Cognitive functioning in older adults with early, late, and very late onset alcohol dependence

Background: Alcohol dependence in older adults is associated with cognitive impairment. Age of onset of alcohol dependence is an important criterion to distinguish subgroups of alcohol-dependent people. Little is known about the influence of the age of onset of alcohol dependence on cognitive functioning. The primary aim of this study was to examine if older alcohol-dependent people with early, late or very late onset of alcohol dependence differ in terms of cognitive dysfunction. Methods: A total of eighty-five older alcohol-dependent people who were admitted to an inpatient detoxification program, were categorized into three age of onset groups: early onset (< 25 years: N = 27, mean age 57.7 +/- 7.4), late onset (25-44 years: N = 28, mean age 61.1 +/- 6.7) and very late onset (>= 45 years: N = 30, mean age 65.6 +/- 6.5). A neuropsychological test battery (Kaufman-Short Neuropsychological Assessment Procedure (K-SNAP), Trail Making Test (TMT) and Stroop Color Word Test) was administered to assess cognitive functioning. Differences between groups were examined with analyses of variance (ANOVAs). Results: There were no significant differences in performance on any of the neuropsychological measures between the three age of onset groups. However, compared to a non-alcohol-dependent norm group, all three age of onset groups performed below average. Conclusions: The results suggest that older adults who start drinking heavily (very) late in life have similar cognitive impairments compared to their peers who have been drinking for decades. This emphasizes the vulnerability of the aging brain to the toxic effects of alcohol.