Alcohol Use and Cognitive Functioning Among Middle‐Aged and Older Adults in China: Findings of the China Health and Retirement Longitudinal Study Baseline Survey

Background Alcohol use and its associated problems are on the rise in China. In this study, we examined the associations between alcohol use and cognitive functioning in a representative sample of adults aged 45 years and older in China. Methods Baseline data for 16,328 participants of the China Health and Retirement Longitudinal Study were analyzed. Alcohol use was measured by drinking status (never, former, moderate, and at‐risk drinkers), number of standard drinks per week, and years of drinking. Cognitive functioning was assessed for visuospatial ability, episodic memory, orientation/attention, and overall cognitive functioning. Multivariate linear and logistic regressions were used to examine the independent association between alcohol use and cognitive functioning controlling for age, gender, education, domestic partner status, and depressive symptoms. Results The study participants were, on average, 66 years old (median 59, range 45 to 102). The prevalence of ever drinking during lifetime and current at‐risk drinking (>14 drinks per week) in this population was 34.6 and 6.7%, respectively. Drinking was more common among men with 48.8% being ever drinkers and 14.4% current at‐risk drinkers, respectively. At‐risk drinkers, compared to people who never drank alcohol, had worse episodic memory (β = −0.11, p = 0.048). Moreover, number of standard drinks per week was associated with worse episodic memory (β = −0.001, p = 0.02). None of the other measures of alcohol use was associated with the overall or domain‐specific cognitive functioning. Conclusions At‐risk drinking status was associated with worse episodic memory. Clinicians should incorporate alcohol use assessment into routine care for middle‐aged and older adults in China and provide them with resources and strategies to effectively manage their alcohol use. This may help preserve episodic memory in this population. Among 16,328 adults aged 45 years and older in China, the average episodic memory scores after adjustment for age, gender, education, domestic partner status, and depressive symptoms were highest among former drinkers and lowest among at‐risk drinkers (people who had >14 drinks [one drink equals 14 grams of pure alcohol] per week).