Alcohol Use at Any Level Tied to Increased Risk of Dementia: Daily Dose

Patient Care brings primary care clinicians a lot of medical news every day—it’s easy to miss an important study. The Daily Dose provides a concise summary of one of the website's leading stories you may not have seen.

On September 24, 2025, we reported on findings from a study published in BMJ Evidence-Based Medicine that examined the relationship between alcohol intake and dementia.

The study

The investigation pooled data from 2 population-based cohorts—the US Million Veteran Programme (MVP) and the UK Biobank—encompassing 559 559 adults aged 56 to 72 years at baseline, with mean follow-up of 4 years in the US cohort and 12 years in the UK cohort. Over the study period, 14 540 participants developed dementia and 48 034 died. Genetic analyses further drew on data from more than 2.4 million individuals across 45 genome-wide association study (GWAS) cohorts.

The findings

In conventional observational analyses, researchers observed a U-shaped association: nondrinkers, heavy drinkers (>40 drinks per week), and individuals with alcohol use disorder (AUD) were at higher risk compared with light drinkers (<7 drinks per week). For example, heavy drinkers demonstrated a 41% higher dementia risk (hazard ratio [HR], 1.41; 95% CI, 1.15-1.74), and those with AUD had a 51% increased risk (HR, 1.51; 95% CI, 1.42-1.60).

However, Mendelian randomization (MR) analyses using genetic proxies contradicted the apparent protective effect of light drinking. The genetic data showed a monotonic increase in dementia risk with greater alcohol intake. A 1-SD increase in log-transformed drinks per week was associated with a 15% rise in dementia risk (odds ratio [OR], 1.15; 95% CI, 1.03-1.27), while a twofold increase in AUD prevalence corresponded to a 16% higher risk (OR, 1.16; 95% CI, 1.03-1.30).

Authors' comments

"These findings provide evidence for a relationship between all types of alcohol use and increased dementia risk. While correlational observational data suggested a protective effect of light drinking, this could be in part attributable to reduced drinking seen in early dementia; genetic analyses did not support any protective effect, suggesting that any level of alcohol consumption may contribute to dementia risk. Public health strategies that reduce the prevalence of alcohol use disorder could potentially lower the incidence of dementia by up to 16%."

Click here for more details.