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Table of Contents
Vol. 27, No. 4, 2006
Issue release date: December 2006
Section title: Original Paper
Free Access
Neuroepidemiology 2006;27:201–207
(DOI:10.1159/000096300)

Reported Alcohol Consumption and Cognitive Decline: The Northern Manhattan Study

Wright C.B.a · Elkind M.S.V.a · Luo X.b · Paik M.C.b · Sacco R.L.a, c
aDivision of Stroke and Critical Care, Department of Neurology, College of Physicians and Surgeons of Columbia University, and Departments of bBiostatistics and cEpidemiology, Mailman School of Public Health, Columbia University, New York, N.Y., USA
email Corresponding Author

Abstract

Background: Moderate alcohol intake may slow cognitive decline, and both vascular and neurodegenerative mechanisms have been implicated. Methods: We examined reported alcohol intake and cognitive decline in a community-based cohort of Hispanic, black and white individuals (n = 1,428). The role of the apolipoprotein E ε4 (APOE4) allele as a modifier was also studied. Results and Conclusions: Reported drinking was as follows: 300 participants (21%) were ‘never’ drinkers, 622 (44%) ‘past’ drinkers, 145 (10%) reported taking less than 1 drink weekly, 330 (23%) 1 drink weekly up to 2 daily and 31 (2%) more than 2 drinks daily. A positive relationship was seen between reported alcohol intake and cognition. Drinking less than 1 drink a week (p = 0.09), between 1 drink weekly up to 2 drinks daily (p = 0.001) and more than 2 drinks daily (p = 0.003) were associated with less cognitive decline on the modified Telephone Interview for Cognitive Status compared to never drinkers. This dose-response relationship was not modified by the presence of an APOE4 allele in a subsample.

© 2006 S. Karger AG, Basel


  

Key Words

  • Alcohol drinking
  • Cognition disorders
  • Apolipoprotein E4

References

  1. Espeland MA, Gu L, Masaki KH, Langer RD, Coker LH, Stefanick ML, Ockene J, Rapp SR: Association between reported alcohol intake and cognition: results from the Women’s Health Initiative Memory Study. Am J Epidemiol 2005;161:228–238.
  2. 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;153:185–192.
  3. Huang W, Qiu C, Winblad B, Fratiglioni L: Alcohol consumption and incidence of dementia in a community sample aged 75 years and older. J Clin Epidemiol 2002;55:959–964.
  4. Mukamal KJ, Kuller LH, Fitzpatrick AL, Longstreth WT Jr, Mittleman MA, Siscovick DS: Prospective study of alcohol consumption and risk of dementia in older adults. JAMA 2003;289:1405–1413.
  5. Dufouil C, Tzourio C, Brayne C, Berr C, Amouyel P, Alperovitch A: Influence of apolipoprotein E genotype on the risk of cognitive deterioration in moderate drinkers and smokers. Epidemiology 2000;11:280–284.
  6. Herbert LE, Scherr PA, Beckett LA, Albert MS, Rosner B, Taylor JO, Evans DA: Relation of smoking and low-to-moderate alcohol consumption to change in cognitive function: a longitudinal study in a defined community of older persons. Am J Epidemiol 1993;137:881–891.
  7. Leroi I, Sheppard JM, Lyketsos CG: Cognitive function after 11.5 years of alcohol use: relation to alcohol use. Am J Epidemiol 2002;156:747–752.
  8. Sacco RL, Elkind M, Boden-Albala B, Lin IF, Kargman DE, Hauser WA, Shea S, Paik MC: The protective effect of moderate alcohol consumption on ischemic stroke. JAMA 1999;281:53–60.
  9. Mukamal KJ, Longstreth WT Jr, Mittleman MA, Crum RM, Siscovick DS: Alcohol consumption and subclinical findings on magnetic resonance imaging of the brain in older adults: the cardiovascular health study. Stroke 2001;32:1939–1946.
  10. Luchsinger JA, Tang MX, Siddiqui M, Shea S, Mayeux R: Alcohol intake and risk of dementia. J Am Geriat Soc 2004;52:540–546.
  11. Blair CK, Folsom AR, Knopman DS, Bray MS, Mosley TH, Boerwinkle E: Atherosclerosis Risk in Communities Study I: APOE genotype and cognitive decline in a middle-aged cohort. Neurology 2005;64:268–276.
  12. Carmelli D, Swan GE, Reed T, Schellenberg GD, Christian JC: The effect of apolipoprotein E ε4 in the relationships of smoking and drinking to cognitive function. Neuroepidemiology 1999;18:125–133.
  13. Stampfer MJ, Kang JH, Chen J, Cherry R, Grodstein F: Effects of moderate alcohol consumption on cognitive function in women. N Engl J Med 2005;352:245–253.
  14. Launer LJ, Feskens EJ, Kalmijn S, Kromhout D: Smoking, drinking, and thinking: the Zutphen Elderly Study. Am J Epidemiol 1996;143:219–227.
  15. Andersen K, Launer LJ, Dewey ME, Letenneur L, Ott A, Copeland JR, Dartigues JF, Kragh-Sorensen P, Baldereschi M, Brayne C, Lobo A, Martinez-Lage JM, Stijnen T, Hofman A, EURODEM Incidence Research Group: Gender differences in the incidence of AD and vascular dementia: the EURODEM Studies. Neurology 1999;53:1992–1997.
  16. Hendrie HC, Gao S, Hall KS, Hui SL, Unverzagt FW: The relationship between alcohol consumption, cognitive performance, and daily functioning in an urban sample of older black Americans. J Am Geriatr Soc 1996;44:1158–1165.
  17. Cerhan JR, Folsom AR, Mortimer JA, Shahar E, Knopman DS, McGovern PG, Hays MA, Crum LD, Heiss G, Atherosclerosis Risk in Communities (ARIC) Study Investigators: Correlates of cognitive function in middle-aged adults. Gerontology 1998;44:95–105.
  18. Sacco RL, Kargman DE, Gu Q, Zamanillo MC: Race-ethnicity and determinants of intracranial atherosclerotic cerebral infarction: the Northern Manhattan Stroke Study. Stroke 1995;26:14–20.
  19. Tang MX, Cross P, Andrews H, Jacobs DM, Small S, Bell K, Merchant C, Lantigua R, Costa R, Stern Y, Mayeux R: Incidence of AD in African-Americans, Caribbean Hispanics, and Caucasians in northern Manhattan. Neurology 2001;56:49–56.
  20. Elkind MS, Cheng J, Boden-Albala B, Paik MC, Sacco RL, The Northern Manhattan Stroke Study: Elevated white blood cell count and carotid plaque thickness : The Northern Manhattan Stroke Study. Stroke 2001;32:842–849.
  21. Sacco RL, Benson RT, Kargman DE, Boden-Albala B, Tuck C, Lin IF, Cheng JF, Paik MC, Shea S, Berglund L: High-density lipoprotein cholesterol and ischemic stroke in the elderly: the Northern Manhattan Stroke Study JAMA 2001;285:2729–2735.
  22. Brandt J, Spencer M, Folstein MF: The Telephone Interview For Cognitive Status. Neuropsychiatry Neuropsychol Behav Neurol 1988;1:111–117.
  23. De Jager CA, Budge MM, Clarke R, Barak Y, Aizenberg D, Achiron A: Utility of TICS-M for the assessment of cognitive function in older adults. Int J Geriatr Psychiatry 2003;18:318–324.
  24. Desmond D, Tatemichi TK, Hanzawa L: The Telephone Interview For Cognitive Status (TICS): reliability and validity in a stroke sample. Int J Geriatr Pshychiatry 1994:803–807.

    External Resources

  25. Block G, Hartman AM, Dresser CM, Carroll MD, Gannon J, Gardner L: A data-based approach to diet questionnaire design and testing. Am J Epidemiol 1986;124:453–469.
  26. Willett WC, Sampson L, Stampfer MJ, Rosner B, Bain C, Witschi J, Hennekens CH, Speizer FE: Reproducibility and validity of a semiquantitative food frequency questionnaire. Am J Epidemiol 1985;122:51–65.
  27. Hixson JE, Vernier DT: Restriction isotyping of human apolipoprotein E by gene amplification and cleavage with HhaI. J Lipid Res 1990;31:545–548.
  28. Gurland BJ, Wilder DE, Lantigua R, Stern Y, Chen J, Killeffer EH, Mayeux R: Rates of dementia in three ethnoracial groups. Internat J Geriatr Psychiatry 1999;14:481–493.
  29. Bond GE, Burr R, McCurry SM, Rice MM, Borenstein AR, Kukull WA, Teri L, Bowen JD, McCormick WC, Larson EB: Alcohol, gender, and cognitive performance: a longitudinal study comparing older Japanese and non-Hispanic white Americans. J Aging Health 2004;16:615–640.
  30. Dufouil C, Ducimetiere P, Alperovitch A, Epidemiology of Vascular Aging (EVA) Study Group: Sex differences in the association between alcohol consumption and cognitive performance. Am J Epidemiol 1997;146:405–412.
  31. Kalmijn S, van Boxtel MP, Verschuren MW, Jolles J, Launer LJ: Cigarette smoking and alcohol consumption in relation to cognitive performance in middle age. Am J Epidemiol 2002;156:936–944.
  32. Elias PK, Elias MF, D’Agostino RB, Silbershatz H, Wolf PA: Alcohol consumption and cognitive performance in the Framingham Heart Study. Am J Epidemiol 1999;150:580–589.
  33. Galanis DJ, Joseph C, Masaki KH, Petrovitch H, Ross GW, White L: A longitudinal study of drinking and cognitive performance in elderly Japanese American men: the Honolulu-Asia Aging Study. Am J Public Health 2000;90:1254–1259.
  34. Christian JC, Reed T, Carmelli D, Page WF, Norton JA Jr, Breitner JC: Self-reported alcohol intake and cognition in aging twins. J Stud Alcohol 1995;56:414–416.
  35. Lanterna LA, Rigoldi M, Tredici G, Biroli F, Cesana C, Gaini SM, Dalpra L: APOE influences vasospasm and cognition of noncomatose patients with subarachnoid hemorrhage. Neurology 2005;64:1238–1244.
  36. Ruitenberg A, van Swieten JC, Witteman JC, Mehta KM, van Duijn CM, Hofman A, Breteler MM: Alcohol consumption and risk of dementia: the Rotterdam Study. Lancet 2002;359:281–286.
  37. Henn C, Loffelholz K, Klein J: Stimulatory and inhibitory effects of ethanol on hippocampal acetylcholine release. Naunyn Schmiedebergs Arch Pharmacol 1998;357:640–647.
  38. Wright CB, Elkind MS, Rundek T, Boden-Albala B, Paik MC, Sacco RL: Alcohol intake, carotid plaque, and cognition: the Northern Manhattan Study. Stroke 2006;37:1160–1164.
  39. Gaziano JM, Buring JE, Breslow JL, Goldhaber SZ, Rosner B, VanDenburgh M, Willett W, Hennekens CH: Moderate alcohol intake, increased levels of high-density lipoprotein and its subfractions, and decreased risk of myocardial infarction. N Engl J Med 1993;329:1829–1834.
  40. Rubin R, Rand ML: Alcohol and platelet function. Alcohol Clin Exp Res 1994;18:105–110.
  41. Lines CR, McCarroll KA, Lipton RB, Block GA, Prevention of Alzheimer’s in Society’s Elderly Study Group: telephone screening for amnestic mild cognitive impairment. Neurology 2003;60:261–266.

  

Author Contacts

Clinton Wright, MD, MS
Division of Stroke and Critical Care
College of Physicians and Surgeons of Columbia University
NI-Room 640, 710 W 168th Street, New York, NY 10032 (USA)
Tel. +1 212 305 1710, Fax +1 212 305 1658, E-Mail cbw7@columbia.edu

  

Article Information

Published online: October 16, 2006
Number of Print Pages : 7
Number of Figures : 0, Number of Tables : 2, Number of References : 41

  

Publication Details

Neuroepidemiology

Vol. 27, No. 4, Year 2006 (Cover Date: December 2006)

Journal Editor: Román, G.C. (San Antonio, Tex.)
ISSN: 0251–5350 (print), 1423–0208 (Online)

For additional information: http://www.karger.com/NED


Copyright / Drug Dosage / Disclaimer

Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher or, in the case of photocopying, direct payment of a specified fee to the Copyright Clearance Center.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in goverment regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

Abstract

Background: Moderate alcohol intake may slow cognitive decline, and both vascular and neurodegenerative mechanisms have been implicated. Methods: We examined reported alcohol intake and cognitive decline in a community-based cohort of Hispanic, black and white individuals (n = 1,428). The role of the apolipoprotein E ε4 (APOE4) allele as a modifier was also studied. Results and Conclusions: Reported drinking was as follows: 300 participants (21%) were ‘never’ drinkers, 622 (44%) ‘past’ drinkers, 145 (10%) reported taking less than 1 drink weekly, 330 (23%) 1 drink weekly up to 2 daily and 31 (2%) more than 2 drinks daily. A positive relationship was seen between reported alcohol intake and cognition. Drinking less than 1 drink a week (p = 0.09), between 1 drink weekly up to 2 drinks daily (p = 0.001) and more than 2 drinks daily (p = 0.003) were associated with less cognitive decline on the modified Telephone Interview for Cognitive Status compared to never drinkers. This dose-response relationship was not modified by the presence of an APOE4 allele in a subsample.

© 2006 S. Karger AG, Basel


  

Author Contacts

Clinton Wright, MD, MS
Division of Stroke and Critical Care
College of Physicians and Surgeons of Columbia University
NI-Room 640, 710 W 168th Street, New York, NY 10032 (USA)
Tel. +1 212 305 1710, Fax +1 212 305 1658, E-Mail cbw7@columbia.edu

  

Article Information

Published online: October 16, 2006
Number of Print Pages : 7
Number of Figures : 0, Number of Tables : 2, Number of References : 41

  

Publication Details

Neuroepidemiology

Vol. 27, No. 4, Year 2006 (Cover Date: December 2006)

Journal Editor: Román, G.C. (San Antonio, Tex.)
ISSN: 0251–5350 (print), 1423–0208 (Online)

For additional information: http://www.karger.com/NED


Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: 8/10/2006
Published online: 12/13/2006
Issue release date: December 2006

Number of Print Pages: 7
Number of Figures: 0
Number of Tables: 2

ISSN: 0251-5350 (Print)
eISSN: 1423-0208 (Online)

For additional information: http://www.karger.com/NED


Copyright / Drug Dosage

Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher or, in the case of photocopying, direct payment of a specified fee to the Copyright Clearance Center.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in goverment regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

References

  1. Espeland MA, Gu L, Masaki KH, Langer RD, Coker LH, Stefanick ML, Ockene J, Rapp SR: Association between reported alcohol intake and cognition: results from the Women’s Health Initiative Memory Study. Am J Epidemiol 2005;161:228–238.
  2. 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;153:185–192.
  3. Huang W, Qiu C, Winblad B, Fratiglioni L: Alcohol consumption and incidence of dementia in a community sample aged 75 years and older. J Clin Epidemiol 2002;55:959–964.
  4. Mukamal KJ, Kuller LH, Fitzpatrick AL, Longstreth WT Jr, Mittleman MA, Siscovick DS: Prospective study of alcohol consumption and risk of dementia in older adults. JAMA 2003;289:1405–1413.
  5. Dufouil C, Tzourio C, Brayne C, Berr C, Amouyel P, Alperovitch A: Influence of apolipoprotein E genotype on the risk of cognitive deterioration in moderate drinkers and smokers. Epidemiology 2000;11:280–284.
  6. Herbert LE, Scherr PA, Beckett LA, Albert MS, Rosner B, Taylor JO, Evans DA: Relation of smoking and low-to-moderate alcohol consumption to change in cognitive function: a longitudinal study in a defined community of older persons. Am J Epidemiol 1993;137:881–891.
  7. Leroi I, Sheppard JM, Lyketsos CG: Cognitive function after 11.5 years of alcohol use: relation to alcohol use. Am J Epidemiol 2002;156:747–752.
  8. Sacco RL, Elkind M, Boden-Albala B, Lin IF, Kargman DE, Hauser WA, Shea S, Paik MC: The protective effect of moderate alcohol consumption on ischemic stroke. JAMA 1999;281:53–60.
  9. Mukamal KJ, Longstreth WT Jr, Mittleman MA, Crum RM, Siscovick DS: Alcohol consumption and subclinical findings on magnetic resonance imaging of the brain in older adults: the cardiovascular health study. Stroke 2001;32:1939–1946.
  10. Luchsinger JA, Tang MX, Siddiqui M, Shea S, Mayeux R: Alcohol intake and risk of dementia. J Am Geriat Soc 2004;52:540–546.
  11. Blair CK, Folsom AR, Knopman DS, Bray MS, Mosley TH, Boerwinkle E: Atherosclerosis Risk in Communities Study I: APOE genotype and cognitive decline in a middle-aged cohort. Neurology 2005;64:268–276.
  12. Carmelli D, Swan GE, Reed T, Schellenberg GD, Christian JC: The effect of apolipoprotein E ε4 in the relationships of smoking and drinking to cognitive function. Neuroepidemiology 1999;18:125–133.
  13. Stampfer MJ, Kang JH, Chen J, Cherry R, Grodstein F: Effects of moderate alcohol consumption on cognitive function in women. N Engl J Med 2005;352:245–253.
  14. Launer LJ, Feskens EJ, Kalmijn S, Kromhout D: Smoking, drinking, and thinking: the Zutphen Elderly Study. Am J Epidemiol 1996;143:219–227.
  15. Andersen K, Launer LJ, Dewey ME, Letenneur L, Ott A, Copeland JR, Dartigues JF, Kragh-Sorensen P, Baldereschi M, Brayne C, Lobo A, Martinez-Lage JM, Stijnen T, Hofman A, EURODEM Incidence Research Group: Gender differences in the incidence of AD and vascular dementia: the EURODEM Studies. Neurology 1999;53:1992–1997.
  16. Hendrie HC, Gao S, Hall KS, Hui SL, Unverzagt FW: The relationship between alcohol consumption, cognitive performance, and daily functioning in an urban sample of older black Americans. J Am Geriatr Soc 1996;44:1158–1165.
  17. Cerhan JR, Folsom AR, Mortimer JA, Shahar E, Knopman DS, McGovern PG, Hays MA, Crum LD, Heiss G, Atherosclerosis Risk in Communities (ARIC) Study Investigators: Correlates of cognitive function in middle-aged adults. Gerontology 1998;44:95–105.
  18. Sacco RL, Kargman DE, Gu Q, Zamanillo MC: Race-ethnicity and determinants of intracranial atherosclerotic cerebral infarction: the Northern Manhattan Stroke Study. Stroke 1995;26:14–20.
  19. Tang MX, Cross P, Andrews H, Jacobs DM, Small S, Bell K, Merchant C, Lantigua R, Costa R, Stern Y, Mayeux R: Incidence of AD in African-Americans, Caribbean Hispanics, and Caucasians in northern Manhattan. Neurology 2001;56:49–56.
  20. Elkind MS, Cheng J, Boden-Albala B, Paik MC, Sacco RL, The Northern Manhattan Stroke Study: Elevated white blood cell count and carotid plaque thickness : The Northern Manhattan Stroke Study. Stroke 2001;32:842–849.
  21. Sacco RL, Benson RT, Kargman DE, Boden-Albala B, Tuck C, Lin IF, Cheng JF, Paik MC, Shea S, Berglund L: High-density lipoprotein cholesterol and ischemic stroke in the elderly: the Northern Manhattan Stroke Study JAMA 2001;285:2729–2735.
  22. Brandt J, Spencer M, Folstein MF: The Telephone Interview For Cognitive Status. Neuropsychiatry Neuropsychol Behav Neurol 1988;1:111–117.
  23. De Jager CA, Budge MM, Clarke R, Barak Y, Aizenberg D, Achiron A: Utility of TICS-M for the assessment of cognitive function in older adults. Int J Geriatr Psychiatry 2003;18:318–324.
  24. Desmond D, Tatemichi TK, Hanzawa L: The Telephone Interview For Cognitive Status (TICS): reliability and validity in a stroke sample. Int J Geriatr Pshychiatry 1994:803–807.

    External Resources

  25. Block G, Hartman AM, Dresser CM, Carroll MD, Gannon J, Gardner L: A data-based approach to diet questionnaire design and testing. Am J Epidemiol 1986;124:453–469.
  26. Willett WC, Sampson L, Stampfer MJ, Rosner B, Bain C, Witschi J, Hennekens CH, Speizer FE: Reproducibility and validity of a semiquantitative food frequency questionnaire. Am J Epidemiol 1985;122:51–65.
  27. Hixson JE, Vernier DT: Restriction isotyping of human apolipoprotein E by gene amplification and cleavage with HhaI. J Lipid Res 1990;31:545–548.
  28. Gurland BJ, Wilder DE, Lantigua R, Stern Y, Chen J, Killeffer EH, Mayeux R: Rates of dementia in three ethnoracial groups. Internat J Geriatr Psychiatry 1999;14:481–493.
  29. Bond GE, Burr R, McCurry SM, Rice MM, Borenstein AR, Kukull WA, Teri L, Bowen JD, McCormick WC, Larson EB: Alcohol, gender, and cognitive performance: a longitudinal study comparing older Japanese and non-Hispanic white Americans. J Aging Health 2004;16:615–640.
  30. Dufouil C, Ducimetiere P, Alperovitch A, Epidemiology of Vascular Aging (EVA) Study Group: Sex differences in the association between alcohol consumption and cognitive performance. Am J Epidemiol 1997;146:405–412.
  31. Kalmijn S, van Boxtel MP, Verschuren MW, Jolles J, Launer LJ: Cigarette smoking and alcohol consumption in relation to cognitive performance in middle age. Am J Epidemiol 2002;156:936–944.
  32. Elias PK, Elias MF, D’Agostino RB, Silbershatz H, Wolf PA: Alcohol consumption and cognitive performance in the Framingham Heart Study. Am J Epidemiol 1999;150:580–589.
  33. Galanis DJ, Joseph C, Masaki KH, Petrovitch H, Ross GW, White L: A longitudinal study of drinking and cognitive performance in elderly Japanese American men: the Honolulu-Asia Aging Study. Am J Public Health 2000;90:1254–1259.
  34. Christian JC, Reed T, Carmelli D, Page WF, Norton JA Jr, Breitner JC: Self-reported alcohol intake and cognition in aging twins. J Stud Alcohol 1995;56:414–416.
  35. Lanterna LA, Rigoldi M, Tredici G, Biroli F, Cesana C, Gaini SM, Dalpra L: APOE influences vasospasm and cognition of noncomatose patients with subarachnoid hemorrhage. Neurology 2005;64:1238–1244.
  36. Ruitenberg A, van Swieten JC, Witteman JC, Mehta KM, van Duijn CM, Hofman A, Breteler MM: Alcohol consumption and risk of dementia: the Rotterdam Study. Lancet 2002;359:281–286.
  37. Henn C, Loffelholz K, Klein J: Stimulatory and inhibitory effects of ethanol on hippocampal acetylcholine release. Naunyn Schmiedebergs Arch Pharmacol 1998;357:640–647.
  38. Wright CB, Elkind MS, Rundek T, Boden-Albala B, Paik MC, Sacco RL: Alcohol intake, carotid plaque, and cognition: the Northern Manhattan Study. Stroke 2006;37:1160–1164.
  39. Gaziano JM, Buring JE, Breslow JL, Goldhaber SZ, Rosner B, VanDenburgh M, Willett W, Hennekens CH: Moderate alcohol intake, increased levels of high-density lipoprotein and its subfractions, and decreased risk of myocardial infarction. N Engl J Med 1993;329:1829–1834.
  40. Rubin R, Rand ML: Alcohol and platelet function. Alcohol Clin Exp Res 1994;18:105–110.
  41. Lines CR, McCarroll KA, Lipton RB, Block GA, Prevention of Alzheimer’s in Society’s Elderly Study Group: telephone screening for amnestic mild cognitive impairment. Neurology 2003;60:261–266.