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Heavy Alcohol Use and History of Alcohol Dependence Lead to Cognitive Problems Later in Life
Bret A. Moore, PsyD, ABPP
Board-Certified Clinical Psychologist, San Antonio, TX
Dr. Moore has disclosed that he has no relevant financial or other interests in any commercial companies pertaining to this educational activity.
Review of: Woods AJ, Porges EC, Bryant VE, et al. Current heavy alcohol consumption is associated with greater cognitive impairment in older adults. Alcoholism: Clinical and Experimental Research 2016; ahead of publication.
STUDY TYPE: Quasi-experimental study
There are a few truths when it comes to cognitive functioning and acute alcohol use. We know that alcohol intoxication can lead to imbalance, disorientation, and loss of consciousness. We also know the ability to hang on to small amounts of information for a few seconds is impaired. However, what’s less clear is the long-term impact on cognitive abilities in heavy drinkers as they age. It may seem like a “no-brainer” that cognitive abilities would be worse in heavy drinkers as they get older, but research on the topic has been conflicting.
In an attempt to gain a clearer answer to this question, 66 individuals between the ages of 21 and 69 (mean age was 38.5) were classified as either heavy drinkers (n = 21) or low-risk drinkers (n = 45). Heavy drinkers were defined as 5 or more drinks per day or more than 14 per week for men, and 4 or more per day or an average of 7 per week for women. The low-risk group consisted of individuals who drank less than the heavy group or not at all. The researchers collected information about alcohol use history, and administered a comprehensive battery of tests measuring global cognitive functioning, attention/executive function, learning, memory, motor and verbal function, and processing speed.
Results
Older (40 and over) heavy drinkers did worse in the areas of learning, memory, motor skills, and overall cognitive ability compared to younger heavy drinkers. The same was true for heavy versus low-risk drinkers. Interestingly, those with a documented history of alcohol dependence, regardless of age or whether they were considered heavy or low-risk drinkers, performed worse in these same areas. A history of alcohol dependence seems to put drinkers at any level at greater risk for cognitive problems down the road.
CATR’s Take
Although this was a fairly small study, the findings are clear that heavy drinking, with or without alcohol dependence, is associated with memory and overall cognitive impairment. This was not likely to simply be a function of age-related cognitive decline, since these patients were relatively young, with a mean age of 38.5 and nobody over the age of 65.
Practice implications
If you have hard-drinking patients who are not motivated to moderate their drinking, you should tell them that recent research shows a clear association between heavy drinking and memory and learning problems. Many patients will probably be receptive to at least experimenting with a period of sobriety (say, a month or more) to see if they feel mentally sharper. More than likely, many of them will.
Addiction TreatmentSTUDY TYPE: Quasi-experimental study
There are a few truths when it comes to cognitive functioning and acute alcohol use. We know that alcohol intoxication can lead to imbalance, disorientation, and loss of consciousness. We also know the ability to hang on to small amounts of information for a few seconds is impaired. However, what’s less clear is the long-term impact on cognitive abilities in heavy drinkers as they age. It may seem like a “no-brainer” that cognitive abilities would be worse in heavy drinkers as they get older, but research on the topic has been conflicting.
In an attempt to gain a clearer answer to this question, 66 individuals between the ages of 21 and 69 (mean age was 38.5) were classified as either heavy drinkers (n = 21) or low-risk drinkers (n = 45). Heavy drinkers were defined as 5 or more drinks per day or more than 14 per week for men, and 4 or more per day or an average of 7 per week for women. The low-risk group consisted of individuals who drank less than the heavy group or not at all. The researchers collected information about alcohol use history, and administered a comprehensive battery of tests measuring global cognitive functioning, attention/executive function, learning, memory, motor and verbal function, and processing speed.
Results
Older (40 and over) heavy drinkers did worse in the areas of learning, memory, motor skills, and overall cognitive ability compared to younger heavy drinkers. The same was true for heavy versus low-risk drinkers. Interestingly, those with a documented history of alcohol dependence, regardless of age or whether they were considered heavy or low-risk drinkers, performed worse in these same areas. A history of alcohol dependence seems to put drinkers at any level at greater risk for cognitive problems down the road.
CATR’s Take
Although this was a fairly small study, the findings are clear that heavy drinking, with or without alcohol dependence, is associated with memory and overall cognitive impairment. This was not likely to simply be a function of age-related cognitive decline, since these patients were relatively young, with a mean age of 38.5 and nobody over the age of 65.
Practice implications
If you have hard-drinking patients who are not motivated to moderate their drinking, you should tell them that recent research shows a clear association between heavy drinking and memory and learning problems. Many patients will probably be receptive to at least experimenting with a period of sobriety (say, a month or more) to see if they feel mentally sharper. More than likely, many of them will.
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