Verbal and figural memory deficits in abstinent alcoholics
Hightower, Michael Glenn
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Early investigations of memory dysfunction in alcoholics have suggested that alcoholics who have been abstinent for a period of three to four weeks experience complete recovery of verbal memory functioning independent of drinking history and age. After a similar period of abstinence, older alcoholics with long drinking histories have generally demonstrated only partial recovery of nonverbal memory functioning while younger alcoholics, regardless of drinking history, have been reported to completely recover these nonverbal functions. In view of the neuropathological evidence of bilateral cerebral damage in alcoholics (which may be partially reversible) and the demonstration of behavioral continuities which continue with abstinence between alcoholics with and without Korsakoff's disease, the absence of a m.ore permanent verbal memory deficit, especially in alcoholics with long drinking histories, is surprising. Several investigators have suggested that the finding of complete recovery of verbal memory has been primarily due to the insensitivity of the tests which have been used to assess these functions rather than to recovery per se. Recent investigators, using tests which were purported to be more sensitive to subtle verbal information processing disturbances, have found alcoholics to demonstrate verbal memory deficits even after three to four weeks of abstinence. However, it is unclear as to how the tests used by these investigators were more sensitive to verbal memory deficit than were those used in earlier studies Furthermore, continuing verbal memory deficits were demonstrated on tests which have little clinical utility. The present study investigated the relationship between chronic alcohol abuse and verbal and figural memory. Specifically, the pattern of memory deficit in alcoholics who had been abstinent for a period of four weeks was examined as a function of age and number of years of heavy drinking. Four groups of right-handed male Caucasian alcoholics were studied; (1) older longer-term; (2) older shorter-term; (3) younger longer-term; and (4) younger shorter-term. Comparison groups of older and younger nonalcoholics were also tested. Groups were matched on socioeconomic status. The Revised Wechsler Memory Scale (RWMS) was used to assess memory. The RWMS is a clinically useful memory battery which has been related to other indices of cerebral dysfunction and it provides measures of verbal and figural short- and long-term memory. After four weeks of abstinence, nonalcoholics were found to perform significantly better than longer- and shorter-term alcoholics on verbal short-term mem.ory and better than longer-term alcoholics on verbal long-term and figural short-term memory. Younger individuals performed significantly better than older individuals on measures of figural short- and long-term memory. There were no significant interactions between number of years of heavy drinking and age. Older and younger longer-term alcoholics and younger shorter-term alcoholics performed significantly better on figural short-term memory than on verbal short-term memory. Younger groups, regardless of alcohol abuse status, performed significantly better on figural long-term memory than on verbal long-term memory. In terms of degree of impairment, each alcoholic group demonstrated moderate impairment on verbal short-term memory. Older alcoholics, regardless of number of years of heavy drinking, were moderately impaired on verbal long-term memory while younger alcoholics were mildly impaired on this measure. Figural memory measures were clearly sensitive to memory deficit only in older, longer-term alcoholics. Overall, verbal memory measures, especially measures of verbal short-term memory, were the most sensitive indicators of memory deficit in alcoholics with four weeks of abstinence.