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Moderate alcohol consumption as risk factor for adverse brain outcomes and cognitive decline: longitudinal cohort study

Click HERE to contact Anya Topiwala, clinical lecturer in old age psychiatry

Abstract

Objectives: To investigate whether moderate alcohol consumption has a favourable or adverse association or no association with brain structure and function.

Design: Observational cohort study with weekly alcohol intake and cognitive performance measured repeatedly over 30 years (1985-2015). Multimodal magnetic resonance imaging (MRI) was performed at study endpoint (2012-15).

Setting: Community dwelling adults enrolled in the Whitehall II cohort based in the UK (the Whitehall II imaging substudy).

Participants: 550 men and women with mean age 43.0 (SD 5.4) at study baseline, none were “alcohol dependent” according to the CAGE screening questionnaire, and all safe to undergo MRI of the brain at follow-up. Twenty three were excluded because of incomplete or poor quality imaging data or gross structural abnormality (such as a brain cyst) or incomplete alcohol use, sociodemographic, health, or cognitive data.

Main outcome measures: Structural brain measures included hippocampal atrophy, grey matter density, and white matter microstructure. Functional measures included cognitive decline over the study and cross sectional cognitive performance at the time of scanning.

Results: Higher alcohol consumption over the 30 year follow-up was associated with increased odds of hippocampal atrophy in a dose dependent fashion. While those consuming over 30 units a week were at the highest risk compared with abstainers (odds ratio 5.8, 95% confidence interval 1.8 to 18.6; P≤0.001), even those drinking moderately (14-21 units/week) had three times the odds of right sided hippocampal atrophy (3.4, 1.4 to 8.1; P=0.007). There was no protective effect of light drinking (1-<7 units/week) over abstinence. Higher alcohol use was also associated with differences in corpus callosum microstructure and faster decline in lexical fluency. No association was found with cross sectional cognitive performance or longitudinal changes in semantic fluency or word recall.

Conclusions: Alcohol consumption, even at moderate levels, is associated with adverse brain outcomes including hippocampal atrophy. These results support the recent reduction in alcohol guidance in the UK and question the current limits recommended in the US.

Push-Ups

Radim Hajek

Robert Drtina

Radim Hajek and Robert Drtina got together for a great scene. They start off with some push-ups and then get into arm wrestling which Robert wins. Radim compliments him on his strength and then offers him a massage. He starts to feel Robert’s arms, but before a massage can begin they both kiss. Then they stand up and begin to feel each other’s bodies, kissing some more. Radim begins to rub his hand over Robert’s groin and they kiss some more. Then Radim opens Robert’s pants and they drop to the floor, revealing his cock. Radim drops down and takes the soft cock in his mouth and begins to suck. The cock responds and is soon nice and hard. Radim’s mouth works over the cock suck it really well, then he stands and his pants are opened too. His cock is already quite hard and Robert goes down onto his knees and starts to suck. With those big balls hanging low, on Radim, Robert sucks and wanks on that big cock. Radim lays on the bed and Robert sits so that he can continue to suck and wank on that cock. As he is being sucked Radim reaches round and takes hold of Robert’s dick. He wanks on it as Robert’s head bobs up. Then Robert lays on the bed, with his legs up and Radim starts to play with his ass. He tongues that hole and then slips a finger in to open it up. His cock is next and it slides into that hot hole and starts to fuck. Radim fucks that ass nice and deep, with Robert moaning. Changing position, with Robert bent over, the fucking continues. Radim really works that hot hole. They move again and Robert sits his hot ass down on that throbbing cock, wanking himself as he rides. With Robert bent over again and Radim’s dick deep in his ass he wanks himself to a fine cumshot. Radim continues his fucking until he is ready to cum too and he pulls out, squirting all over Robert’s chest to bring a lovely scene to an end, finishing with another kiss.