Multiple withdrawals and binge drinking may significantly exacerbate cognitive deficits [32,63]. Older drinkers show greater alcohol-related cognitive changes and are less likely to recover function once they cease drinking, selleck compound even after drinking history is controlled for [13]. Other factors such as gender and education also likely contribute to vulnerability to cognitive impairment, and lower levels of education are associated with less recovery over time and females appear to be more vulnerable to cognitive impairment despite generally lower drinking levels than men [13,63]. It is unclear whether education is a protective factor or whether low pre-morbid intelligence is a risk for both cognitive impairment and poor educational attainment [13].

It has also been suggested that genetic influences – such as a family history of alcoholism – may be a risk factor for development of alcohol use cognitive disorders, with cognitive dysfunction potentially predating alcohol misuse [13]. Another feature common to ARD and WKS is stability, and even improvement, in cognitive functioning over time provided that abstinence is maintained. A two-year follow-up of nursing home residents with dementia reported that patients with ARD demonstrated a stabilization of cognitive and functional status, as opposed to individuals with Alzheimer’s disease or vascular dementia who experienced a general decline [43]. This is consistent with reports from a Scottish study [64] of stability and even improvement in some cognitive domains for an ARD group over a one-year follow-up.

Similarly, individuals with WKS also have potential for recovery, although this is not commonly recognized [4]. Improvements in general knowledge, visual long-term memory, and verbal fluency have been found in abstinent individuals with KS over two years, and cognitive improvement is associated with higher pre-morbid education and fewer detoxifications in the past [65]. Early observations by Victor and colleagues [66] also suggest that a large proportion (21%) of individuals with KS can make a full recovery. These clinical findings are consistent with current neuroimaging evidence that suggests the possibility of at least partial structural and functional recovery from alcohol-related brain damage if abstinence is maintained.

A recent animal study reported that while the effects of chronic ethanol exposure (including working memory and episodic memory impairment) can recover with prolonged abstinence, the deficits of thiamine deficiency Brefeldin_A (spatial memory impairment and increased perseverative behavior) are more persistent [28]. Clinical considerations The assessment and management of individuals with selleck chemical ARQ197 ARD and WKS entail a number of clinical issues. Firstly, a thorough nutritional and drinking history should be taken, with confirmation from an informant if possible.