title: Alcohol consumption and cognitive ability in older adults
Creators: name: Garvin, SJ
Publisher: name: University of Liverpool Repository
Year: 2020

description: This thesis explored the relationship between alcohol consumption and cognitive ability in later life. This was achieved by systematically reviewing the literature (Chapter 1), and conducting a longitudinal study using data from the English Longitudinal Study of Ageing (ELSA) (Chapter 2). Both chapters are intended for publication in Ageing and Society and have been written in the style of their publication. The author guidelines for this journal is included in Appendix A. Improvements in healthcare and technology means people are living longer. It is expected that there will be a 106% increase in the number of people over 85 years living in England by 2040 (Office of National Statistics, 2016). As people age, there is a gradual decline in some cognitive functions, and research has explored the sociodemographic and health factors associated with this decline, such as education, health, and socioeconomic status (Deary et al., 2009). Lifestyle behaviours, such as alcohol consumption, may influence an individual’s cognitive decline trajectory, and understanding more about the behaviours associated with maintaining cognitive ability can create opportunities for health promotion and intervention (Plassman et al., 2010). Reduced cognitive ability in old age is one of the most feared aspects of growing old, and is associated with increased risk of mortality, disability, and an overall inferior quality of life (Hedden &amp; Gabrieli, 2004). Excessive alcohol consumption carries similar risks, and heavy drinkers (consuming &gt;14 units per week) have a reduced life expectancy, and are at greater risk of injury, disability, and cognitive impairment (Wood et al., 2018). Alcohol consumption has been steadily increasing in the general population in recent years, with particularly high rates observed in older adults (Ardnt et al., 2011). Alcohol has a proportionately greater physiological and cognitive effect on older people, compared to younger adults (Menninger, 2002). Chronic, excessive alcohol use is linked to significant cognitive impairment, and older people may be at a greater risk of this due to the cognitive decline they are experiencing as part of the normal ageing process (Alcohol Concern, 2010; Monds, 2017). To further explore this topic, Chapter 1 systematically reviews the published literature examining the relationship between alcohol consumption and cognition in older people (65 years+). Studies that assessed the domains of cognition associated with cognitive decline in old age – memory, executive function, processing speed, and reasoning – were included, and the details of the studies were extracted and analysed. The results of the analysis of the review are discussed, and suggestions are made regarding the potential direction of future research in this area. Following this, Chapter 2 describes a longitudinal study using ELSA data to further explore the association between alcohol consumption and cognition in old age. ELSA is a representative cohort study, collecting data every two years from a cohort of people aged 50 years+, living in England. The present study uses three waves of ELSA data, spanning eight years. The cognitive domains of memory, verbal fluency, and processing speed, and alcohol consumption were used to examine the change in these cognitive functions as people aged and how alcohol influenced this. By focusing on specific domains of cognition related to age-related decline, I aim to produce research that will lead to a deeper understanding of the impact of alcohol consumption on cognition in old age.