Give up all drink or risk de­men­tia

GPs to tell mid­dle-aged they must change their life­style to lower Alzheimer’s threat

The Daily Telegraph - - Front Page - By Laura Don­nelly HEALTH EDITOR

MID­DLE-AGED peo­ple should be told that there is “no safe level of al­co­hol con­sump­tion” and should stop drink­ing al­to­gether if they want to re­duce the risk of de­men­tia, health watch­dogs will warn to­day.

Guid­ance from the Na­tional In­sti­tute of Health and Care Ex­cel­lence (Nice) on how to pro­tect against de­men­tia sug­gests that even drink­ing within the Gov­ern­ment’s safe lim­its can in­crease the risk of Alzheimer’s dis­ease.

The ad­vice says drink­ing any al­co­hol can in­crease the risk of de­men­tia, dis­abil­ity and frailty, telling GPs that peo­ple should be en­cour­aged “to re­duce the amount they drink as much as pos­si­ble”. It sug­gests Bri­tain’s “so­cial norms” when it comes to al­co­hol “need to be chal­lenged”.

The warn­ing – by the of­fi­cial watch­dog that in­forms the NHS on which drugs and treat­ments to of­fer – comes as the Gov­ern­ment for­mally re­views “safe” lev­els of al­co­hol con­sump­tion. Last year, Nice sug­gested in draft guid­ance that the rules should be re­vised, but it will to­day is­sue for­mal guid­ance that will put min­is­ters un­der pres­sure to scrap cur­rent rec­om­men­da­tions.

The new ad­vice says the pub­lic should be told that there is “no safe level of al­co­hol con­sump­tion” and calls on GPs to tackle the mid­dle-aged about life­style be­hav­iours linked to de­men­tia.

Re­search has found that one third of all cases of Alzheimer’s dis­ease can be linked to life­style fac­tors such as ex­er­cise, obe­sity, smok­ing and al­co­hol. The guid­ance is aimed at adults aged be­tween 40 and 65, amid con­cerns that many of the life­styles of those in midlife now are worse than those of pre­vi­ous gen­er­a­tions, and will con­trib­ute to a ris­ing tide of de­men­tia.

The ad­vice says that early ac­tion to im­prove life­styles has the great­est im­pact, but that it is never too late to re­duce the risk of the con­di­tion.

The cur­rent gov­ern­ment ad­vice sug­gests women can drink two to three units of al­co­hol a day (one 175ml glass of wine) and men three units with­out com­pro­mis­ing their health. “Drink­ing al­co­hol daily at home has be­come nor­mal for some peo­ple, and this poses a threat to health,” the guid­ance says.

It also says peo­ple should not see mid­dle age or retirement as a time to slow down their pace of life.

“Re­duc­ing ac­tiv­ity – ‘slow­ing down’ and hav­ing ‘earned a rest’ – are of­ten seen as an ex­pected part of grow­ing older,” it says, but sug­gests that in­stead, health would be bet­ter pro­tected by a more ac­tive life­style in mid-life.

The rec­om­men­da­tions for the NHS and lo­cal coun­cils also call for sweep­ing changes in the way pub­lic spa­ces are gov­erned, in an ef­fort to re­duce rates of smok­ing. It calls for smoke-free poli­cies to be ex­panded to cover pub­lic parks and open-air mar­kets.

John Britton, pro­fes­sor of epi­demi­ol­ogy at the Univer­sity of Not­ting­ham and Nice guide­line de­vel­op­ment group chair­man, said: “It is well known that smok­ing, too much al­co­hol, in­ac­tiv­ity and be­ing over­weight is bad for our health, but many peo­ple don’t re­alise

that th­ese things can also in­crease the like­li­hood of de­vel­op­ing de­men­tia and other causes of poor qual­ity of life in older age.

“The ev­i­dence we looked at sug­gested that peo­ple can pre­vent th­ese out­comes by mak­ing sim­ple changes in life – stop­ping smok­ing, cut­ting al­co­hol, be­ing more ac­tive and los­ing weight. Even small but reg­u­lar changes – such as climb­ing the stairs in­stead of us­ing an es­ca­la­tor – can have sig­nif­i­cant ef­fects.”

The guid­ance stresses that not all de­men­tia risks can be elim­i­nated, given some will have a ge­netic sus­cep­ti­bil­ity to the con­di­tion, and warns against sug­gest­ing those who de­velop it are “at fault”.

Hi­lary Evans, chief ex­ec­u­tive of Alzheimer’s Re­search UK, said: “There is now mount­ing ev­i­dence that a healthy life­style from mid-life can help to re­duce the risk of de­men­tia in later life, but pub­lic un­der­stand­ing of the risk fac­tors for de­men­tia is still low.”

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