How does drinking ruin your brain? [Oh Yunhwan's exclamation point]
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Suppression of brain activity like a car brake...Increased risk of premature dementia by two to three times
A 67-year-old man visited the hospital with his guardian. According to his guardian, his memory has declined a lot recently and his anger has increased. In particular, he has had a habit of drinking one bottle of soju every day for 20 years before going to bed due to old sleep disorders. The adverse health effects of excessive drinking are already well known. Drinking affects not only liver disease, gastrointestinal disease, and pancreatic disease, but also cognitive functions of the brain. Drinking can damage the structure and function of the hippocampus and frontal lobe of the brain, which degrades functions such as information processing, storage, and analysis, just as computer hard disks and central processing units are damaged. This leads to a decrease in cognitive functions including memory, concentration, and problem-solving ability.
The effect of drinking on cognitive function is related to the effect of alcohol on the brain's neurotransmitter system. Alcohol activates specific receptors (GABA) to inhibit brain activity, which is like continuing to step on a car brake. Low concentrations of alcohol have anti-anxiety effects, but at high concentrations, alcohol poisoning may be caused by other receptors.
In addition, alcohol blocks certain receptors (NMDA) and interferes with neurotransmission, which plays an important role in learning and memory. It's as if a road sign required while driving is obscured. Alcohol also reduces the level of acetylcholine in the brain, which is equivalent to engine performance degradation due to a lack of engine oil in a car. 90% of alcohol is metabolized from the liver through acetaldehyde to acetic acid and excreted. In this process, the metabolic rate of aldehyde dehydrogenase (ALDH), a speed-regulating enzyme, is limited, and when alcohol is consumed in excess at a rapid pace, acetaldehyde, an intermediate metabolite, accumulates. Acetaldehyde is a cytotoxic substance in most body tissues, including the brain. It is also known that alcohol can damage blood vessels in the brain and cause chronic hypoxic conditions in brain tissues, which promotes oxidative stress and neuroinflammation, accelerating the pathological mechanisms of Alzheimer's disease.
Asians have a greater risk of brain damage from drinking
Epidemiological studies show that people with alcohol disorders have significantly decreased cognitive function, executive function, memory, and attention compared to the control group. In another cohort study, people with a daily alcohol intake of 30g (4 cups based on 17 degrees soju) or more were more than three times more likely to develop Alzheimer's disease 23 years later than non-drinkers, and more than twice as likely to develop vascular dementia. In addition, a large-scale cohort study in France published in 2018 found that people with alcohol disorders were at about three times more risk of developing Alzheimer's disease early (before the age of 65) than those who did not.
Depending on the genetic polymorphism of alcoholase, the risk of cognitive decline due to alcohol may vary from person to person. Low enzyme activity to decompose alcohol can delay the decomposition of alcohol and acetaldehyde, causing more toxicity to the brain. It has been reported that Asians with low activity of these enzymes have a higher risk of brain damage even if they drink the same amount of alcohol.
As the weather gets warmer again, the number of dinners and drinking parties is increasing. Excessive drinking can affect the structure and function of the brain, resulting in cognitive decline. This is the result of a combination of various mechanisms such as the effect of alcohol on the brain's neurotransmitter system, chronic damage to the brain, malnutrition, liver function decline, and genetic factors. It is desirable to control the amount of alcohol consumed in consideration of an individual's disease history and genetic characteristics.
Oh Yoon-hwan, Professor of Family Medicine at Chung-Ang University Kwangmyong Hospital, [email protected]
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