Alcohol drinking and alcohol use disorder across the ages: Dynamic effects on the brain and function.

Abstract

This chapter focuses on (a) the epidemiology and diagnosis of alcohol use disorder (AUD); (b) neuroradiological signatures of syndromes of AUD and concomitant signs and symptoms; (c) the dynamic course of component neuropsychological processes in drinking and sobriety; and (d) the effects of adolescent drinking on cognitive, motor, and brain function. The conclusion provides a summary of accepted facts about AUD and identifies salient questions about AUD remaining to be answered. WHAT THE FIELD KNOWS Epidemiology and Definition of Excessive Drinking and Alcohol Use DisorderEpidemiology. The World Health Organization (WHO; 2018) Global Status Report on Alcohol and Health 2018 estimated rates of AUD in the United States at 3% to 6% of the population, with a nearly 30% lifetime AUD prevalence. Despite its high prevalence, fewer than 10% of individuals with AUD receive treatment. Determination of drinking patterns considers consumption amount and frequency in the context of National Institute on Alcohol Abuse and Alcoholism (NIAAA) guidelines, which recommend no more than one drink per day (maximum seven drinks per week) for women, no more than two drinks on any one day (maximum 14 drinks per week) for men, and never to drink while pregnant or when planning a pregnancy. Alcohol consumption is increasing among people approaching retirement age, with women exceeding the trajectory increase of men both in regular to heavy drinking and binge drinking (Breslow et al., 2017), although an increase in frequent heavy drinking has also been documented in older men (Han et al., 2019). Binge drinking is defined as consuming more than four (for women) or five (for men) alcohol drinks in 2 hours (NIAAA, 2020).An AUD diagnosis is made based on the criteria listed in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5; American Psychiatric Association, 2013) or the International Statistical Classification of Disease and Related Health Problems, 10th revision (ICD-10; WHO, 2016). These diagnostic codes depict AUD on a severity spectrum from mild to severe. "Alcohol abuse and alcohol dependence" as a diagnosis is no longer in the nosology. The DSM-5 diagnosis has 11 criteria; the presence of two or more within a 12-month span qualifies as an AUD. Especially relevant to recognizing how AUD contributes to cognitive compromise of frontally based functions involving social cognition and perseveration are two criteria:

Alcohol Use Disorder and Dementia: A Review

“…[97][98][99] The neuropsychological profile of AUD uncomplicated by neurological confounders (e.g., WKS, hepatic encephalopathy) also includes deficits in executive functions. [100][101][102] Additionally, people with uncomplicated AUD show impairments in episodic memory (i.e., the ability to learn, store, and retrieve information about unique personal experiences including time and place), 103 visuospatial processing (i.e., the ability to perceive, analyze, and manipulate visual patterns and images, such as copying complex figures or orienting three-dimensional objects), 104,105 social cognition (i.e., the ability to interpret social information and behave appropriately), 106,107 and gait and balance. 108 Features of WKS are persistent inability to remember new information (i.e., anterograde amnesia) and occasional confabulation.…”