Highlights
- •There are no population studies estimating the burden of alcoholic cerebellar degeneration.
- •Small studies have estimated that 33% to 67% of alcohol abusers have cerebellar degeneration.
- •Cerebellar dysfunction was present in 14.6% of chronic alcoholics living in rural Ecuador.
- •Years of drinking, amount of alcohol intake and binge drinking were associated with cerebellar dysfunction.
- •This low prevalence might be explained by an adequate nutritional status of participants.
Abstract
Background
There are no population studies estimating the burden of alcoholic cerebellar degeneration
(ACD). We aimed to assess prevalence and correlates of ACD among chronic alcohol drinkers
living in rural Ecuador.
Methods
Characteristics of alcohol intake were evaluated in community-dwelling men aged ≥40 years enrolled in the Atahualpa Project. Cerebellar dysfunction evaluation used the
Brief Ataxia Rating Scale (BARS). Association between alcohol intake and the BARS
was assessed in generalized linear models adjusted for relevant confounders. In subjects
who had CT, the relationship between cerebellar atrophy and the BARS was evaluated.
Results
Of the 313 men identified during a door-to-door survey, 246 (79%) were enrolled. All
admitted continuous drinking for ≥10 years. Of these, 41% started drinking below legal age (18 years), 72% were current drinkers, and 83% engaged in binge drinking. Average alcohol
intake was 330 ± 351 g/week. Mean BARS score was 1.4 ± 2 points, with 14.6% (95% C.I.: 10.8%–19.6%) of individuals having ≥4 points and considered to have clinically relevant ACD. The BARS was associated with
years of drinking (p = 0.036), amount of alcohol intake (p < 0.0001), and binge drinking (p = 0.026). Predictive models showed significant relationships between BARS score margins
and years of drinking and the amount of alcohol intake, independent of other variables.
There was no association between cerebellar atrophy on CT and the BARS in 214 participants.
Conclusions
Prevalence of clinically relevant ACD in this population is low. There are both independent
and synergistic effects of years of drinking, amount of alcohol intake and binge drinking
in the severity of cerebellar dysfunction.
Keywords
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Article info
Publication history
Published online: June 24, 2016
Accepted:
June 22,
2016
Received in revised form:
June 2,
2016
Received:
May 1,
2016
Identification
Copyright
© 2016 Elsevier B.V. All rights reserved.
