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Cognition and adaptive functioning in older people attending drug and alcohol services

Published online by Cambridge University Press:  01 February 2017

L.A. Monds Open the ORCID record for L.A. Monds [Opens in a new window] ,
N.J. Ridley ,
C. Rivas ,
A. Withall ,
B. Draper  and
N. Lintzeris
L.A. Monds
Affiliation:
Drug and Alcohol Services, South Eastern Sydney Local Health District, c/o The Langton Centre, 591 South Dowling Street, Surry Hills, New South Wales 2010, Australia Discipline of Addiction Medicine, Central Clinical School, Sydney Medical School, The University of Sydney, New South Wales 2006, Australia
N.J. Ridley
Affiliation:
Drug and Alcohol Services, South Eastern Sydney Local Health District, c/o The Langton Centre, 591 South Dowling Street, Surry Hills, New South Wales 2010, Australia
C. Rivas
Affiliation:
Drug and Alcohol Services, South Eastern Sydney Local Health District, c/o The Langton Centre, 591 South Dowling Street, Surry Hills, New South Wales 2010, Australia
A. Withall
Affiliation:
School of Public Health & Community Medicine, UNSW Australia, Sydney, New South Wales 2031, Australia
B. Draper
Affiliation:
School of Psychiatry, UNSW Australia, Sydney, New South Wales 2031, Australia Academic Department for Old Age Psychiatry, Prince of Wales Hospital, Randwick, New South Wales 2031, Australia
N. Lintzeris*
Affiliation:
Drug and Alcohol Services, South Eastern Sydney Local Health District, c/o The Langton Centre, 591 South Dowling Street, Surry Hills, New South Wales 2010, Australia Discipline of Addiction Medicine, Central Clinical School, Sydney Medical School, The University of Sydney, New South Wales 2006, Australia
*
Correspondence should be addressed to: Professor Nicholas Lintzeris, Drug and Alcohol Services, South Eastern Sydney Local Health District, c/o The Langton Centre, 591 South Dowling Street, Surry Hills, NSW 2010, Australia. Phone: (02) 9332 8703; Fax: (02) 9332 8700. Email: nicholas.lintzeris@health.nsw.gov.au.
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Abstract

Background:

Substance use disorders in older adults are expected to increase dramatically in the coming years. Given the increased susceptibility to cognitive deficits in older substance users (defined here as aged 50+ years due to the accelerated health decline observed in this population), it is important to consider the functional correlates of cognitive impairment in these older adults. This study details the cognitive status of older individuals attending outpatient drug and alcohol (D&A) treatment services and seeks to determine of the association of cognitive impairment to self-reported daily functioning.

Methods:

Ninety nine clients aged 50 years or over attending outpatient D&A treatment services in Sydney, Australia participated. Cognition was assessed using the Addenbrooke's Cognitive Examination – Revised (ACE-R). Recent substance use (Australian Treatment Outcome Profile), physical and mental health (SF12, Geriatric Depression Scale), social isolation (Lubben Social Network Scale), and activities of daily living (Bayer ADL Scale) were also assessed.

Results:

Nearly two-thirds of participants screened positive for cognitive impairment on the ACE-R; 41% and 65% of clients met the cut-off scores for mild cognitive impairment (MCI) and more severe cognitive impairment, respectively. Self-reported seizure history was a predictor of cognitive impairment.

Conclusions:

The results suggest that cognitive impairment in this group is common. The assessment of cognitive status for this older group of patients should not only include the identification of cognitive impairment but also encompass mental health and social functioning. A greater understanding of the needs of this cohort will also enable better co-ordination with other health and welfare services tailored to this population.

Keywords

substance abusecognitive assessmentseizures
Type
Research Article
Information
International Psychogeriatrics , Volume 29 , Issue 5 , May 2017 , pp. 815 - 823
Copyright
Copyright © International Psychogeriatric Association 2017 

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