Alcohol Use Disorder Is Associated with Higher Risks of Adverse Brain Outcomes

Alcohol use disorder (AUD) is on the ascendancy in the US older adult population, while the association between AUD and adverse brain outcomes remains inconclusive. The objective of this work is to investigate the associations between AUD with the onset of Alzheimers disease and Parkinsons disease. In a retrospective cohort design using US insurance claim data (2007-2020), 129,182 patients with AUD were matched with 129,182 controls by age, sex, race, and clinical characteristics. After adjusting for covariates, AUD was associated with a higher risk of Alzheimers disease (female adjusted HR=1.78, 95% CI: 1.68-1.90, P<0.001; male adjusted HR=1.80, 95% CI: 1.71-1.91, P<0.001) and a higher risk of Parkinsons disease (female adjusted HR=1.49, 95% CI: 1.32-1.68 P<0.001; male adjusted HR=1.42, 95% CI: 1.32-1.52, P<0.001) in the overall sample. In separate analyses of Black, White, and Hispanic patients, those with AUD had higher risk of Alzheimers disease (adjusted HRs[&ge;]1.58; Ps[&le;]0.001). A significantly elevated risk for Parkinsons disease was found only in the White subpopulation (female adjusted HR=1.55, 95% CI: 1.36-1.77, P<0.001; male adjusted HR=1.45, 95% CI: 1.33-1.57, P<0.001). Alcohol use disorder is associated with Alzheimers disease. Alcohol use disorder is associated with Parkinsons disease in White persons. Cognitive screening and neurological examination among older adults with severe problematic alcohol use hold the promise for early detection of Alzheimers disease and Parkinsons disease.