Center for Imaging of Neurodegenerative Diseases (CIND) , San Francisco VA Medical Center, San Francisco, California; Department of Radiology and Biomedical Imaging, University of California, San Francisco, California.
Alcohol Clin Exp Res. 2013 Oct;37(10):1794-803. doi: 10.1111/acer.12140. Epub 2013 May 17.
Increasing age and chronic cigarette smoking are independently associated with adverse effects on multiple aspects of neurocognition in those seeking treatment for alcohol use disorders. However, the potential interactive effects of age and cigarette smoking on neurocognition in early abstinent alcohol-dependent individuals (ALC) have not investigated.
Cross-sectional performances of never-smoking healthy comparison participants (nvsCOM; n = 39) and 1-month-abstinent, treatment-seeking, never-smoking (nvsALC; n = 30), former-smoking (fsALC; n = 21), and actively smoking (asALC; n = 68) ALC were compared on a comprehensive neurocognitive battery. Domains of functioning evaluated were cognitive efficiency, executive functions, fine motor skills, general intelligence, learning and memory, processing speed, visuospatial functions and working memory. Participants were between 26 and 71 years of age at the time of assessment.
asALC showed steeper age-related effects than nvsCOM on the domains of visuospatial learning, auditory-verbal memory, cognitive efficiency, executive functions, processing speed, and fine motor skills. In pairwise comparisons, fsALC and asALC performed more poorly than both nvsCOM and nvsALC on multiple domains; nvsCOM and nvsALC showed no significant differences. Domain scores for the ALC groups generally fell in the low-to-high-average range of functioning. A clinically significant level of impairment was apparent in only 25% of ALC participants on visuospatial learning, visuospatial memory, and fine motor skills domains. Measures of alcohol use or consumption were not significantly related to neurocognition in the ALC cohorts.
The age-related findings suggest that the combination of active chronic smoking and alcohol dependence in this 1-month-abstinent ALC cohort was associated with greater than normal age-related effects in multiple domains. In general, a low level of clinically significant impairment was observed in the alcohol-dependent participants. The findings from this study, in conjunction with previous research, strongly support smoking cessation interventions for those seeking treatment for alcohol and substance use disorders.
在寻求治疗酒精使用障碍的患者中，年龄的增长和慢性吸烟与神经认知的多个方面的不良影响独立相关。然而，在早期戒断的酒精依赖个体（ALC）中，年龄和吸烟对神经认知的潜在交互作用尚未得到研究。
从未吸烟的健康对照组参与者（nvsCOM；n = 39）和 1 个月戒断、寻求治疗、从未吸烟（nvsALC；n = 30）、前吸烟（fsALC；n = 21）和主动吸烟（asALC；n = 68）的 ALC 中比较了跨吸烟状况的交叉表现。评估的功能域包括认知效率、执行功能、精细运动技能、一般智力、学习和记忆、处理速度、视空间功能和工作记忆。参与者在评估时的年龄在 26 至 71 岁之间。
与 nvsCOM 相比，asALC 在视空间学习、听觉言语记忆、认知效率、执行功能、处理速度和精细运动技能等领域表现出更陡峭的年龄相关效应。在两两比较中，fsALC 和 asALC 在多个领域的表现均不如 nvsCOM 和 nvsALC；nvsCOM 和 nvsALC 之间没有显著差异。ALC 组的域分数通常落在低至高平均功能范围。只有 25%的 ALC 参与者在视空间学习、视空间记忆和精细运动技能领域表现出明显的临床显著损伤。酒精使用或消耗的措施与 ALC 队列的神经认知没有显著相关。
年龄相关的发现表明，在这个 1 个月戒断的 ALC 队列中，主动慢性吸烟和酒精依赖的结合与多个领域的正常年龄相关效应相关。一般来说，在酒精依赖的参与者中观察到的临床显著损伤水平较低。本研究的结果与以前的研究一起，强烈支持为寻求治疗酒精和物质使用障碍的人提供戒烟干预。
