The Course of Cognitive Performance during Inpatient Treatment in Patients with Alcohol Use Disorder with No, Mild or Major Neurocognitive Disorders

Abstract

Aims: In patients with a history of chronic alcohol abuse, neurocognitive disorders (NCD) are not uncommon. The current study aimed to explore the course of cognitive performance, as measured by the Montreal Cognitive Assessment (MoCA), and everyday cognitive functioning, as measured by the Patient Competency Rating Scale (PCRS), in a large group of patients with alcohol use disorder (AUD) admitted to the Center of Excellence for Korsakov and Alcohol-related Cognitive Impairments.

Methods: A multiple time-series design was used, in which the MoCA was administered at three time points of assessment, and the PCRS was completed by both the patient and a clinician at two time points, all during clinical treatment.

Results: A total of 524 patients were included, 71 of whom were diagnosed with AUD only, 284 with AUD and mild NCD (ARCI) and 169 with AUD, major NCD and fulfilling criteria for Korsakoff's syndrome (KS).

Conclusions: Cognitive performance improved for all three groups during treatment, sustained abstinence and recovery from AUD. A low memory performance on the MoCA without improvement over time was predictive for KS, while improvement on this domain did not differentiate between AUD and ARCI. Changes in overall cognitive performance and orientation in patients with KS were positively related to changes in everyday cognitive functioning.

Fig. 1.

Tukey box-and-whisker plots showing the distribution of the time between two assessments in days. The time between T0 (intake or clinical admission) and T1 (after 6 weeks of clinical admission) ranged from 16 to 394 (left panel), and the time between T1 (after 6 weeks of clinical admission) and T2 (clinical discharge) ranged from 5 to 645 (right panel). The box plots indicate the interquartile range and median; the whiskers indicate the minimum and maximum values, excluding the outliers which are represented by the white circles.

Fig. 2.

Mean Montreal Cognitive Assessment—Total Score (MoCA-TS; top left panel), Memory Index Score (MoCA-MIS; top right panel), Domain Score orientation (MoCA-DS; bottom left panel) and Domain Score memory (MoCA-DS; bottom right panel) on three assessment time points, split per group.