Detailed Instructions: In this task, you are given a text of many news articles seperated by special token "|||||". Your task is to summarize them.
Q: (CNN) Excessive alcohol use could increase your risk for all types of dementia, particularly early-onset dementia, according to a new study. 
  
 The study, published Tuesday in the journal Lancet Public Health, looked at over 1 million adults released from French hospitals between 2008 and 2013 who were diagnosed with dementia, a clinical syndrome characterized by a progressive deterioration in cognitive ability. 
  
 Using data from the French National Hospital Discharge database, the researchers found that alcohol-use disorders were diagnosed in 16.5% of the men with dementia and 4% of the women with dementia -- over twice as much as in those without dementia for both sexes. 
  
 Alcohol-use disorders refer to "the chronic harmful use of alcohol or alcohol dependence," the researchers wrote. 
  
 In order to isolate the role of alcohol use, patients with neurological disorders such as Parkinson's and Huntington's , which can also lead to dementia, were excluded from the study. 
  
 "The most novel result is the large contribution of alcohol-use disorders to the burden of dementia over the lifespan," said Dr. Michael Schwarzinger, a researcher at the Transitional Health Economics Network in Paris and a leading author of the study. 
  
 The association was particularly strong for those with early-onset dementia, diagnosed when the patient is younger than 65. Over half of the individuals in the early-onset group had alcohol-related dementia or an additional diagnosis of alcohol-use disorder. 
  
 "Given the strength of the association, what is the most surprising to me is that alcohol-use disorders had received so little interest in dementia research and public health policies," Schwarzinger said. 
  
 How alcohol might damage the brain 
  
 Although many studies have shown a strong association between excessive alcohol use and dementia, this study is unique in its findings about early-onset dementia, according to Dr. Kostas Lyketsos, a neuropsychiatry professor and director of the Johns Hopkins Memory and Alzheimer's Treatment Center who was not involved in the study. 
  
 "That is rather unique," Lyketsos said. "It does remind us that alcoholics have shorter life expectancies." 
  
 The study was also among the largest of its kind. But, according to Lyketsos, the large size could leave the study open to selection bias. 
  
 "There's a tradeoff between size and precision of the variables," he said. "The more people you have, the less confidence you have in the elements that go into the diagnosis of dementia. 
  
 "I also want to point out that this was really a sample of hospitalized individuals. It's very unusual for people with dementia, at least in the milder stages, to be hospitalized," he added. 
  
 Research suggests multiple ways heavy alcohol use can lead to dementia. First, ethanol and its byproduct acetaldehyde are known to have a toxic effect on the brain that can lead to long-term structural and functional brain damage, Schwarzinger says. 
  
 Heavy alcohol use can also lead to a condition called hepatic encephalopathy, characterized by a loss in brain function due to increases of ammonia in the blood caused by liver damage. 
  
 "Heavy drinking is also strongly associated with vascular risk factors such as high blood pressure or diabetes mellitus as well as cardiovascular diseases," Schwarzinger added. 
  
 "Lastly, heavy drinking clusters (in) people with less education, smoking habits, and/or depression. All of these factors were found to be independent risk factors for dementia onset." 
  
 Though heavy alcohol use increased the risk of dementia in general, the association was shown to be stronger in men. 
  
 When other factors were not controlled for, heavy drinking was associated with a higher risk of dementia among both men and women. In men, the risk was increased by a factor of 4.7, while in women, it increased by a factor of 4.3. 
  
 But even when the researchers controlled for factors like high blood pressure, obesity and tobacco smoking, heavy alcohol use was still associated with a more than threefold increase in dementia among both sexes. 
  
 Results differed by sex 
  
 The study also showed that the average age of dementia onset differed between men and women. Men were more likely to develop it a younger age and women at an older age. 
  
 "Gender differences on dementia onset have been puzzling for decades," Schwarzinger said. "Men have a poorer lifestyle than women on average, in particular heavier alcohol consumption. Therefore, it is somewhat unsurprising that early-onset dementia identifies a cluster of men with alcohol use disorders." 
  
 The gender difference could also result from the study's methodology, according to Lyketsos. 
  
 "That was one of the reasons I'm a little concerned about selection bias," he said. "There could be a gender effect on who goes to the hospital with dementia." 
  
 Alcohol use was also not objectively measured in the participants, one of the study's main limitations. 
  
 "We have no idea what is the level of drinks they were actually drinking," Schwarzinger added. "That kind of information you can only get in a cohort study with a questionnaire." 
  
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 Though the study had a very large sample size, it looked at individuals in only one country, making it difficult to generalize across cultures. According to a 2014 report from the World Health Organization, each person consumes an average of 12.2 liters of pure alcohol in France versus 9.2 liters in the United States. 
  
 But Schwarzinger cautioned that people outside France should still take the findings seriously: "While the rate of alcohol use disorders is lower in the USA, it remains substantial enough to be considered major risk factor for dementia onset." ||||| Heavy drinkers are putting themselves at risk of dementia, according to the largest study of its kind ever conducted. 
  
 Research published in the Lancet Public Health journal provides powerful evidence that people who drink enough to end up in hospital are putting themselves at serious risk of vascular dementia and Alzheimer’s disease. It will also raise questions for moderate drinkers about the possible long-term consequences of their social habit. 
  
 The study, which used the French National Hospital Discharge database, looked at more than a million people diagnosed with dementia between 2008 and 2013. 
  
 Older people drinking too much could create NHS ‘timebomb’, says doctor Read more 
  
 More than a third – 38% of the 57,000 cases of early-onset dementia – were directly alcohol-related and 18% had an additional diagnosis of alcohol use disorders. Overall, alcohol use disorders were associated with a three times greater risk of all types of dementia. 
  
 Dr Sara Imarisio, head of research at Alzheimer’s Research UK, said: “As this study only looked at the people who had been admitted to hospital due to chronic heavy drinking, it doesn’t reveal the full extent of the link between alcohol use and dementia risk. Previous research has indicated that even moderate drinking may have a negative impact on brain health and people shouldn’t be under the impression that only drinking to the point of hospitalisation carries a risk.” 
  
 Experts said the new research should change attitudes. “What is most surprising about this paper is that it has taken us so long to recognise that alcohol misuse and dependence are such potent risk factors for the development of dementia,” said Robert Howard, professor of old age psychiatry at University College London. 
  
  
  
 “We have long known that alcohol is directly neurotoxic, thiamine deficiency in alcoholics devastates memory, alcohol-related conditions such as cirrhosis and epilepsy can damage the brain and that vascular brain damage is accelerated by alcohol. Surprisingly, we’ve not traditionally considered alcohol and its misuse as an important risk factor for dementia and we were clearly wrong not to have done so.” 
  
 Even moderate drinking can damage the brain, claim researchers Read more 
  
 The study was not set up to look at the effects of moderate drinking on people’s dementia risk. But the lead author, Dr Michaël Schwarzinger of the Translational Health Economics Network in France, warned that the research showed damage done to the brain by alcohol is never repaired. Heavy drinkers who had given up alcohol for a time did not reduce their dementia risk, even though they were less likely to die early. “It is very striking that for people who were heavy drinkers and had at least a period of abstinence, the level of risk of dementia is about the same,” he told the Guardian. 
  
 That is in line with imaging studies that have shown even moderate drinking has a permanent effect. A study published in the British Medical Journal last year found that those who drank 14-21 units a week had three times the normal odds of damage to that part of the brain concerned with memory. Guidance in the UK is not to drink more than 14 units a week. 
  
 Advice on alcohol and dementia has been confusing. Some studies have suggested that one or two units a day – perhaps a small glass of wine – could be protective. But Schwarzinger said they were small studies and he personally would question whether that can be so. 
  
  
  
 “Alcohol is a devastating problem, whatever the organ. Now we can add the brain to the list of liver, kidney and heart,” he said. 
  
 “A variety of measures are needed, such as reducing availability, increasing taxation, and banning advertising and marketing of alcohol, alongside early detection and treatment of alcohol use disorders.” 
  
 Prof Clive Ballard of the University of Exeter Medical School, UK, writing a commentary for the journal, said: “Their study is immensely important and highlights the potential of alcohol use disorders, and possibly alcohol consumption, as modifiable risk factors for dementia prevention … In our view, this evidence is robust and we should move forward with clear public health messages about the relationship between both alcohol use disorders and alcohol consumption, respectively, and dementia.” 
  
 Dr James Nicholls, director of policy and research development at Alcohol Research UK, said the concerns raised by the study were very serious. “If heavy alcohol use increases the risk of dementia then there are enormous social and economic implications,” he said. “We must recognise that good quality, widely accessible alcohol treatment has important long-term benefits, including reducing the levels of dementia in society. And we must invest in these services, reversing the trend of recent years.” |||||
A:
A new study suggests that heavy drinking raises a person's risk for dementia, especially the early-onset variety. The research, published in Lancet Public Health, looked at 1.1 million French hospital patients diagnosed with dementia from 2008 to 2013. Of those patients, 16.5% of the men and 4% of the women had alcohol use disorders, which CNN reports is about twice the rate of those without dementia. The stats for early-onset dementia were worse. Of 57,000 cases, 38% were "alcohol related by definition" and another 18% featured an additional diagnosis of alcohol use disorder, per the Guardian. The bottom line? "Alcohol use disorders were a major risk factor for onset of all types of dementia, and especially early-onset dementia" per the study. "Thus, screening for heavy drinking should be part of regular medical care." The WHO defines chronic heavy drinking as roughly four to five drinks a day for a man and about three for a woman, per Science Daily. And while the study focused on heavy drinking, the results raise questions for those who indulge in more moderate fashion as well, notes the Guardian. "What is most surprising about this paper is that it has taken us so long to recognize that alcohol misuse and dependence are such potent risk factors for the development of dementia," says Robert Howard of University College London. Study author Michael Schwarzinger says that while the rate of alcohol use disorders is lower in the US than in France, "it remains substantial enough to be considered [a] major risk factor for dementia onset."