The Doctor’s Surgery
Theodore Dalrymple
A drink at lunchtime destroys my cognitive function for the ensuing afternoon, but the first drink of the evening (provided that I have not drunk at lunchtime) sharpens it greatly.
As that great physiologist Falstaff puts it, ‘It ascends me into the brain; dries me there all the foolish, and dull, and crudy vapours which environ it … which delivered o’er to the voice … becomes excellent wit.’ A third or fourth drink, however, undoes the good work, and again makes me sluggish of thought.
If the effect of alcohol varies in an individual over the short term, what of the effect of alcohol in whole groups over the long term? This is a question that has agitated both health Cavaliers and health Roundheads for many years, with the result that – as usual – everyone believes what they want to believe. Mankind is divided into two fundamental groups, the forbidders and the laissez-fairers.
A new university study from Athens, Georgia, attempts to answer the vexed question of whether a little bit of what you fancy (in this case, alcohol) does you good. The answer the researchers found was that moderate drinking is associated with – they studiously avoid using the word causes – a reduction in cognitive decline with age. Heavy drinking accelerates the decline, which is even faster among those who never drink.
As is always the case with such findings, there are problems with definitions, reliability and meaning. The authors define moderate drinking as up to eight drinks a week for women and 14 for men on self-report. The latter is notoriously unreliable, almost always in the direction of underestimate. And how significant, other than statistically, is the cognitive decline that they are able to measure?
Moreover, starting with a sample of 20,000 people, they were able to do some of their tests only on fewer than half of them. This alone could introduce a bias in the results.
Although the authors deny themselves the pleasure or the pain of claiming that the association between cognitive preservation and moderate drinking (as they define it) is causative, they nevertheless discuss the means by which it might be; for example, by reducing the number of strokes.
But this would depend on an association of moderate drinking with a lower rate of stroke, which is itself controversial. At the moment, the fashion is for claiming that where blood pressure and stroke are concerned there is no safe amount of alcohol, although previously it was held that moderate drinking was protective.
The authors fall back on a neoFalstaffian possible explanation that ‘Moderate drinking … increases brainderived neurotrophic factor levels, a key regulator of neuronal plasticity and development.’
Perhaps most interesting, though not commented upon by the authors, is that they found cognitive decline was more severe in those who could least afford such a decline – namely those who started out at a lower cognitive level in the first place.
My advice to readers, therefore, is to have been born intelligent: this will serve you in good stead later in your life. Fortunately for readers of The Oldie, this advice is superfluous.
The authors use the word ‘dose’ in connection with alcohol as if the latter were but a medicine and people drank only to ward off disease. Presumably they ask their guests whether they would like a dose of claret. Moreover, for the authors, alcohol is just alcohol, but there is a distinct possibility that the health effects of one type of alcohol are not the same as those of another. The scope for further inconclusive research is infinite.
Cheers!