Objective: Cognitive dysfunction is common in patients with Alcohol Use Disorders (AUD). This impairment needs to be detected since it affects the quality of life of patients and compliance with therapeutic programs. As global cognitive and executive functions may be differently affected in AUD patients, we wondered whether, when diagnosing cognitive dysfunction, specific measurement of executive functioning could provide an incremental value that could be used in addition to global cognitive measurement. Methods: Cognitive status was evaluated at admission using the Montreal Cognitive Assessment (MoCA) test, the Frontal Assessment Battery (FAB) and a battery of Neuropsychological (NP) reference tests in 134 patients with AUD hospitalized in an addictions treatment unit. Results: Seventy patients (52%) had cognitive dysfunction according to the battery of Neuropsychological (NP) tests. Among these 70 patients, 59 (84%) and 38 (54%) had abnormal MoCA and FAB test results, respectively. Concordance between the MoCA and the FAB was weak (kappa = 0.27). Analysis through logistic regression showed that the Area under Curve (AUC) obtained with the MoCA test was a better single predictor of cognitive impairment (0.85) than that obtained with the FAB (0.73). Combining the two tests produced an AUC of 0.86, a value not significantly different from that obtained with the MoCA. Conclusions: The MoCA-FAB combination did not perform better than the MoCA alone as a screening tool for cognitive dysfunction among AUD patients. This confirms that the MoCA is an efficient screening tool since it can detect frontal as well as general cognitive disorders.

Objective: Overweight, Arterial Hypertension (AH) and diabetes are frequently associated with alcohol use disorders. As each of these co-morbidities is independently associated with cognitive impairment, we studied whetherthey could worsen alcohol-related cognitive impairment. Methods: A retrospective analysis of a clinical database of patients with an alcohol use disorder admitted to an addiction treatment unit of a teaching hospital. Patient weight was classified using WHO recommendations; arterial hypertension and Type 2 diabetes were diagnosed according to the most recent guidelines. Cognitive status was assessed using the MoCA administered on admission and at discharge by trained staff members. Results: Among the 387 patients included (69.3% male, mean age 50.4), 6.4% suffered from Type II diabetes, AH was present in 22.4% of the sample, and 20.6% were obese (BMI>=30). MoCA scores at admission did not differ as a function of BMI, or AH or Type II diabetes status. At discharge, MoCA scoreshad improved in all subgroups; however, a multivariate analysis showed that they had improved significantly less in the AH group compared to the non-AH group. Conclusions: Our results confirm the impact of hypertension on cognitive dysfunction, including in patients with severe alcohol use disorders. Monitoring of blood pressure levels is, therefore, an important preventive measure for cognitive dysfunction in these patients.