Adult Cognitive Functioning In Adolescent-Onset And Persistent Alcohol Use Disorders In Men

Abstract

Alcohol use disorders ("AUDs") have a high prevalence rate, are heterogeneous, and are associated with deficits in executive abilities, learning, and memory. The literature on adolescent AUD and adult cognitive functioning is limited, and no prospective study has simultaneously examined how an AUD-onset during a neurologically-vulnerable period, persistence of use in adulthood, and an interaction of these processes may attenuate or exacerbate cognitive issues. This study used two AUD subtypes commonly employed to characterize the heterogeneity in AUD presentation - the adolescent-onset and persistent subtype - to address these questions, and also relied on measures of behavioral disinhibition and intellectual functioning ascertained during childhood to address the concern that the relationship between AUDs and later-cognitive functioning may be subject to confounding. It was hypothesized that premorbid childhood risk factors would relate to both AUD subtype and adult cognition, that both an adolescent-onset and a persistent course of AUD would relate to cognitive deficits in adulthood, and that accounting for premorbid risk factors would attenuate this relationship. A community sample of 650 men born in Minnesota was assessed at six visits occurring between age 11 and age 29 and divided into AUD groups of adolescent-onset persisters and desisters, adult-onset persisters and desisters, and controls. Both AUD-membership and age 29 cognitive performance were associated with risk factors that preceded AUD-onset; when accounting for premorbid risk, there was scant evidence that AUDs were associated with cognitive deficits. Future research of AUDs and cognition should account for premorbid risk factors.