Aging, Alcohol Use, And Cognitive Impairment

To compare neurocognitive consequences of alcohol use across age groups, researchers administered a comprehensive battery of neurocognitive tests to 66 adults (mean age 38.5 years, age range 21–69 years, 53% women, 70% white, 30% black) recruited for another study who were at high risk for HIV and hepatitis C infection but had neither. The battery covered domains of global cognition; speed of processing; and attention/executive, learning, memory, verbal, and motor function. Current alcohol use and lifetime DSM-IV alcohol dependence were measured using the Timeline Followback method and a structured clinical interview. The association of alcohol use with neurocognitive tests was compared across “younger” (<40 years) and “older” (>40 years) groups.

• Twenty-one participants (32%) had current heavy* drinking and 35 (53%) had a lifetime history of alcohol dependence.
• Current heavy alcohol use was associated with significantly worse scores on global cognition, learning, memory, and motor function in older participants but not in younger participants.
• Lifetime history of alcohol dependence was associated with significantly worse scores on global cognition, learning, memory, motor, and attention/executive function, but the association did not differ across age groups.

* Heavy alcohol use defined as: ≥5 drinks on one occasion and/or >14 drinks per week for men, and ≥4 drinks on one occasion and/or >7 drinks per week for women.

Comments: In this small cross-sectional sample, current heavy alcohol use was associated with worse neurocognitive scores in “older” adults, whereas lifetime history of alcohol dependence was associated with lower scores across all ages. Although the study’s small sample limited statistical adjustment for many confounders, the finding of greater impairment from current heavy alcohol use among older adults has certain face validity and supports current recommendations for lower-risk drinking limits.

Kevin L. Kraemer, MD, MSc

Reference: Woods AJ, Porges EC, Bryant VE, et al. Current heavy alcohol consumption is associated with greater cognitive impairment in older adults. Alcohol Clin Exp Res. 2016;40:2435–2444.