Should I drink water or wine? Impacts of online nutritional counseling on the alcohol consumption of elderly individuals with mild cognitive impairment

Abstract Background People with mild cognitive impairment (MCI) have an increased health risk when they consume alcohol in comparison with people without cognitive impairment. Excessive alcohol consumption is an established modifiable risk factor that contributes to the risk of developing dementia. Objective Within a secondary data analysis of a 2 × 2 randomized controlled trial (RCT) – consisting of a computerized cognitive intervention and a nutrition counseling intervention –, we evaluated the impact of a nutritional counseling group (neither focusing solely on alcohol consumption) on alcohol consumption in people with MCI at a 12-months follow-up, identified predictors of changes in alcohol consumption, and determined whether women benefited in the same way as men. Methods One hundred eighty-nine (189) of 270 trial participants reported consuming alcohol at baseline and started one of the two nutritional counseling programs (ITT sample). Data were collected at a 12-months follow-up and imputed for n = 15 participants. Participants received either whole-food plant-based (WFPB) nutritional group counseling or nutritional group counseling based on the German Nutrition Society’s (DGE) recommendations. Alcohol consumption was quantified with standard drinks (10 g alcohol)/day. Multiple linear regressions were used to identify potential predictors of reduction. P -values were corrected. Results The sample’s average age was 70.6 years and nearly showed gender parity (52% female). Both interventions led to a significant reduction in alcohol consumption in people with MCI after 12 months (Cohen''''s d = .30 (WFPB); Cohen''''s d = .39 (DGE)). There were no significant differences in the change in consumption level over time between the nutritional counseling groups ( p = .173). Women substantially reduced their alcohol consumption over time only in the DGE nutritional counseling group (Cohen''''s d = .33). In successful alcohol reducers ( n = 84), higher baseline alcohol consumption (β = .670, p < .001), older age (β = .158, p = .035), and stricter adherence in the counseling group (β = .184, p = .017) were significant predictors of a greater reduction ( F (7,76) = 18.539, p = .003). Higher cognitive functioning was a significant negative predictor of reduction (β = -.199, p = .009). Conclusion In context of the lifestyle intervention of the BrainFit-Nutrition study, nutritional counseling for people with MCI was effective for reducing alcohol intake. Our results suggest focusing on younger people living with MCI as well as higher educated people, especially men, to optimize the potential of modifiable risk factors for dementia. However, gender differences exist. A gender-specific nutritional counseling program is advised in the light of the gender health gap. Trial registration ISRCTN10560738; registered 11/23/2021.