Abstract
Alcohol abuse affects brain health throughout life. Alcoholic dementia is a controversial subject, but alcohol abuse may impact individuals across the cognitive spectrum over long periods of time. The National Alzheimer Coordinating Center (NACC) UDS includes questions about alcohol and other substance abuse, both recent and remote. We examined the behavioral and cognitive impact of recent and remote alcohol abuse. Subjects were 33208 NACC cases at initial evaluation with known alcohol abuse history without illicit substance abuse history. Alcohol/Substance abuse was defined as work, driving, legal, or social impairment over 1 year. Subjects were never-abusers (N=31558), remote abusers (abuse > 1 year ago) (N=1337), or recent abusers (N=313) (abuse ≤ 1 year ago) and “ever”. Subjects were stratified by Clinical dementia rating and compared items using two-sample t-tests. Ever-abusers reported more NPI-Q items than never-abusers in all CDR groups, and all racial/ethnic groups. NPI-Q item analysis showed significantly more Anxiety and Appetite changes in CDR0, all items except Delusions and Elation in CDR0.5 and all items except Delusions, Anxiety and Apathy in CDR1–3. Never abusers had significantly higher NPI-Q scores and more items endorsed than remote abusers for each CDR stage, except CDR=3 which had a small N(Never Abusers N=1040 vs. Any Abuse N=74). CDR-SB did not differ significantly between Never Abusers and those with history of abuse. Our results associate alcohol abuse with increased and more severe NPI-Q behavioral symptoms. Remote abusers exhibit more symptoms than never-abusers, supporting the hypothesis that alcohol abuse is associated with long-lasting behavioral symptoms. However, Alcohol abuse history does not appear to change functional socres based on CDR-SB. The NACC database is funded by NIA/NIH Grant U01 AG016976.
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