Kylie Dingwall & Dr Sheree Cairney

- Brain atrophy, ventricular enlargement, widened sulci
- Learning, memory, visual spatial, executive impairments
Rosenbloom, Sullivan and Pfefferbaum, 2003

• Chronic use – Consumption of large amounts of alcohol on a daily or near daily basis
• Episodic use or ‘binge’ use - consumption of large amounts of alcohol in one sitting on an irregular or episodic basis

Full video available from www.abc.net.au/catalyst/stories/s2019179

• Computerised, non-verbal assessment intended for the repeated assessment of cognitive function in diverse groups
• A number of subtests measuring:
−Visual motor function
−Executive function
−Psychomotor function
−Visual Attention
−Visual Learning and Memory

•Detect cognitive impairments associated with episodic alcohol use among Aboriginal people.
•Monitor cognition longitudinally for Aboriginal people attending rehab
•Identify and compare impairment and recovery profiles of chronic and episodic alcohol users
•Examine the factors contributing to continued alcohol use post-treatment

• Setting: Residential alcohol treatment programs in Northern
Territory.
• Participants: 41 chronic alcohol users, 40 episodic users and 24 healthy controls (M age = 34.24; SD = 9.73).
• Measurements: CogState at baseline (start of treatment), then 4 weeks and 8 weeks later.
Baseline 4 weeks 8 weeks

• Baseline:
Impaired visual-motor, learning, memory and executive functions
• Within 4 weeks:
All except visual-motor function had recovered
• No significant difference between Chronic and Episodic users

• Episodic and chronic alcohol users presented a comparable profile of cognitive deficit and recovery
• Cognitive performance may improve rapidly with abstinence (i.e. within 1 month)
• Persisting visual-motor impairments.
• The majority of alcohol related cognitive impairments may arise from the residual biochemical effects of alcohol which ameliorate following detoxification

• Participants: 37 alcohol users assessed at baseline upon entry to treatment
• Method: Re-interviewed and re-assessed after an average of 11 months (SD = 4.4) after treatment
6-12 months

Outcomes:
• 6 (16%) abstained
• 31 (84%) continued using
• Of continued users:
• 3 (10%) reduced their alcohol intake
• 23 (74%) continued using at the same level
(change in use was unknown for 5 individuals).
• Improved users ( abstained or reduced their use; n = 9) were compared to relapsed users ( continued heavy use ; n = 23)

Relapsed users:
• Poorer paired associate learning at baseline
• Poorer paired associate learning, visual attention, executive function, learning and memory at follow up
• Less likely to return to a community with restricted alcohol access
• More likely to experience the psychological symptom of worry at follow up

• Alcohol affects frontal, hippocampal, cerebellar brain regions
• Impairments in executive functions, memory, learning, psychomotor function.
• Chronic and Episodic users present similar profiles of impairment and recovery
• Cognitive and impairment and accessibility were important factors in relapse

Available From: www.menzies.edu.au/brainstories

• Australian Bureau of Statistics. (2006a). National Aboriginal and
Torres Strait Islander Health Survey 2004-05. [Cat. No. 4715.0].
Canberra: Australian Government Publishing Service
• Vos, T., Barker, B., Stanley, L., & Lopez, A. D. (2007). The burden of disease and injury in Aboriginal and Torres Strait Islander peoples
2003. Brisbane: School of Population Health, The University of
Queensland
• Australian Bureau of Statistics. (2008). The health and welfare of
Australia's Aboriginal and Torres Strait Islander Peoples, 2008 [Cat.
No. 4704.0]. Canberra: Australian Government Publishing Service
• Carlen, P. L., Wortzman, G., Holgate, R. C., Wilkinson, D. A., &
Rankin, J. G. (1978). Reversible cerebral atrophy in recently abstinent chronic alcoholics measured by computed tomography scans. Science 200 (4345), 1076-7078
• Cairney, S., Clough, A. R., Jaragba, M. J., & Maruff, P. (2007).
Cognitive impairment in Aboriginal people with heavy episodic patterns of alcohol use. Addiction, 102, 909-915