Role of Patient Sex in Early Recovery from Alcohol-Related Cognitive Impairment: Women Penalized.

Amandine Luquiens,Régis Alarcon,Hélène Donnadieu-Rigole,Stéphanie Pelletier,Amine Benyamina,Pascal Perney,Bertrand Nalpas,Benjamin Rolland

doi:10.3390/jcm8060790

Abstract

Background: The objective was to explore the role of patient sex in cognitive recovery and to identify predictive factors for non-recovery in alcohol use disorder (AUD). Methods: All patients with AUD admitted to a residential addictions treatment center were systematically assessed at admission and after 6 weeks of abstinence in a controlled environment. The inclusion criteria were that patients were admitted for AUD with baseline alcohol-related cognitive impairment (baseline total Montreal Cognitive Assessment (MoCA) score < 26) and reassessed at 6 weeks (n = 395). A logistic regression model was built to determine the influence of sex on recovery status (MoCA < or ≥ 26) taking into account the interaction effect of sex with alcohol consumption on cognitive function. Results: The mean age was 50.10 years (SD = 9.79), and 27.41% were women. At baseline, the mean MoCA scores were 21.36 (SD = 3.04). Participants who did not achieve recovery (59.3% of women vs 53.8% of men) had lower total MoCA scores at baseline. The 2 factors that was significantly and independently associated with non-recovery and with a non-zero coefficient was being a woman and initial MoCA score (respective adjusted odds ratios (AOR) = 1.5 and 0.96, p-values < 0.05). Conclusions: These results could influence the time required in a controlled environment to maintain abstinence and the duration of in-care for women.

Highlights

Inclusion criteria were as follows: (1) DSM-5 criteria for alcohol use disorder (AUD); (2) baseline alcohol-related cognitive impairment defined by a baseline total Montreal Cognitive Assessment (MoCA) score < 26 [35]; and (3) completion of the facility’s 6-week program including reassessment with a MoCA score at 6 weeks
This study of a large sample of systematically included recently-detoxified participants with AUD having benefited from cognitive remediation shows sex-related differences in early-recovery at 6 weeks in a controlled environment, using return to a normal MoCA score as a proxy for recovery
This finding has several implications. It highlights the importance of taking into account the interaction effect of sex and alcohol consumption, and of exploring the role of sex in the understanding of cognitive impairment and recovery with the perspective of implementing specific therapeutic strategies

Summary

Introduction

In addition to pre-existing cognitive vulnerability to addictive disorders [3] often involving less inhibitory capacities, specific deficits related to heavy drinking have been reported in AUD patients. The objective was to explore the role of patient sex in cognitive recovery and to identify predictive factors for non-recovery in alcohol use disorder (AUD). Methods: All patients with AUD admitted to a residential addictions treatment center were systematically assessed at admission and after 6 weeks of abstinence in a controlled environment. The inclusion criteria were that patients were admitted for AUD with baseline alcohol-related cognitive impairment (baseline total Montreal Cognitive Assessment (MoCA) score < 26) and reassessed at 6 weeks (n = 395). Participants who did not achieve recovery (59.3% of women vs 53.8% of men) had lower total MoCA scores at baseline. Conclusions: These results could influence the time required in a controlled environment to maintain abstinence and the duration of in-care for women

Methods

Results

Conclusion