Drinking heavily—eight or more alcoholic drinks per week—may increase the risk of brain damage and cognitive problems, according to a new study published on April 9, 2025, in Neurology, the journal of the American Academy of Neurology.
The study found that heavy drinkers were more likely to have brain injuries known as hyaline arteriolosclerosis, as well as other markers linked to dementia, such as tau tangles.
While the study does not prove that alcohol causes these problems, it shows a strong connection between heavy drinking and brain health issues in older adults.
The research was led by Dr. Alberto Fernando Oliveira Justo from the University of São Paulo Medical School in Brazil.
He explained, “Heavy alcohol consumption is a major global health concern, and our study shows it may cause lasting damage to the brain, increasing the risk of memory and thinking problems as people age.”
Hyaline arteriolosclerosis is a condition where tiny blood vessels in the brain become stiff and narrow. This limits blood flow and can harm brain tissue over time. The damage often appears as lesions—areas of injured tissue—which are linked to memory loss and other cognitive issues.
The study looked at the brains of 1,781 people who had died at an average age of 75. Their brains were donated for research and carefully examined for signs of injury, including vascular lesions and tau tangles—twisted proteins commonly seen in Alzheimer’s disease.
Researchers also recorded each person’s brain weight and height, and spoke with family members about their drinking habits.
The participants were divided into four groups: 965 people who never drank, 319 moderate drinkers (seven or fewer drinks per week), 129 heavy drinkers (eight or more drinks per week), and 368 former heavy drinkers.
To give perspective, one alcoholic drink was defined as having 14 grams of alcohol. That equals about 350 ml of beer, 150 ml of wine, or 45 ml of spirits.
Researchers found that 40% of people who never drank had vascular brain lesions, 45% of moderate drinkers had them, 44% of heavy drinkers had them and 50% of former heavy drinkers had them.
But when they adjusted the data for other factors like smoking, exercise, and age at death, the risks were even clearer. Heavy drinkers were 133% more likely to have vascular brain lesions than those who never drank. Former heavy drinkers had 89% higher odds, and even moderate drinkers had 60% higher odds.
Heavy and former heavy drinkers also had higher chances of developing tau tangles—41% and 31% greater odds, respectively. These tangles are considered a warning sign of Alzheimer’s disease.
Former heavy drinkers had a lower ratio of brain weight to body size and showed more cognitive problems, though this was not seen in current heavy drinkers. It may be that former drinkers had been drinking heavily for longer before stopping, but the study did not include details about drinking duration.
Another important finding was that people who drank heavily died, on average, 13 years earlier than those who never drank.
Dr. Justo emphasized that these findings are important for public health. “Heavy drinking is clearly linked to injury in the brain,” he said. “And that can have serious effects on memory and thinking. Raising awareness of these risks can help people make better choices and reduce the burden of alcohol-related brain diseases.”
Still, the study had some limitations. Because it was based on information after death, researchers could not study participants’ memory and thinking abilities while they were alive. They also didn’t have details on how long participants had been drinking or if they had changed their habits over time.
Even with those limitations, this study adds to growing evidence that heavy alcohol use can harm the brain. It’s another reminder that how much—and how often—we drink has a real impact on long-term brain health, especially as we age.
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The study is published in Neurology.
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