.  The data dredge of 32,000 nurses has been used in many studies to prove things which later, double blind studies have totally disproven.  But that doesn't stop them from trying again.  As Stephen Milloy put it so well:

"But who needs data when you can spoon-feed junk science to a gullible media?" 
    - Steven Milloy, Fox News

The truth about  alcoholic beverages is less than music to the ears.  For every drink you take, in order to process the alcohol, hepatocytes (liver cells) are destroyed.  (why heavy drinkers get a condition known as cirrhosis of the liver)  When the alcohol gets into the bloodstream it can damage body cells and then, when it crosses the blood brain barrier it damages brain cells.  So you see, the medical evidence is rather overwhelming that alcohol DAMAGES the brain rather than feeds it.  Additionally alcohol is an addictive substance and those who work with substance abuse tell us that even ONE drink a day can addict susceptible people. 

There are some antioxidents in wine so having 4 oz of wine with dinner may have some benefits and may not harm you - wine has a very low alcohol content.  However, you can get the same antioxidents from chocolate without the alcoholic content!

Here is the abstract of the study:

>>>>>>Effects of Moderate Alcohol Consumption on Cognitive Function in Women

Meir J. Stampfer, M.D., Jae Hee Kang, Sc.D., Jennifer Chen, M.P.H., Rebecca Cherry, M.D., and Francine Grodstein, Sc.D. 
 

ABSTRACT
Background The adverse effects of excess alcohol intake on cognitive function are well established, but the effect of moderate consumption is uncertain.
Methods Between 1995 and 2001, we evaluated cognitive function in 12,480 participants in the Nurses' Health Study who were 70 to 81 years old, with follow-up assessments in 11,102 two years later. The level of alcohol consumption was ascertained regularly beginning in 1980. We calculated multivariate-adjusted mean cognitive scores and multivariate-adjusted risks of cognitive impairment (defined as the lowest 10 percent of the scores) and a substantial decline in cognitive function over time (defined as a change that was in the worst 10 percent of the distribution of the decline). We also stratified analyses according to the apolipoprotein E genotype in a subgroup of women.
Results After multivariate adjustment, moderate drinkers (those who consumed less than 15.0 g of alcohol per day [about one drink]) had better mean cognitive scores than nondrinkers. Among moderate drinkers, as compared with nondrinkers, the relative risk of impairment was 0.77 on our test of general cognition (95 percent confidence interval, 0.67 to 0.88) and 0.81 on the basis of a global cognitive score combining the results of all tests (95 percent confidence interval, 0.70 to 0.93). The results for cognitive decline were similar; for example, on our test of general cognition, the relative risk of a substantial decline in performance over a two-year period was 0.85 (95 percent confidence interval, 0.74 to 0.98) among moderate drinkers, as compared with nondrinkers. There were no significant associations between higher levels of drinking (15.0 to 30.0 g per day) and the risk of cognitive impairment or decline. There were no significant differences in risks according to the beverage (e.g., wine or beer) and no interaction with the apolipoprotein E genotype.
Conclusions Our data suggest that in women, up to one drink per day does not impair cognitive function and may actually decrease the risk of cognitive decline.

Source Information
From the Channing Laboratory, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School (M.J.S., J.H.K., J.C., F.G.); and the Departments of Epidemiology (M.J.S., F.G.) and Nutrition (M.J.S.), Harvard School of Public Health all in Boston; and Vanderbilt Children's Hospital, Nashville (R.C.).
<<<<<<
 

If you wish to view the full text of the study (must buy it for $10 - I did purchase access in order to write the analysis above) go to :

http://www.nejm.org

----- Original Message ----- 
 
>  Daily Drink Helps Keep Brain Sharp, Data Suggest

>  By Rob Stein
>   
>   Women who imbibe a little wine, beer or even spirits every day are less likely than
> teetotalers to see their memories and other thinking powers fade as they age, according to the
> largest study to assess alcohol's impact on the brain.

>  The study of more than 12,000 elderly women found that those who consumed light to moderate
> amounts of alcohol daily had about a 20 percent lower risk of experiencing problems with their
> mental abilities later in life.

>  "Low levels of alcohol appear to have cognitive benefits," said Francine Grodstein of Brigham
> and Women's Hospital in Boston, senior author on the study, published in today's New England
> Journal of Medicine. "Women who consistently were drinking about one-half to one drink per day
> had both less cognitive impairment as well as less decline in their cognitive function compared
> to women who didn't drink at all," Grodstein said.

Washington Post - Daily drink helps keep brain sharp  (full Washington post article)