Alzheimer's disease (AD) , the most common type of dementia, poses a significant threat to the global elderly population. In recent years, alcohol consumption in China has been steadily increasing. As a potential lifestyle factor, drinking behavior may influence AD progression, but the relationship with AD-related brain changes remains insufficiently understood.

To investigate the impact of alcohol consumption on brain structural changes in AD patients using voxel-based morphometry (VBM) analysis.

Data were retrospectively collected from AD patients hospitalized at Huashan Hospital, Fudan University, between 2020 and 2023. Information on alcohol consumption, brain MRI scans, and other clinical variables was obtained through medical records and telephone follow-up. A total of 66 AD patients with complete data were included in the analysis. Patients were stratified by disease severity (based on Mini-mental State Examination scores) and drinking status into mild-to-moderate AD with and without a history of alcohol consumption, severe AD with and without a history of alcohol consumption. VBM was used to compare differences in gray matter volume (GMV) among the groups.

Among the 66 patients, 42 had mild-to-moderate AD, and 24 had severe AD. Among the mild-to-moderate group, 16 had a history of alcohol consumption and 26 did not. Among patients with mild to moderate AD, the proportion of males with a history of alcohol consumption and the proportion of those with a history of smoking were higher than those without such histories (P<0.05) . Among the 24 patients with severe AD, 9 had a history of alcohol consumption and 15 did not. Among the patients with severe AD, the proportion of males with a history of alcohol consumption and the proportion of those with a history of smoking were higher than those without a history of alcohol consumption (P<0.05) . In patients with mild to moderate AD, the GMV of the right angular gyrus in those without a history of alcohol consumption was lower than that in those with a history of alcohol consumption (t=-3.698, P<0.05) . In patients with severe AD who had a history of alcohol consumption, the GMV of the left superior temporal gyrus was lower than that of those without a history of alcohol consumption (t=5.774, P<0.05) .

A history of alcohol consumption appears to significantly influence patterns of gray matter atrophy in AD patients. In mild-to-moderate AD, drinking may be associated with attenuated atrophy in the right angular gyrus, whereas in severe AD, it is linked to increased atrophy in the left superior temporal gyrus. These findings suggest a dual role of alcohol consumption in the progression of AD.

阿尔茨海默病（AD）作为认知症最常见的类型，对全球老年人群危害严重，而近年来中国饮酒量不断增加，饮酒习惯作为一种潜在的生活方式因素，其与AD疾病进展的关系尚未被充分揭示。

通过基于体素大脑形态学分析（VBM）技术，探究饮酒对不同AD患者大脑结构变化的影响。

收集2020—2023年在复旦大学附属华山医院住院的确诊为AD的患者资料，采用回顾性病历信息采集及电话回访的方式对AD患者饮酒情况、颅脑结构核磁共振成像数据等信息进行收集，对数据完整的66例AD患者进行分析。根据AD严重程度（依据简易精神状态量表得分进行划分）及饮酒情况分为轻中度AD患者有无饮酒史者及重度AD患者有无饮酒史者，利用VBM方法比较不同AD患者脑灰质体积（GMV）差异。

66例AD患者中，轻中度AD患者42例、重度AD患者24例。42例轻中度AD患者中有饮酒史者16例，无饮酒史者26例。轻中度AD患者中有饮酒史者男性所占比例、有吸烟史所占比例高于无饮酒史者（P<0.05）。24例重度AD患者中有饮酒史者9例，无饮酒史者15例。重度AD患者中有饮酒史者男性所占比例、有吸烟史所占比例高于无饮酒史者（P<0.05）。轻中度AD患者中无饮酒史者大脑右侧角回GMV小于有饮酒史者（t=-3.698，P<0.05）。重度AD患者中有饮酒史者大脑左侧颞上回GMV小于无饮酒史者（t=5.774，P<0.05）。

饮酒史可显著影响AD患者大脑GMV的萎缩模式，轻中度患者主要表现为右侧角回萎缩减轻，而重度患者则以左侧颞上回萎缩加重为特征，即饮酒在AD进程中具有双重作用。