Cognitive Assessment and Remediation in Treatment of Alcoholism
Part I – Reversing impaired cognitive functioning caused by excessive drinking
Brain damage and cognitive impairment is a common and serious consequence of excessive drinking – but it can be reversed! Some impairment might improve on its own over time, with cessation of drinking, whilst some can be improved with remedial exercises and pharmacological treatment.
Spontaneous recovery – i.e. recovery without any active intervention – has been seen over a period of time, with cessation of drinking, in some Individuals. Whilst one reason could be the sheer absence of alcohol (intoxication), other factors, such as improved eating and nutrition, together with social interaction, which are part and parcel of any treatment program, could play some role in recovery. Additionally, the brain itself has the ability to recover over time, in the absence of alcohol, by ‘rewiring’ itself. In doing so, it can revive some of the cognitive abilities impaired because of drinking.
Where spontaneous recovery does not take place, or to aid spontaneous recovery and further improve cognitive functioning, remedial exercises (Brain Training) can be used. It involves activities that require the use of those brain areas damaged by alcohol and those functions impaired by alcohol. Remedial exercises for the brain have been shown to facilitate recovery from impairment.Activities requiring the use of executive/ higher cognitive functions, known to be affected by excessive drinking, can reduce shrinkage in the Cortex – center for the higher level functions – and improve these functions over time.
Apart from remediation exercises, pharmaceutical treatment may also be useful, especially for patients with chronic organic brain disorders. Because of the nature of damage, these individuals may show only modest, or even no improvement at all in cognitive functioning with the passage of time. Pharmacological treatment has been shown to restore some cognitive functioning.
Exercising those areas of the brain damaged by excessive drinking, along with the use of pharmacological treatment like thiamine supplements, can facilitate re-growth of the brain, as well as improving impaired cognitive functions. Thiamine has been shown to improve memory functions in particular.
However, before cognitive impairment can be addressed and remedied, the level of impairment needs to be assessed and baseline established so that progress can be monitored and measured. Initial and periodic cognitive assessment is thus an equally important part of the remediation process.