Cognitive Impairment and Alcoholism
Almost all of us know from experience – either from our own or those around us – that alcohol affects the brain. Those of us who drink have at least once experienced being intoxicated by alcohol and are aware of the effects, both positive (the high) and negative (hangover or being drunk and unable to function), that alcohol has on the brain and body.
However, what most of us are unaware of is that alcohol not only adversely affects the brain at the time one engages in drinking, but that long term excessive drinking can cause physical damage to the brain and can permanently affect cognitive functioning. If you have any heavy drinkers around you then one of the things you’ve probably noticed is how forgetful they are or have become. This is only one of the cognitive impairments caused by alcohol. Brain damage due to alcohol abuse or addiction has been found to affect those areas of the brain associated with executive functions (higher cognitive functioning), memory, visuospatial abilities, together with coordination and balance.
Not only long term excessive drinking, but even social drinking and binge drinking for a short period of time can negatively impact cognitive functioning. Some studies have suggested that alcohol adversely affects cognitive functioning in social drinkers. Significantly lower test performance scores have been seen in individuals with self reported alcohol levels that correspond to those considered social drinking.
Cognitive impairment only worsens with continued drinking and approximately 45 to 70 percent of individuals suffering from alcoholism have impaired cognitive functioning, together with deficits in problem solving, abstract thinking, concept shifting, psychomotor performance and memory.
Some brain damage and cognitive impairment is reversible and improves over time with mere abstinence from alcohol. However, some impairment may continue to exist long after the individual has stopped drinking and this needs to be addressed during treatment.
Individuals who have abstained from alcohol for a long period of time can appear to perform tasks with normal level of efficiency. However, studies examining test performance of such individuals reveal poorer performance as compared to normal individuals. Additionally, brain examination studies have shown activation of more brain areas in these individuals than is normally required, indicating that the brain compensates for the impairment by calling in other areas of the brain not usually involved in the task to make up. These individuals might thus be caught out when asked to multitask, which would require multiple brain areas to be involved simultaneously. The level of impairment can only be revealed by Neuropsychological Tests and may not be apparent otherwise.
When treating alcoholism, it is important to assess the presence and level of cognitive deficits and structure; or modify the treatment program, accordingly incorporating cognitive remediation. This is not only so that the individuals having suffered from alcoholism undergo comprehensive treatment, addressing all the adverse affects of alcoholism, but also because cognitive impairment can have implications on the overall effectiveness of the treatment program.
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