CONTENTS

Table of Contents
Introduction

1. Overview
2. Recognizing Alcohol Misuse and Abuse in Older Adults
3. Alcohol and Aging
4. Diagnosing Alcohol Problems in Older Adults
5. Recognizing Other Forms of Substance Abuse
6. Prevention and Early Intervention Strategies
7. Treatment
8. Outcomes and Cost Issues in Alcohol Treatment for Older Adults
9. Legal and Ethical Issues

Supplements
Resources

At Any Age, It Does Matter:
Substance Abuse and Older Adults (for Professionals)

Other Cognitive Impairments

Alcohol abuse and dependence are directly correlated with other potential causes of cognitive impairment. These include trauma from falls, motor vehicle crashes or other accidents, and the development of Wernicke-Korsakoff syndrome.⁶³

Wernicke-Korsakoff syndrome is clinically characterized by cognitive deficits (especially anterograde memory deficits), gait ataxia, and nystagmus. Its pathophysiology usually involves the lack of the vitamin thiamin. It is important to screen for Wernicke-Korsakoff syndrome because it is a potentially reversible cause of cognitive impairment.^64,65

The extent to which alcohol use interferes with performance on neuropsychological testing has been well reviewed.^64,66 Several studies have demonstrated acute effects of alcohol on abstraction and visual-spatial problems but not on verbal skills. Less is known about the role of alcohol use in causing permanent cognitive changes.

Studies have shown that among alcoholics without dementia, abstinence greatly improves cognitive ability.^66,67 A more recent epidemiologic study of older African-American men found that increasing amounts of alcohol consumption were associated with worsening performance on dementia screening scales.⁶⁸