Cognitive decline related to substance consumption in a Colombian kindred with familial Alzheimer's disease: A retrospective cohort study

Abstract

AbstractBackgroundSubstance use is a presumed risk factor for Alzheimer's Disease (AD). So, it would be essential to evaluate it in people who already have a high risk of dementia. Neuroscience Group of Antioquia, GNA, is a research group from Medellin, Colombia, which studies Presenilin 1 (PS1) E280A mutation carriers. These carriers will course four stages of AD: 1) asymptomatic Pre‐Mild Cognitive Impairment (Pre‐MCI), 2) symptomatic pre‐MCI, 3) MCI; and 4) Dementia. Substance consumption could modify age‐at‐onset of those stages, but this association has not been deeply explored.MethodWe performed a retrospective cohort study with 163 subjects enrolled between January 25, 2019, and April 29, 2020. Of those participants, 69 (42.3%) were non‐carriers, and 94 (57.7%) were carriers. A psychiatrist interviewed the subjects through the "CACoS" questionnaire, an instrument specifically designed for this research. The subjects' cognitive information included CERAD test battery, MMSE, CDR, and a subjective memory complaints checklist. We analyzed the relationship between the onset of AD stages and substance consumption through a time‐to‐event analysis (survival analysis and Cox proportional hazards regression).ResultFor dementia onset, there was an association with less than one time per month of alcohol consumption in the last year (HR 0.42, CI 0.18‐0.96). For MCI onset, there was a relationship with less than one time per month of alcohol consumption in the last year (HR 0.39, CI 0.17‐0.91), and also with consumption of 5 to 11 drinks per day of consumption in the previous twelve months (HR 0.12, CI 0.01‐0.99). For pre‐MCI onset, there was a relationship with daily coffee consumption throughout life (HR 2.37, CI 1.07‐5.25).ConclusionA low frequency of alcohol consumption could be protective against MCI and dementia, but coffee was associated with Pre‐MCI acceleration. It would be critical to continue exploring these substances' role as modifiable risk factors soon.