Alcohol-related cognitive impairment: a systematic review of cognitive and pharmacological interventions.

Introduction: Alcohol-related Cognitive Impairment (ARCI) is highly prevalent among patients with alcohol dependence, with 50-70% of these patients presenting some degree of impairment. Although it negatively influences treatment outcome, this condition is underdiagnosed and undertreated. Objectives: The aim of this systematic review is to investigate the existing evidence regarding both cognitive and pharmacological interventions for ARCI. Methods: We systematically reviewed PubMed, Scopus and Science direct databases up to May 2019 and followed the PRISMA guidelines. The quality of the studies was assessed using the Jadad Scale. Results: 26 studies were eligible for inclusion (14 referring to neuropsychological interventions and 12 to pharmacological treatments). Among neuropsychological interventions, computerised treatments, errorless learning and component method showed positive effects on working memory, memory measures and general cognitive function. On the other hand, thiamine, memantine and metilphenidate improved working memory, long term memory and general cognitive function. Nevertheless, these studies have several limitations, such as small sample size, lack of replication of the results or low specificity of the interventions. Conclusions: Cognitive functions can be improved by using specific neuropsychological and pharmacological interventions, and these improvements can have a positive effect on the reduction of alcohol use. However, methodological weaknesses of studies in this field prevent from having a gold standard treatment for Alcoholrelated Cognitive Impairment. and further research based on promising strategies (e.g. digital interventions, thiamine) is required. Also, ecological interventions are needed in order to enhance the transferring and generalisation of the acquired abilities into the natural environment. [ABSTRACT FROM AUTHOR]