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(Stroke. 2001;32:1939.)
© 2001 American Heart Association, Inc.

Original Contributions

Alcohol Consumption and Subclinical Findings on Magnetic Resonance Imaging of the Brain in Older Adults

The Cardiovascular Health Study

Kenneth J. Mukamal, MD, MPH; W. T. Longstreth Jr, MD, MPH; Murray A. Mittleman, MD, DrPH; Rosa M. Crum, MD, MHS David S. Siscovick, MD, MPH

From the Divisions of General Medicine and Primary Care (K.J.M.) and Cardiology (M.A.M.), Beth Israel Deaconess Medical Center, Boston, Mass; Departments of Neurology (W.T.L.), Epidemiology (W.T.L., D.S.S.), and Medicine (D.S.S.), University of Washington, Seattle, Wash; Department of Epidemiology (M.A.M.), Harvard School of Public Health, Boston, Mass; and Department of Epidemiology (R.M.C.), Johns Hopkins University School of Hygiene and Public Health, Baltimore, MD.

Correspondence to Kenneth J. Mukamal, MD, MPH, Division of General Medicine and Primary Care, Beth Israel Deaconess Medical Center, 330 Brookline Ave, LY-303, Boston, MA 02215. E-mail kmukamal{at}caregroup.harvard.edu

Background and Purpose—— Subclinical findings on MRI of the brain are associated with poorer cognitive and neurological function among older adults. We sought to determine how alcohol consumption is related to these findings.

Methods—— As part of the Cardiovascular Health Study, 3660 adults aged 65 years and older underwent MRI of the brain from 1992 to 1994. We excluded 284 participants with a confirmed history of cerebrovascular disease. We assessed self-reported intake of beer, wine, and liquor at the annual clinic visit closest to the date of the MRI and grouped participants into 6 categories: abstainers, former drinkers, <1 drink weekly, 1 to <7 drinks weekly, 7 to <15 drinks weekly, and 15 drinks weekly. Neuroradiologists assessed white matter grade, infarcts, ventricular size, and sulcal size in a standardized and blinded manner. We used multivariate regression to control for sociodemographic and clinical characteristics.

Results—— We found a U-shaped relationship between alcohol consumption and white matter abnormalities. Compared with abstainers, individuals consuming 1 to <7 drinks had an OR of 0.68, and those consuming 15 drinks weekly had an OR of 0.95 (p for quadratic term=0.01). Heavier alcohol consumption was associated with a lower prevalence of infarcts (OR for 15 drinks weekly relative to abstainers 0.59; P for trend=0.004), but larger ventricular size (OR for 15 drinks weekly relative to abstainers 1.32; P for trend=0.006) and sulcal size (OR for 15 drinks weekly relative to abstainers 1.53; P for trend=0.007).

Conclusions—— Moderate alcohol consumption is associated with a lower prevalence of white matter abnormalities and infarcts, thought to be of vascular origin, but with a dose-dependent higher prevalence of brain atrophy on MRI among older adults. The extent to which these competing associations influence overall brain function will require further study.

Editorial Comment

The Cardiovascular Health Study

Daniel Bereczki, MD, PhD; Guest Editor

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