Neuropsychologists' beliefs about alcohol and dementia

Alcohol-related dementia (ARD) is a controversial concept, and the prevailing view of neuropsychologists regarding this disorder is unknown. The purpose of this study was to gain an understanding of neuropsychologists' beliefs and practices regarding ARD. A total of 140 board-certified neuropsychologists completed an anonymous online survey about alcohol and dementia. Almost all respondents (93%) reported alcohol has direct neurotoxic effects, but most were unsure whether moderate alcohol use can be neuroprotective. The presence and course of cognitive deficits as well as functional impairments were rated as the most important factors to consider when making this diagnosis, and declines in memory, executive functions, and processing speed were most frequently observed cognitive changes. Neuropsychologists were mixed in their opinions about cognitive prognosis, with half the sample endorsing stability of cognitive deficits and about one-third of the group indicating gradual improvement. Although laboratory workup was not a major diagnostic consideration, 68% of respondents recommended treatment with vitamins and nutritional supplements. Findings are consistent with the research literature and suggest that while neuropsychologists generally believe alcohol can have direct neurotoxic effects, they vary in their beliefs about diagnosis, treatment, and prognosis. Future research should focus on providing diagnostic and treatment guidelines for ARD.