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AlzRisk Risk Factor Literature Search Strategy and Results

Risk Factor: Alcohol
  (Ethanol, Drinking, Alcohol consumption, Alcohol intake, Alcoholic beverage)
Risk Factor Type: Behavior, Nutrition and supplements
Current Understanding:
The tables below present a modest number of reports whose results, taken collectively, suggest an association between moderate alcohol consumption and reduced risk of both clinical Alzheimer disease (AD) and total dementia. Overall, these data suggest that moderate alcohol consumption is a modifiable protective factor, while heavy alcohol consumption may promote dementia. Results from other lines of research corroborate the value of moderate alcohol consumption in relation to cognitive decline in older adults, as well as better cardiovascular health. This research also documents the neurotoxic effect and other negative health consequences of heavy use, particularly among older individuals. Thus, starting or increasing alcohol consumption in late life for prevention of Alzheimer’s disease is not recommended. Specific aspects of the relationship between alcohol and cognitive outcomes still remain unclear, including the optimal quantity, timing, and type of alcohol consumption to reduce the risk of AD and cognitive decline; whether the observed protective effect is directly causal or mediated through the effect on cardiovascular health; and the active biological agents and mechanism of action. For a review of the putative mechanisms by which alcohol consumption may influence AD risk and a more detailed commentary on interpreting the findings below in a broader context, please view the Discussion.
Last Search Completed: 28 April 2013 - Last content update released on 11 Nov 2013.

Risk Factor Overview


We searched Pubmed for peer-reviewed articles reporting on the association between alcohol use and Alzheimer’s disease (AD) incidence in cohort or nested case-control studies. The search returned 506 unique citations that, after title and abstract review against our inclusion criteria, were narrowed down to 73 citations for full-text review (all published in English). Of these, 13 fully met criteria for inclusion in our summary tables. Among the excluded was one article that mentioned results that did not reach statistical significance but did not provide point-estimate(s) or 95% confidence intervals. Among the included were four articles based on data from the same underlying cohorts. We review such duplicate articles on a case-by-case basis, and select the most informative article(s) based on sample size, follow-up time, exposure assessment or modeling, and appropriateness of analytic methods. Please see our methods section for more detail on our general systematic review methods.

Search & Review Flowchart
Search Strategy
Selection of Papers Reporting on Data from the Same Cohort

Search Strategy Flowchart

Search Strategy

Using our systematic review methods, we developed a search strategy (table below) for Pubmed.

Search Strategy Table

Selection of Papers Reporting on Data from the Same Cohort

Some cohort studies produced multiple articles reporting on the association between alcohol use and risk for Alzheimer’s disease. To avoid presenting duplicate results, we reviewed such articles on a case-by-case basis and selected the most informative article(s) based on sample size, follow-up time, exposure assessment or modeling, and appropriateness of analytic methods.

For each cohort listed below, we cite the duplicative articles we reviewed and give our rationale for their inclusion or exclusion. The full citation for each article is provided in the reference section.


We included both Deng 2006 and Zhou 2011 because they reported findings from alternate definitions of alcohol use and from different lengths of follow-up. Deng 2006 compared light-to-moderate drinking vs. non-use over 2-years of follow-up. In contrast, Zhou 2011 compared monthly, weekly, and daily use to occasional use over 5-years of follow-up.

Personnes Agées QUID (PAQUID)

We included both Orgogozo 1997 and Larrieu 2004 because they reported findings for different lengths of follow-up. Orgogozo 1997 compared mild, moderate, and heavy wine consumption to non-consumption over 3 years of follow-up. Larrieu 2004 compared moderate and mild wine consumption to non-consumption over 8 years of follow-up.


Deng J, Zhou DH, Li J, Wang YJ, Gao C, Chen M. A 2-year follow-up study of alcohol consumption and risk of dementia. Clin Neurol Neurosurg. 2006;108(4):378-83.

Larrieu S, Letenneur L, Helmer C, Dartigues JF, Barberger-Gateau P. Nutritional factors and risk of incident dementia in the PAQUID longitudinal cohort. J Nutr Health Aging. 2004;8(3):150-4.

Orgogozo JM, Dartigues JF, Lafont S, Letenneur L, Commenges D, Salamon R, Renaud S, Breteler MB. Wine consumption and dementia in the elderly: a prospective community study in the Bordeaux area. Rev Neurol. 1997;153(3):185-92.

Zhou R, Deng J, Zhang M, Zhou HD, Wang YJ. Association between bone mineral density and the risk of Alzheimer's disease. J Alzheimers Dis. 2011;24(1):101-8.