Cognitive performance in long-term abstinent elderly alcoholics

In a new study comparing elderly abstinent alcoholics with light- or nondrinking peers, the recovering alcoholics generally demonstrated equal or superior cognitive functioning to those who were not alcoholic.

“We [had] expected to find impairment because we'd see the additive effect of alcohol and aging,” said lead researcher George Fein, Ph.D., of the study in the November issue of Alcoholism: Clinical and Experimental Research .

Researchers looked at 91 abstinent alcoholics, men and women, with an average age of 67.3 years. Their lifetime drinking average was between 124 and 249 standard drinks per month, and their alcohol abstinence average was 14.8 years. The study group underwent cognitive and clinical testing along with 52 participants who were light drinkers or nondrinkers.

Both groups underwent attention, verbal ability, reaction time and immediate memory testing. The researchers also collected information about drinking behavior and any associated medical and psychiatric diagnoses and symptoms, and measured cranium size with MRI.

“Our results don't say that elderly individuals fully recover from the effects of alcohol. Our results say that there's a select sample of elderly alcoholics who are functioning very well,” said Fein, president and senior scientist of Neurobehavioral Research, Inc., in Honolulu.

Petros Levounis, M.D., director of the Addiction Institute of New York at St. Luke's and Roosevelt Hospitals, agreed that the study showed “there is such a thing as being elderly, to have been an alcoholic and to maintain intact cognition.”

Levounis added, “Of course, it can also be possible to be elderly, to [remain] a heavy drinker and to continue to have intact cognition. My clinical impression from my work with patients is that the damage alcohol does to the brain is very real and abstinence will help slow down or even halt the deterioration.”

The study researchers found that the alcoholic group tended to have larger craniums than their control group peers and theorized that the difference could account for the equal or better performance of the alcoholic group. “When you're recruiting in people [aged] 65 to 85 amongst alcoholics, you end up getting people who are really exceptionally well functioning and those tend to be the ones with enhanced functional reserve capacity,” Fein said.

Fein has previously investigated the relationship between cranium size, or “reserve capacity,” and brain function, a correlation that is controversial in scientific circles. He suggested that brain growth in very early childhood might mean the difference between normal functioning and cognitive impairment for abstinent alcoholics in their later years.

Levounis, who is not connected with the new study, said that it offers no record of cranium measurements for members of the control group — biological data he sees as critical to the study's conclusions. “That a larger brain somehow is associated with a higher ability to retain cognitive function is a proposition I would be very, very cautious before adopting…. Without these numbers, we cannot even start looking at it,” he said.

Fein emphasized that the study results are not an invitation for people with good cerebral reserve — big brains — to abuse alcohol. “These are people who also stopped drinking — who have significant abstinence,” he said.

Alcoholism: Clinical and Experimental Research : Contact Mary Newcomb at (317) 375-0819 or [email protected] or visit http://www.alcoholism-cer.com

Fein G, McGillivray S. Cognitive performance in long-term abstinent elderly alcoholics. Alcoholism: Clinical and Experimental Research 31(11), 2007.