Alcohol and Dementia: Critical Lessons from USA and South Africa
By Sophie Okolo, Milken Institute Center for the Future of Aging
Studies have shown that excessive alcohol use can lead to many health problems such as dementia. While the link between heavy drinking and dementia is still being researched, raising awareness of alcohol consumption as a risk factor for dementia and cognitive decline is important. To commemorate National Aging Life Care Month, this blog post will explore the link between heavy drinking and dementia as well compare and contrast alcohol consumption in two big drinking nations - the United States and South Africa. The goal is for aging professionals to learn and explore how different cultures can prevent cognitive decline. Despite steps to address dementia in South Africa, there is still no national plan which may include tackling alcohol related dementia. The U.S. has several organizations, such as the Alzheimer’s Association, which provide interventions to reduce cognitive decline.
According to the World Health Organization (WHO), South Africa is one of the biggest drinking nations in the world and has the highest level of alcohol consumption in Africa per capita. This is most alarming, since South Africa has already been highlighted as the worst country in the world for drunk driving, where about 58 percent of road deaths can be related to alcohol consumption. WHO also places the United States among the top 25 countries in terms of per capita alcohol consumption.
In 2015, the National Institute for Health and Care Excellence released recommendations that plan to help prevent and delay health problems, including dementia. Among the recommendations is for people between the ages of 40 and 64 to “reduce the amount they drink as much as possible.” As dementia rates continue to increase in the United States and South Africa, it is important that aging professionals raise awareness of the causal relationship between heavy drinking and dementia. Medical experts now describe the link as alcohol-related dementia (ARD), which is a form of dementia caused by long-term, heavy drinking, leading to neurological damage and impaired cognitive function. Binge drinking typically occurs after four drinks for women and five drinks for men-in about two hours, according to the National Institute on Alcohol Abuse and Alcoholism.
Alzheimer's disease (AD) is the most common cause of dementia and may contribute to 60–70 percent of cases. It is the sixth leading cause of death in the U.S. and an estimated 5.5 million Americans currently suffer from AD. If current population trends continue, the number of people with Alzheimer’s disease will increase significantly, unless the disease can be effectively treated or prevented. Due to increases in longevity, dementia is one of the most common diseases among older people. It is also a leading cause of frailty, institutionalization, and death; therefore it has a great impact on both the individual and society.
In South Africa, more than 2.2 million South Africans have Alzheimer’s, and many live with the stigma attached to the condition. Rural areas are especially affected since communities think people with Alzheimer’s are ‘bewitched’ or are simply ‘acting out’. While there is no proven effective treatment nor much intervention, the general consensus is that a lack of exercise, obesity and binge drinking can increase the chance of getting Alzheimer’s.
Despite the incidence of dementia, physical activity and brain exercises have positive effects on the aging brain. Physical activity, such as brisk walking, increases the flow of oxygen to the brain. Brain exercises, such as learning a new sport or foreign language, can set the brain cells into action and increase mental power. With studies now showing the link between heavy drinking and dementia, aging professionals in South Africa and the U.S. can discuss ways of raising awareness of aging and alcohol.
Increase in alcohol-related deaths and accidents have led to recent discussions to ban alcohol in countries and regions such as Malawi, India, and Coogee Beach (Sydney, Australia). Globally, about 3.3 million deaths were connected with alcohol consumption in 2012; 7.6 percent of deaths among males and 4.0 percent of deaths among females. Other statistics for South Africa and the United States only include:
- South Africa’s average alcohol consumption is almost double the WHO African region average of 6 liters, and is expected to increase to 12.1 in 2025.
- More than a quarter of the drinking population in South Africa are deemed binge drinkers, consuming at least 60 grams or more of pure alcohol in one sitting within a 30-day period.
- Americans over age 60 are drinking more than they were 20 years ago.
- Alcoholism is the third leading lifestyle-related cause of death in the U.S. 79,000 deaths per year are traced to excessive drinking.
While there is plenty of evidence that chronic alcoholism can cause serious damage to the brain, it would be wise to also emphasize and encourage the benefits of other healthy habits. Many studies state that regular exercise, no smoking, healthy diets, and little or moderate alcohol intake can help reduce the risk of dementia and other cognitive decline. These lessons, including further exploration of the causal relationship between heavy drinking and dementia, call for both nations to invest more in health and wellness.
Sophie Okolo is an associate with the Milken Institute Center for the Future of Aging, where she focuses on enhancing the center’s healthy aging program through writing editorials, convening experts, developing projects and partnering with national organizations. She works to increase awareness and support for scientific and social advancements in prevention and wellness and to spread innovative health solutions to diverse communities. Her professional interests include improving the quality of life for older people around the world and increasing awareness of preventive health care. Before joining the Institute, Okolo served as editor in chief of Global Health Aging, a web-based publication featuring news, research and opinion on healthy aging and longevity. Her previous work spans policy, research and communication with nonprofit organizations including the National Association of States United for Aging and Disabilities and American Action Forum. She has authored articles on aging in Africa, science, disease and innovation. Okolo holds a B.S. in bioinformatics from Ramapo College and an M.P.H. with a focus in community health and gerontology from Armstrong Atlantic State University.