Delineating the Effects of Alcohol Use on Cognition in Individuals With Neurocognitive Disorders

Ari B. Cuperfain, MD; Sandra E. Black, MD; Mira Fostoc, BSc; Morris Freedman, MD; Clement Ma, PhD; Tarek Rajji, MD; Stephen Strother, PhD; David F. Tang-Wai, MD; Maria Carmela Tartaglia, MD; Sanjeev Kumar, MD; TDRA Clinical Research Database Group

J Clin Psychiatry 2025;86(3): 24m15738

Abstract

Objective: Excessive alcohol use is a recognized modifiable risk factor for the development of dementia; however, the neuropsychological profile of cognitive impairment seen with alcohol use is heterogeneous. We studied cognitive characteristics associated with alcohol use in a “real-world” memory clinic cohort of patients with neurocognitive disorders.

Methods: We used the Toronto Dementia Research Alliance memory clinic research database to generate an age, sex, and education matched sample of individuals with alcohol-related cognitive impairment (ARCI group; n=51) and twice as many individuals without such history (Comparator group; n=102). We compared cognitive domain and subdomain Toronto Cognitive Assessment scores between the two groups using linear regression.while controlling for age, sex, education, concurrent psychiatric disorders, global cognition, and traumatic brain injury.

Results: Mean (SD) age was 67.67 (13.01) years for the ARCI group and 67.96 (12.82) years for the Comparator group. The ARCI and Comparator groups had 35% and 36% females, respectively. Neither global cognition nor other cognitive domains differed significantly between the two groups. Among cognitive subdomains, only the intrusion rates on the delayed recall task were higher (worse performance) in the ARCI group (mean [SD]=0.79 [1.21]) relative to the Comparator group (mean [SD]=0.34 [0.69]; P_corrected=.018).

Conclusions: Our study suggests that ARCI results in specific deficits involving cognitive control during delayed recall task. This may help advance development of markers to delineate ARCI from other causes of cognitive impairment. Future work may test these findings in larger, well-characterized samples.

J Clin Psychiatry 2025;86(3):24m15738

Author affiliations are listed at the end of this article.

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