Wine consumption and risk of cognitive decline in adults: A systematic review of human studies, 2013–2025

Abstract

Wine consumption has been proposed to influence cognitive health because of its polyphenolic compounds, but evidence regarding its effects remains inconsistent. This systematic review evaluated the association between wine consumption and cognitive outcomes in adults. We conducted a systematic review following PRISMA 2020 guidelines and registered the protocol with PROSPERO (CRD420261303152). PubMed/MEDLINE, Scopus, Web of Science, PsycINFO, and the Cochrane Library were searched for studies published between Jan 1, 2013, and Dec 31, 2025. Eligible studies included randomized controlled trials and observational studies involving adults aged 18 years or older that examined wine consumption and cognitive outcomes. Two reviewers independently screened studies, extracted data, and assessed methodological quality. Findings were synthesised narratively because of methodological heterogeneity. Of 3,120 records identified, 30 studies met the inclusion criteria (24 observational studies and six intervention studies) involving more than 100,000 participants. Most observational studies reported that low-to-moderate wine consumption was associated with better cognitive performance, slower cognitive decline, or lower dementia risk compared with abstinence or heavy drinking. A meta-analysis included within the review reported a 28% lower risk of cognitive decline among wine consumers than non-consumers (RR 0·72, 95% CI 0·63–0·80). However, several studies found that these associations were attenuated after adjustment for socioeconomic and lifestyle factors. Evidence from intervention studies was limited and inconsistent, whereas heavy alcohol consumption was consistently associated with adverse cognitive outcomes. The evidence base is dominated by studies from high-income and non-African settings, limiting its applicability to African populations. Low-to-moderate wine consumption is frequently associated with favourable cognitive outcomes in observational studies; however, current evidence remains insufficient to establish a causal neuroprotective effect. Heavy alcohol consumption is consistently associated with cognitive harm. Future research should prioritise longitudinal African cohorts with repeated alcohol-exposure assessment, culturally appropriate cognitive measures, and rigorous control for socioeconomic confounding.