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Alcohol and Memory
In the Seniors' Health Study, we found that over one quarter of the clients in the outreach program had problems with their short term memory. Other research and clinical studies with seniors have identified the same problem.
Why does memory become a problem?
As the human brain ages, it shrinks. Brain imaging techniques show chronic alcohol use leads to greater shrinkage in the cortex frontal lobes than we normally see as people age. The frontal lobe is where the higher intellectual functions occur.
The rate of the frontal cortex shrinkage seems to correlate with approximately the amount of alcohol consumed (drink more, get more shrinkage). Women may be more susceptible than men to alcohol related brain shrinkage. According to research reported in the NIAAA 2000 Alcohol Alert #47, Imaging and Alcoholism: A Window on the Brain, there appears to be similar shrinkage in deeper parts of the brain, including the brain structures that are associated with memory, and the cerebellum which helps regulate coordination and balance. (1)
People who have alcohol problems can run into problems with abstract reasoning. Part of the trouble seems to be storing information, rather than a specific inability to learn or remember. Its like putting the correct information in a file drawer. Somehow, the file isnt getting labelled properly. That makes it difficult to retrieve the information.(2)
Younger people (i.e. those under 40) who alcohol problems show substantial recovery of all cognitive functions if they stop drinking.(3) For older people who have long standing alcohol problems, the picture is somewhat different. They certainly perform better on cognitive tests, but there can still be difficulties in problem solving tasks years later. (4)
Depression has been shown to be associated with the ability to think and understand. A disproportionate percentage of older adults suffer from depression.
An older client who has an alcohol problem and significant short term memory losses often:
May not remember appointments (he or she simply forgets it as soon as its made);
May not remember drinking (when or how much) and it's not simply a matter of "being in denial" or "manipulation";
May not remember what is being taught.
Implications for Getting and Receiving Help
The fact that many seniors who have alcohol problems also experience memory impairments can have important implications for how well standard alcohol treatment approaches work for seniors.
Many of the existing programs have a strong cognitive therapy base which may be inappropriate for many seniors needsthe approach simply wont make sense to people who have memory problems. Unfortunately, the majority of alcohol treatment programs do not directly consider the impact that clients memory impairments have, and they do not try to use rehabilitation treatment strategies to remedy identified the cognitive problems.
Test Yourself/ Learning More
If you are looking for an interesting overview of memory and aging, check out Baycrest Centre for Geriatric Care's interactive memory site: www.baycrest.org/memoryandaging/main.html
It talks about types of memory and changes with normal aging; as well as about cognitive disorders. It uses quizzes, audio vignettes, and a short audio-visual presentation on cognitive disorders (with transcript).
References
Page last updated Wednesday March 02, 2005
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