The neuropsychological consequences of abstinence among older alcoholics: a cross-sectional study.
BACKGROUND
The older alcoholic has been distinguished from the younger alcoholic with regard to both the acute effects of alcohol and also the recovery of functioning with abstinence. Few studies, however, have included samples of exclusively older subjects. In this investigation we examined the recovery of functioning in an older cohort of recovering alcoholics (age range 55-83) to determine which neuropsychological functions improve and which remain impaired with abstinence.


METHODS
We used a cross-sectional design, comparing three demographically matched groups on a battery of neuropsychological tests: (a) older alcoholics who had been abstinent for greater than 6 months, (b) older alcoholics who had been abstinent for less than 6 months, and (c) a control group of older subjects without alcohol abuse histories.


RESULTS
In almost all tasks, the alcoholics who were abstinent for less than 6 months performed worse than the control group. In contrast, the alcoholics who had been abstinent for more than 6 months differed from the control group on learning and recall of a word list, immediate and delayed recall of a complex figure, initial letter fluency, and clock drawing.


CONCLUSIONS
Memory and executive skills appear to be resistant to recovery or at least slower to recover with abstinence in the older alcoholic. The impairment with visuospatial skills reported in prior investigations of alcoholics may be related to compromised executive functions, which interfere with the encoding of more complex visuospatial information and thus affect recall of such information. Studies that involve larger samples of older alcoholics are needed to understand their ability to recover cognitive functioning with abstinence.
Munro
C A
CA
University of Pittsburgh Medical Center, Western Psychiatric Institute and Clinic, Pennsylvania, USA. cmunro@jhmi.edu
Saxton
J
J
Butters
M A
MA
D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D020751:Alcohol-Induced Disorders; D000437:Alcoholism / Q000150:complications / Q000503:physiopathology / Q000628:therapy*; D003072:Cognition Disorders / Q000209:etiology* / Q000503:physiopathology; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008569:Memory Disorders / Q000209:etiology; D008875:Middle Aged; D009483:Neuropsychological Tests; D013375:Substance Withdrawal Syndrome / Q000503:physiopathology*; D013997:Time Factors