Background With economic development and associated multidimensional social changes, the past three decades have witnessed striking increase in alcohol consumption in China compared to other countries. Cognitive impairment is a serious threat to the health of the elderly in the context of demographic aging process. Previous cross-sectional studies and clinical trials have documented inconsistent conclusions on whether drinking alcohol has dose-response association with cognitive function in the literature. Using a nationally representative and longitudinal dataset, this research intends to examine the relationship between alcohol consumption and cognitive performance in elderly population in China.

Methods We used 2011–2013 longitudinal data from the China Health and Retirement Longitudinal Study (CHARLS) comprising 17314 participants with an average age of 59 years. Alcohol consumption was measured by drinking status (never, former, moderate, excessive drinkers) based on number of standard drinks per week. We studied mental intactness and episodic memory function as measures of cognitive functioning. Lagged dependent variable models were used to examine independent associations between alcohol consumption and cognitive functioning. Our models controlled for demographic factors, socioeconomic factors, baseline cognitive functioning and indicator for lifestyle. We also tested for an inverted J shaped relationship between drinking alcohol and cognitive functioning.

Results A total of 10404 nondrinkers (60.09%), 2450 former drinkers (14.15%), 1599 moderate drinkers (9.24%) and 1525 excessive drinkers (8.81%) were included. Compared to never drinkers, there were no statistically significant associations between this group and moderate drinking group. While, excessive drinkers were consistently associated with on average 0.13-point decrease in episodic memory scores fully adjusted model (P=0.031). For mental intactness, there were no statistically significant differences between never drinkers and other groups. Furthermore, we did not find evidence to support a J-shaped association between standard drinks per week and measures of cognitive functioning.

Conclusion Excessively drinking alcohol was associated with greater decline in episodic memory function, but not mental intactness. There is no association between moderate drinking group and cognitive functioning measures in elder Chinese population.