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High alcohol consumption in middle-aged adults is associated with poorer cognitive performance only in the low socio-economic group. Results from the GAZEL cohort study

Authors

  • Séverine Sabia,

    Corresponding author
    1. Centre for Research in Epidemiology and Population Health, Hôpital Paul Brousse, Villejuif, France,
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  • Alice Guéguen,

    1. Centre for Research in Epidemiology and Population Health, Hôpital Paul Brousse, Villejuif, France,
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  • Claudine Berr,

    1. Hôpital La Colombière, Montpellier, France,
    2. University Montpellier 1, Service de Neurologie, Montpellier, Montpellier, France,
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  • Lisa Berkman,

    1. Department of Society, Human Development and Health, Harvard School of Public Health, Boston, MA, US,
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  • Joël Ankri,

    1. Centre for Research in Epidemiology and Population Health, Hôpital Paul Brousse, Villejuif, France,
    2. Université de Versailles Saint-Quentin, Yvelines, France,
    3. Centre de Gérontologie, Hôpital Ste Perine, AP-HP, France
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  • Marcel Goldberg,

    1. Centre for Research in Epidemiology and Population Health, Hôpital Paul Brousse, Villejuif, France,
    2. Université de Versailles Saint-Quentin, Yvelines, France,
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  • Marie Zins,

    1. Centre for Research in Epidemiology and Population Health, Hôpital Paul Brousse, Villejuif, France,
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  • Archana Singh-Manoux

    1. Centre for Research in Epidemiology and Population Health, Hôpital Paul Brousse, Villejuif, France,
    2. Centre de Gérontologie, Hôpital Ste Perine, AP-HP, France
    3. Department of Epidemiology and Public Health, University College London, UK
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Séverine Sabia, INSERM U1018, Centre for Research in Epidemiology and Population Health, Hôpital Paul Brousse, 16 avenue Paul Vaillant Couturier, Bâtiment 15/16, 94 807 Villejuif Cedex, France. E-mail: Severine.Sabia@inserm.fr

ABSTRACT

Aims  To examine the association of alcohol consumption over 10 years with cognitive performance in different socio-economic groups.

Design  Prospective cohort study, the French GAZEL study.

Setting  France.

Participants  Employees of France's national electricity and gas company.

Measurements  Alcohol intake was assessed annually, beginning in 1992, using questions on frequency and quantity of alcoholic beverages consumed in a week; used to define mean consumption and trajectory of alcohol intake over 10 years. Cognitive performance among participants aged ≥ 55 years (n = 4073) was assessed in 2002–04 using the Digit Symbol Substitution Test (DSST), a measure of psychomotor speed, attention and reasoning. Occupational position at age 35 and education were used as the markers of socio-economic position.

Findings  All analyses were stratified by socio-economic position. In the low occupational group, participants consuming a mean of more than 21 drinks per week had 2.1 points lower (95% CI: −3.9, −0.3) DSST score compared to those consuming four to 14 drinks per week. In participants with primary school education, the corresponding difference was 3.6 points (95% CI: −7.1, −0.0). No association between alcohol consumption and cognitive performance was observed in the intermediate and high socio-economic groups, defined using either occupation or education. Analysis of trajectories of alcohol consumption showed that in the low socio-economic groups large increase or decrease in alcohol consumption was associated with lower cognitive scores compared to stable consumption.

Conclusions  Our results suggest that high alcohol consumption is associated with poorer cognitive performance only in the low socio-economic group, due possibly to greater cognitive reserve in the higher socio-economic groups.

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