Sex differences in the association between alcohol intake and cognitive decline over 4 years in a middle-aged cohort: The Brazilian Longitudinal Study of Adult Health

Background and purpose The association between alcohol intake and cognitive decline has been widely studied. Sex differences and cognitive domains affected by alcohol intake patterns make this topic complex. The objective of this study was to investigate the effect of alcohol intake on cognition in middle-aged participants in the Brazilian Longitudinal Study of Adult Health by sex during 4 years of follow-up. Methods A total of 7595 participants (55% women) aged between 50 and 75 years at baseline were assessed. Semantic and phonemic fluency, memory, and executive functions were assessed at baseline (2008-2010) and repeated during Visit 2. Linear mixed models were used to investigate the association between cognition and current abstainers, never drinkers, light drinkers, moderate drinkers, and heavy drinkers. Results Heavy alcohol intake accentuated the decline in executive functions for men (beta = -0.01, p < 0.05), and in semantic fluency (beta = -0.02, p < 0.05) and memory (beta = -0.02, p < 0.05) for women. Never drinker men also showed an accentuated decline in semantic fluency (beta = -0.02, p < 0.01). Moderate alcohol intake slowed cognitive decline in phonemic fluency for men (beta = 0.02, p < 0.01) and women (beta = 0.01, p < 0.01), and in executive functions (beta = 0.01, p < 0.05) for women. Conclusions Having more than 14 drinks per week can impact executive functions in men and memory in women. In addition, alcohol consumption of seven to 14 drinks per week may have a protective effect on gender-specific cognitive functions. These findings should be considered in public health policies and guidelines on alcohol and cognitive aging.