Impact of Adolescent Alcohol and Drug Use on Neuropsychological Functioning in Young Adulthood: 10-Year Outcomes

Abstract

Because of ongoing neuromaturation, youth with chronic alcohol/substance use disorders (AUD/SUD) are at risk for cognitive decrements during young adulthood. We prospectively examined cognition over 10 years based on AUD/SUD history. Youth (N = 51) with no AUD/SUD history (n = 14), persisting AUD/SUD (n = 18), or remitted AUD/SUD (n = 19) were followed over 10 years with neuropsychological assessments. Groups were compared at baseline and 10-year follow-up. Both AUD/SUD groups declined in visuospatial construction at year 10 (p = .001). Further, cumulative alcohol use (p < .01) and drug withdrawal (p < .05) predicted year-10 visuospatial function. Alcohol use predicted verbal learning/memory (p < .05), while stimulant use predicted visual learning/memory (p = .01). More recent substance use predicted poorer executive function (p < .05). In conclusion, heavy alcohol and other substance use from adolescence through young adulthood may produce cognitive disadvantages, including visuospatial and memory decline. Youth with heavy, chronic alcohol use and/or drug withdrawal symptoms may be at particular risk.

KEYWORDS:

• adolescence
• alcohol
• executive function
• memory
• neurocognition
• substance use disorders
• visuospatial function
• withdrawal
• young adulthood

Acknowledgments

This research was supported by the following National Institutes of Health grants and fellowships: R37 AA07033 (PI: Brown), R01 DA021182 (PI: Tapert), T32 AA013525 (fellow: Hanson; PI: Riley), and F32 DA020206 (PI: Medina). Portions of this study were presented at the Research Society on Alcoholism Annual Meeting, Chicago, IL, 2007. The authors would like to acknowledge the contributions of David Muchin, Kevin Cummins, and Mark Nakamura in making this research possible.

Notes

Note: Values represent means (and standard deviations). Refer to methods section for description of composite variables summarizing substance use over the 10-year follow-up. Sxs = symptoms.

Mann-Whitney post hoc tests:

^a Persisting and Remitted AUD/SUD > Controls;

^b Persisting AUD/SUD > Remitted AUD/SUD and Controls;

^c Persisting AUD/SUD > Controls;

^d Persisting AUD/SUD > Remitted AUD/SUD;

**p < .01. ***p < .001 between three groups.

Note: Values represent means (and standard deviations) unless otherwise noted. SES determined by Hollingshead scores (higher scores reflect lower SES).

Post hoc tests:

^a Remitted AUD/SUD > Controls;

^b Controls > Persisting and Remitted AUD/SUD;

*p < .05. **p < .01. ***p < .001 between three groups.

Note: All regressions controlled for intake age, intake neuropsychological performance, and years of education at year 10.

*p < .05. **p ≤ .01.