Female alcoholics may sustain greater cognitive damage than male alcoholics

Researchers and clinicians already know that alcohol abuse and/or dependence can lead to severe and potentially irreversible brain damage.

It is also known that women, when compared to men, seem to become more "damaged" by chronic alcohol abuse within a shorter period of drinking and with less overall consumption. A new study shows that female alcoholics may also sustain greater cognitive damage than male alcoholics.

Results are published in the May issue of Alcoholism: Clinical & Experimental Research.

"The term , telescoping, generally refers to the fact that women experience the negative physiological consequences of alcohol abuse/dependence earlier in their drinking careers and with less alcohol consumption than do men," explained Barbara A. Flannery, senior scientist at RTI International and corresponding author for the study. "For example, women have greater liver, heart and other cardiovascular consequences than do men."

"Despite our knowledge of alcohol's deleterious effects on the brain," said James C. Garbutt, professor of psychiatry and research scientist at Bowles Center for Alcohol Studies, University of North Carolina, "the more subtle effects of alcohol on cognitive function and brain structure have been more challenging to assess. However, with the advent of increasingly powerful neuroimaging techniques, changes in brain structure and function can be detected in patients early in the course of alcoholism. Furthermore, neuropsychological measures can be utilized in an attempt to correlate decrements in performance with brain pathology. Together, these techniques are opening up a new perspective on alcoholism, with implications for treatment. For example, it is becoming clear that anatomical and functional changes occur before the development of overt dementia."

For this study, researchers compared the performance of four groups , Russian male (n=78) and female (n=24) alcoholics, and non-alcoholic control subjects (n=68) , on a series of neurocognitive tasks: motor speed, visuoperceptual processing, visuospatial processing, decision-making, and cognitive flexibility. Participants were recruited from the Leningrad Regional Center of Addictions, and from Pavlov Medical University.

"At a group level," said Flannery, "the female alcoholics , when compared to the male alcoholics , performed worse on tests of visual working memory, spatial planning, problem solving, and cognitive flexibility." These deficits fall under the category of executive functioning, she added, which are also called higher-order functioning because they involved the integration of more primary cognitive skills.

"Deficits in executive functioning have a more pervasive effect on one's ability to function on a daily basis," Flannery said. "For example, difficulties with problem solving could impact an individual's ability to plan and execute a strategy to overcome a dilemma in daily life."

These results would suggest that women are at risk of developing cognitive problems more rapidly than men, said Garbutt. "The results are particularly interesting because this population is a relatively , pure, alcohol-using population," he said. "This is important because one of the problems in studying alcoholism is that it is commonly associated with other drug use such as marijuana or cocaine, which may produce cognitive problems separate from alcohol. These findings indicate that specific cognitive deficits occur in alcoholism."

Both Flannery and Garbutt believe these results extend the concept of physiological "telescoping" to include cognitive "telescoping," meaning that women appear to experience both physiological and cognitive declines from alcohol use sooner and with less alcohol consumption than do men.

"Women should be made aware," said Flannery, "and this includes teenagers and college women who drink to excess, that alcohol has a more detrimental effect on them both physically and cognitively than on men and it would behoove them to drink more in moderation."

Garbutt concurs, adding that, "more specifically, the study reveals that excessive alcohol can reduce one's intellectual abilities. This is important because this knowledge might have increased motivating power to help some individuals move away from destructive drinking. Further, the observation that women may be more sensitive to these effects could help in counseling and in public-service announcements targeted towards women."