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Even moderate drinking can damage the brain, claim researchers

Nicola Davis in The Guardian


Drinking even moderate amounts of alcohol can damage the brain and impair cognitive function over time, researchers have claimed.

While heavy drinking has previously been linked to memory problems and dementia, previous studies have suggested low levels of drinking could help protect the brain. But the new study pushes back against the notion of such benefits.

“We knew that drinking heavily for long periods of time was bad for brain health, but we didn’t know at these levels,” said Anya Topiwala, a clinical lecturer in old age psychiatry at the University of Oxford and co-author of the research.

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Writing in the British Medical Journal, researchers from the University of Oxford and University College London, describe how they followed the alcohol intake and cognitive performance of 550 men and women over 30 years from 1985. At the end of the study the team took MRI scans of the participants’ brains.

None of the participants were deemed to have an alcohol dependence, but levels of drinking varied. After excluding 23 participants due to gaps in data or other issues, the team looked at participants’ alcohol intake as well as their performance on various cognitive tasks, as measured at six points over the 30 year period.

The team also looked at the structure of the participants’ brains, as shown by the MRI scan, including the structure of the white matter and the state of the hippocampus – a seahorse-shaped area of the brain associated with memory.

After taking into account a host of other factors including age, sex, social activity and education, the team found that those who reported higher levels of drinking were more often found to have a shrunken hippocampus, with the effect greater for the right side of the brain.

While 35% of those who didn’t drink were found to have shrinkage on the right side of the hippocampus, the figure was 65% for those who drank on average between 14 and 21 units a week, and 77% for those who drank 30 or more units a week.

The structure of white matter was also linked to how much individuals drank. “The big fibre tracts in the brain are cabled like electrical wire and the insulation, if you like, on those wires was of a poorer quality in people who were drinking more,” said Topiwala.


In addition, those who drank more were found to fare worse on a test of lexical fluency. “[That] is where you ask somebody to name as many words as they can within a minute beginning with a certain letter,” said Topiwala. People who drank between seven and 14 units a week were found to have 14% greater reduction in their performance on the task over 30 years, compared to those who drank just one or fewer units a week.

By contrast, no effects were found for other tasks such as word recall or those in which participants were asked to come up with words in a particular category, such as ‘animals.’

Expert reaction to the the study was mixed. While Elizabeth Coulthard, consultant senior lecturer in dementia neurology at the University of Bristol, described the research as robust, she cautioned that as the study was observational, it does not prove that alcohol was causing the damage to the brain.

Even small amounts of alcohol increase a woman's risk of cancer



In addition, the majority of the study’s participants were men, while reports of alcohol consumption are often inaccurate with people underestimating how much they drink – an effect that could have exaggerated the apparent impact of moderate amounts of alcohol.

Dr Doug Brown, director of research and development at Alzheimer’s Society said that the new research did not imply that individuals should necessarily turn teetotal, instead stressing that it was important to stick to recommended guidelines.

In 2016, the Department of Health introduced new alcohol guidelines in the UK, recommending that both men and women drink no more than 14 units of alcohol each week – the equivalent of about six pints of beer or seven 175ml glasses of wine.

“Although this research gives useful insight into the long-term effects that drinking alcohol may have on the brain, it does not show that moderate alcohol intake causes cognitive decline. However, the findings do contradict a common belief that a glass of red wine or champagne a day can protect against damage to the brain,” said Brown.

Three-day working week 'optimal for over-40s'

• 18 April 2016
 
• From the sectionBBC Business

Image copyrightAP

Workers aged over 40 perform at their best if they work three days a week, according to economic researchers.

Their research analysed the work habits and brain test results of about 3,000 men and 3,500 women aged over 40 in Australia.

Their calculations suggest a part-time job keeps the brain stimulated, while avoiding exhaustion and stress.

The researchers said this needed to be taken into consideration as many countries raise their retirement age.

Double-edged sword

Data for the study was drawn from the Household, Income and Labour Dynamics in Australia survey, which is conducted by the Melbourne Institute of Applied Economics and Social Research at the University of Melbourne.

It looks at people's economic and subjective well-being, family structures, and employment.

Those taking part were asked to read words aloud, to recite lists of numbers backwards and to match letters and numbers under time pressure.

In general terms, those participants who worked about 25 hours a week tended to achieve the best scores.

"Work can be a double-edged sword, in that it can stimulate brain activity, but at the same time, long working hours and certain types of tasks can cause fatigue and stress which potentially damage cognitive functions," the report said.

Colin McKenzie, professor of economics at Keio University who took part in the research, said it would appear that working extremely long hours was more damaging than not working at all on brain function.

The figures suggest that the cognitive ability of those working about 60 hours a week can be lower than those who are not employed.

However, Geraint Johnes, professor of economics at Lancaster University Management School, said: "The research looks only at over-40s, and so cannot make the claim that over-40s are different from any other workers.

"What the authors find is that cognitive functioning improves up to the point at which workers work 25 hours a week and declines thereafter."

He added: "Actually, at first the decline is very marginal, and there is not much of an effect as working hours rise to 35 hours per week. Beyond 40 hours per week, the decline is much more rapid."

20 Cognitive Biases That Screw Up Human Decisions

What Does it Mean to be a Physician?

Whitcomb, Michael E. MD

 Extraordinary changes have occurred during the past few decades in the design and conduct of the medical school curriculum. To a great extent, this reflects a commitment by medical school deans and faculties to better prepare their students for the challenges they will face throughout their professional careers. The changes that have been adopted are truly impressive, yet there is still more to be accomplished. I have suggested on several occasions that in order for the medical education community to be clear about the kind of changes that are needed, the community needs to define more clearly the purpose of the educational program.^1,2 And I have suggested that in order to reach agreement on that purpose, the community must first answer a fundamental question: What does it mean to be a physician?

This approach reflects my belief that one of the primary purposes of the educational program is for students to learn, in depth, what it means to be a physician. After all, the title is bestowed upon them when they graduate from medical school, even though they are not yet prepared for the actual practice of medicine. Even so, shouldn’t they have an understanding of what it means to be a physician when they receive the title? In posing the question I am not seeking a formal definition of the term physician that one might find in a dictionary. My intent, instead, is to seek agreement within the medical education community on the attributes—that is, the personal qualities—that a physician should possess if he or she is to be capable of meeting the public’s expectations of a doctor.

Some have suggested that possessing a body of knowledge and a set of skills that can be applied in the practice of medicine defines what it means to be a physician. Now, there is no question that certain knowledge and certain skills are essential elements of being a physician. But it is also clear that the knowledge and skills required vary depending upon the particular career path a physician has chosen. So, while it is essential for physicians to be knowledgeable and skillful in order to engage in the practice of medicine, it is not possible to define what it means to be a physician by identifying a body of knowledge and a set of skills that all physicians must possess. On the other hand, there is a specific set of personal attributes that I maintain all physicians should possess if they are to meet the public’s expectations, and that it is those attributes that define the essence of what it means to be a physician.

First, a physician must be caring. One of the most famous quotes in the annals of American medicine comes from the address Francis Peabody gave to Harvard medical students in 1925.³ In that address, Peabody stated, “The secret of the care of the patient is in caring for the patient.” There are many texts that describe in eloquent terms the value that patients place on being truly cared for by a physician. But in modern times, members of the medical profession have too often equated caring with treatment, and have tended at times to limit their role to providing treatment leading to a cure. Unfortunately, this approach has too often meant that physicians ignored the importance of a caring manner, no matter what the treatment options were. Worse, once a patient could no longer be cured, too many physicians believed that there was nothing more to be done and attended in only a minimum way to the patient’s needs. In fact, it is now clear that caring for patients becomes more critical in situations in which the patient understands that treatment will no longer be useful and cure is no longer possible.

A few years ago, the Hastings Center initiated a project to define the goals of medicine.⁴ One of the four major goals that evolved from the project was called The Care and Cure of Those with a Malady, and the Care of Those Who Cannot be Cured. It is essential, therefore, that physicians understand clearly that to serve the goals of medicine, they have a responsibility to continue to care for their patients when they can no longer prescribe a particular form of treatment or offer the likelihood of a cure. If they do not continue to provide care under those circumstances—that is, by being caring—their patients will sense that they have been abandoned by their doctor at a critical time. Clearly, the essence of what it means to be a physician requires that a physician not allow this to occur.

Second, physicians must be inquisitive. Medicine has a long tradition of celebrating all that the members of the profession know about mechanisms of disease and the diagnosis and management of various clinical maladies. Indeed, admission to the study of medicine and advancement throughout the various stages of one’s career are often based solely on what one knows. But the fact is that there is a great deal about medicine that is not known, and there is a great deal that individual physicians do not know about what is known.

Given that, the value of physicians’ being inquisitive about medicine is clear. This attribute contributes in an important way to the quality of care provided by physicians by ensuring that they continue to acquire the knowledge and skills they will need to meet their professional responsibilities as the nature of medicine changes during their careers. But it is also important to recognize that this attribute contributes in a more immediate way to the quality of the care provided to individual patients.

In his new book, How Doctors Think, Jerome Groopman⁵ emphasizes that most of the diagnostic errors made by physicians result from cognitive mistakes. He points out that because of the uncertainty inherent in the practice of medicine, there is a tendency for physicians when encountering a patient to lock in too soon on a particular diagnosis or a particular approach to treatment. By doing so, the physician runs the risk of overlooking clues suggesting that the working diagnosis may not be correct. Even though a patient may present with the classic manifestations of a particular malady, the true physician will always pause before making a diagnosis and embarking on a course of therapy by asking himself or herself, What is there about this patient’s presentation that I don’t understand? Or, importantly, What is there about this patient that I should know before proceeding?

And finally, physicians must be civic minded. This is a confusing concept to grasp, because in modern times the civic responsibility of the individual physician tends to be obscure. Over the years, this responsibility has come to be viewed as an element of professionalism that is somehow embedded, at least implicitly, within the context of the social contract that defines the medical profession’s responsibility to the society as a whole—a responsibility manifested largely by how professional organizations relate to the public. But Bill Sullivan⁶suggests in Work and Integrity: The Crisis and Promise of Professionalism in America that it is critically important that individual physicians become more personally involved in meeting medicine’s responsibility to society. In his view, they must concern themselves with ensuring that the professional organizations to which they belong are focused on serving the interests of the public, rather than simply serving the interests of the organization’s members. But the civic mindedness of physicians should go beyond that to include consciously contributing in a variety of ways to the betterment of the communities in which they live by participating in community organizations and bringing their special talents to bear in volunteer efforts specifically aimed at improving the health of the public.

So, I suggest that although a physician who is not caring, inquisitive, and civic minded may be a highly skilled technician involved in the practice of medicine, such an individual will not truly reflect the essence of what it means to be a physician. Given this, it is essential that as medical schools continue to modify their educational programs, they ensure that those programs reflect a commitment to ensuring that their graduates be caring, inquisitive, and civic-minded physicians. Deans and faculties of medical schools must understand clearly that while their graduates will spend their residencies acquiring much of the knowledge and many of the skills they will need for the practice of their chosen specialties, it is in medical school that they must learn the essential attributes of a true physician.

Are Footballers cleverer than PhD students? Think again

Ability is dictated by what we need to succeed. A chimp would fare better than me in a jungle – that doesn't make it smarter

• Dean Burnett
• guardian.co.uk, Friday 1 February 2013 17.12 GMT

'How can a test accurately measure something when there is no certainty as to what is being measured?' Photograph: Nick Potts/PA

A recent study has shown that footballers can perform better than PhD students on certain cognitive tasks. This is being interpreted in the mainstream media as evidence that footballers are smarter than PhD students. While this is something of a considerable extrapolation, it is a perfect example of how our views and ideas about what counts as "intelligence" are a lot more flexible than most would think.

Scientifically, there is no real consensus per se on what intelligence can be accurately defined as. IQ tests may seem like an obvious way to assess intelligence, but in psychology their use remains controversial. How can a test accurately measure something when there is no certainty as to what is being measured? When you've got demonstrating that intelligence is dependent on working memory capacity, or arguing whether it's supported by singular or multiple processes, you need to be reasonably intelligent to keep up with the varying theories about what that even means.

Intelligence is also strongly influenced by culture. What's considered smart in one culture could well be considered foolish in another. We are all guilty of this bias to some extent. In the UK, a detailed knowledge of science is considered intelligent by many, whereas a detailed knowledge of football usually isn't. But there's nothing to say someone's football knowledge isn't just as or more complex and diverse than someone's knowledge of science. But football is everywhere, you don't need a degree to know about it, children play it all the time – so an in-depth knowledge of it is, perhaps unfairly, not considered an achievement.

Of course, knowing a lot of detailed information about something is only part of intelligence. It's also important to consider how this information is used. This division is referred to by some as crystallised and fluid intelligence, or information you retain and your ability to use it, respectively. Think of it like a computer: you've got your hard drive (data storage) and your processor (data usage); you need both to create a truly useful device.

This is reflected in changes to the structure of the brain, as the brain adapts and dedicates more resources to this constantly occurring demand. Therefore, it shouldn't be surprising that professional footballers would be better at certain mental abilities than non-footballers.

Whatever you think of the sport, a professional football match is undoubtedly a challenging context to be in. With so many variables to consider in a constantly changing scenario, it would be hard enough to keep on top of without thousands of people screaming at you for various reasons. Footballers have to be able to do this if they wish to get to the top of their field, so of course they'd perform better in tests that assess rapid thinking, attention and any other ability that isn't so crucial for other disciplines.

Footballers are stereotyped as being a bit thick, based on their unrefined behaviour and lack of social/cultural awareness. But these things haven't exactly held them back, so why would they have learned otherwise? Our abilities and skills are largely dictated by what we need to do in order to succeed. A chimpanzee would be far better equipped than I to survive in the jungle and would undoubtedly perform better than me in tests that assessed this. Still, I wouldn't let one fill in my tax return.

Perhaps intelligence is the wrong term to use, perhaps it would be fairer to say footballers and PhD students have differing mental abilities. But which of these abilities is considered "intelligent" seems to be a lot more subjective than most people realise.

Liberal Constipation

 George Monbiot

Self-deprecating, too liberal for their own good, today’s progressives stand back and watch, hands over their mouths, as the social vivisectionists of the right slice up a living society to see if its component parts can survive in isolation. Tied up in knots of reticence and self-doubt, they will not shout stop. Doing so requires an act of interruption, of presumption, for which they no longer possess a vocabulary.

Perhaps it is in the same spirit of liberal constipation that, with the exception of Charlie Brooker(1), we have been too polite to mention the study published last month in the journal Psychological Science, which revealed that people with conservative beliefs are likely to be of low intelligence(2). Paradoxically it was the Daily Mail which brought it to the attention of British readers last week(3). It feels crude, illiberal to point out that the other side is, on average, more stupid than our own. But this, the study suggests, is not unfounded generalisation but empirical fact.

It is by no means the first such paper. There is plenty of research showing that low general intelligence in childhood predicts greater prejudice towards people of different ethnicity or sexuality in adulthood(4). Open-mindedness, flexibility, trust in other people: all these require certain cognitive abilities. Understanding and accepting others—particularly “different” others—requires an enhanced capacity for abstract thinking.

But, drawing on a sample size of several thousand, correcting for both education and socioeconomic status, the new study looks embarrassingly robust. Importantly, it shows that prejudice tends not to arise directly from low intelligence, but from the conservative ideologies to which people of low intelligence are drawn. Conservative ideology is the “critical pathway” from low intelligence to racism. Those with low cognitive abilities are attracted to “right-wing ideologies that promote coherence and order” and “emphasize the maintenance of the status quo”(5). Even for someone not yet renowned for liberal reticence, this feels hard to write.

This is not to suggest that all conservatives are stupid. There are some very clever people in government, advising politicians, running thinktanks, writing for newspapers, who have acquired power and influence by promoting rightwing ideologies.

But what we now see among their parties—however intelligent their guiding spirits may be—is the abandonment of any pretence of high-minded conservatism. On both sides of the Atlantic, conservative strategists have discovered that there is no pool so shallow that several million people won’t drown in it. Whether they are promoting the idea that Barack Obama was not born in the US, that manmade climate change is an eco-fascist-communist-anarchist conspiracy or that the deficit results from the greed of the poor, they now appeal to the basest, stupidest impulses, and find that it does them no harm in the polls.

Don’t take my word for it. Listen to what two former Republican ideologues, David Frum and Mike Lofgren, have been saying. Frum warns that “conservatives have built a whole alternative knowledge system, with its own facts, its own history, its own laws of economics.”(6) The result is a “shift to ever more extreme, ever more fantasy-based ideology” which has “ominous real-world consequences for American society.”

Lofgren complains that “the crackpot outliers of two decades ago have become the vital center today”(7). The Republican party, with its “prevailing anti-intellectualism and hostility to science” is appealing to what he calls the “low-information voter” or the “misinformation voter.” While most office holders probably don’t believe the “reactionary and paranoid claptrap” they peddle, “they cynically feed the worst instincts of their fearful and angry low-information political base”.

The madness hasn’t gone as far in the UK, but the effects of the Conservative appeal to stupidity are already making themselves felt. Yesterday the Guardian reported that recipients of disability benefits, scapegoated by the government as scroungers, blamed for the deficit, now find themselves subject to a new level of hostility and threats from other people(8).

These are the perfect conditions for a billionaires’ feeding frenzy. Any party elected by misinformed, suggestible voters becomes a vehicle for undisclosed interests. A tax break for the 1% is dressed up as freedom for the 99%. The regulation that prevents big banks and corporations from exploiting us becomes an assault on the working man and woman. Those of us who discuss manmade climate change are cast as elitists by people who happily embrace the claims of Lord Monckton, Lord Lawson or thinktanks funded by ExxonMobil or the Koch brothers: now the authentic voices of the working class.

But when I survey this wreckage I wonder who the real idiots are. Confronted with mass discontent, the once-progressive major parties, as Thomas Frank laments in his latest book Pity the Billionaire, triangulate and accommodate, hesitate and prevaricate, muzzled by what he calls “terminal niceness”(9). They fail to produce a coherent analysis of what has gone wrong and why, or to make an uncluttered case for social justice, redistribution and regulation. The conceptual stupidities of conservatism are matched by the strategic stupidities of liberalism.

Yes, conservatism thrives on low intelligence and poor information. But the liberals in politics on both sides of the Atlantic continue to back off, yielding to the supremacy of the stupid. It’s turkeys all the way down.