Evidence for the harmful effects of alcohol on brain health has been compelling. And now researchers in the UK and Australia have shown evidence suggesting three periods of dynamic changes in the brain that could be particularly sensitive to the harmful effects of alcohol – gestation (conception to birth), later adolescence (15 to 19 years of age) and older adulthood (over 65 years).
The team warns that these three key periods could increase sensitivity to the effects of environmental exposures such as alcohol and harm prevention policies should take the long view.
Worldwide, around 10% of pregnant women drink alcohol with the rates considerably higher in European countries. Heavy alcohol consumption during pregnancy can lead to fetal alcohol spectrum disorder, cognitive impairment, and is associated with widespread reductions in brain volume. Data also suggests that even low to moderate consumption during pregnancy is significantly linked to poorer psychological and behavioral outcomes in offspring.
In regards to the adolescent years, more than 20% of 15 to 19 year olds in European and other high income countries report at least occasional binge drinking which is defined as 60g of ethanol on a single occasion.
Studies have shown that the transition to binge drinking in adolescence is linked to reduce brain volume, small to moderate deficits in a range of cognitive functions, and poorer white matter development which is critical to efficient brain functioning.
In older people, alcohol disorders are relatively rare in older adults, however even moderate drinking has been shown to be associated to a small but significant loss of brain volume in midlife. Further studies are needed however, to test whether these structural changes translate into functional impairment.
Additionally, demographic trends could compound the effect of alcohol consumption on brain health. As an example, women are now just as likely as men to consume alcohol and experience alcohol related harms.
It is forecast that global consumption of alcohol will rise further in the next decade. The effects of alcohol use and related harms during the COVID-19 pandemic are unclear, however alcohol use increased in the long term after other major public health crises.
The team suggests that population based interventions such as guidelines on low risk drinking, lower drink driving limits, and alcohol pricing policies need to be accompanied by the development of care and training pathways that take into account the human brain at risk throughout life.
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