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Associations of alcohol use in early and middle adulthood with mid- and late-life cognition - a synthetic cohort approach

Buto, P. T.; Zimmerman, S. C.; Kezios, K.; Zeki Al Hazzouri, A.; Glymour, M. M.

2026-03-04 epidemiology
10.64898/2026.02.27.26346914 medRxiv
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OBJECTIVEUsing two cohorts and synthetic datasets, we estimated effects of prospectively reported alcohol use on memory outcomes across middle age. METHODSData were from National Longitudinal Study of Youth 1979 (NLSY79, n=7540, alcohol reports from ages 18-26), Health and Retirement Study (HRS age 50-56 at enrollment, n=13,090), and a synthetic cohort matching early life exposure information from 3,259 NLSY79 participants to later life memory information from 5,451 HRS participants. Covariate-adjusted linear mixed models regressed memory (word list recall) on alcohol use (none, light/moderate, heavy). RESULTSIn NLSY, we found no evidence that associations between light/moderate drinking in early adulthood and mid-life memory score significantly differed from associations between drinking abstention ({beta} = -0.09 (95% CI: -0.30, 0.11)) or heavy drinking ({beta} = -0.26 (-0.48, -0.04)) with memory score. In HRS, both abstaining from alcohol ({beta} = -0.14 (-0.25, -0.02)) and heavy drinking ({beta} = -0.25 (-0.42, -0.07)) were negatively associated with cognitive level. Results from the synthetic cohort mirrored NLSY, suggesting no significant association between abstention ({beta} = 0.13 (-0.10,0.36)) nor heavy drinking ({beta} = 0.02 (-0.25,0.28)) with mid-to-late life memory score. DISCUSSIONAlcohol consumption may not have an effect on memory until later life, though associations may be affected by residual confounding.

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