Background Mild cognitive impairment (MCI) is a cognitive state falling between normal aging and dementia. The relation between alcohol intake and risk of MCI as well as progression to dementia in people with MCI (PDM) remained unclear. Objective To synthesize available evidence and clarify the relation between alcohol intake and risk of MCI as well as PDM. Method We searched electronic databases consisting of PubMed, EMBASE, Cochrane Library, and China Biology Medicine disc (CBM) from inception to October 1, 2019. Prospective studies reporting at least three levels of alcohol exposure were included. Categorical meta-analysis was used for quantitative synthesis of the relation between light, moderate and heavy alcohol intake with risk of MCI and PDM. Restricted cubic spline and fixed-effects dose-response models were used for dose-response analysis. Result Six cohort studies including 4244 individuals were finally included. We observed an unstable linear relation between alcohol intake (drinks/week) and risk of MCI (P linear = 0.0396). It suggested that a one-drink increment per week of alcohol intake was associated with an increased risk of 3.8% for MCI (RR, 1.038; 95% CI 1.002-1.075). Heavy alcohol intake (> 14 drinks/week) was associated with higher risk of PDM (RR = 1.76; 95% CI 1.10-2.82). And we found a nonlinear relation between alcohol intake and risk of PDM. Drinking more than 16 drinks/week (P nonlinear = 0.0038, HR = 1.42; 95% CI 1.00-2.02), or 27.5 g/day (P nonlinear = 0.0047, HR = 1.46; 95% CI 1.00-2.11) would elevate the risk of PDM. Conclusion There was a nonlinear dose-response relation between alcohol intake and risk of PDM. Excessive alcohol intake would elevate the risk of PDM.

OBJECTIVES: To systematically identify, appraise, and summarize research on the effects of behavioral interventions to prevent cognitive decline in community-dwelling older adults using a holistic wellness framework. DESIGN: Systematic review of randomized controlled trials that tested the effectiveness of behavioral interventions within each of the six dimensions of wellness: occupational, social, intellectual, physical, emotional and spiritual. Databases searched included PubMed MEDLINE, EMBASE, CENTRAL, PsycINFO, CINAHL, ALOIS, and The Grey Literature Report through July 1, 2014. SETTING: Community. PARTICIPANTS: Individuals aged 60 and older (N = 6,254). MEASUREMENTS: Consolidated Standards of Reporting Trials Checklist. RESULTS: Eighteen studies met the inclusion criteria. Interventions in the physical dimension of wellness were most common (11 studies); interventions in the spiritual dimension were least common (0 studies). Fifty-nine different measures were used to measure multiple cognitive domains, with memory being the most commonly measured (17 studies) and language being the least commonly measured (5 studies). Fifty percent of the interventions examined in the 18 studies demonstrated statistically significant outcomes on at least one cognitive measure. Interventions in the intellectual dimension that examined cognitively stimulating activities using pen and paper or a computer represented the greatest percentage of statistically significant outcomes. CONCLUSION: Intellectual and physical interventions were most studied, with varied results. Future research is needed using more-consistent methods to measure cognition. Researchers should include the National Institutes of Health Toolbox Cognition Battery among measurement tools to facilitate effective data harmonization, pooling, and comparison