Risk Factors for Cognitive Impairment in Adults Attending Australian Community-Based Substance Use Treatment Services

Cognitive impairment in individuals attending treatment for substance use disorders is common. However, multiple aetiologies contribute to the presentation of cognitive issues in this population, and key risk factors for significant impairment are unclear. This limits effective screening, including identifying which clients are most appropriate for comprehensive neuropsychological assessment. The aims of the current study were to: (i) examine clinical characteristics and risk factors for cognitive impairment in individuals engaged with community-based substance use treatment services; and (ii) explore which risk factors predicted objective cognitive impairment based on a cognitive screening measure.

The current study retrospectively analysed clinical data collected from individuals who participated in cognitive screening programs (n = 559) in two community drug and alcohol services in New South Wales, Australia between 2015 and 2020. This included collation and analysis of: (i) risk factors for cognitive impairment; (ii) objective cognitive screening and questionnaire data.

On cognitive screening, 72% of clients met criteria for suspected cognitive impairment, with high rates of non-modifiable and modifiable risk factors reported by clients. A history of neurodevelopmental conditions, education level, and self-rated cognitive and functional ability significantly predicted score on the Montreal Cognitive Assessment.

This study highlights the high rates of risk factors for cognitive impairment in individuals attending community substance use treatment, and the complexity of determining who requires more comprehensive cognitive assessment. A history of neurodevelopmental conditions or self-reported functional or cognitive difficulties may indicate the need for objective cognitive screening.