Submit Manuscript | http://medcraveonline.com Introduction Recent decades have shown an increasing trend in alcohol consumption, with the highest burden on developing countries. Prevalence of alcohol abuse is fve to seven per cent in the Indian population with an estimated 10-20 million in need for treatment. In the Indian subcontinent alcohol dependence have even accounted for 1.2% of the deaths. 1 It has been seen that any level of alcohol consumption can lead to various degrees of cognitive problem and this is of concern due to the wide use of alcohol. 2 Discussion Mild-to-moderate impairment in intellectual functioning was seen in alcohol users. 3 There was also reduction in size of the brain and changes in brain activity in those individuals. The most common diffculty found in alcohol users was in visuospatial abilities and higher cognitive functioning. 4 Visuospatial abilities refer to perceiving an object and in a way remembering how it is located in 2- and 3-dimensional space. The ability to organize and then set in motion and if needed to change comprises the abstract thinking which forms a part of higher cognition. It was seen that individuals with a binge drinking pattern have impairments in tasks like working memory, planning, attention, and decision making. 5 It was proposed that the effects of alcohol on cognition lies on a continuum from light functional deterioration to cognitive defcits which are serious depending on the amount of drink consumed. 6 Some studies reported defcits in concept formation and abstraction in young-to middle-aged men who were engaged even in social drinking. 7 An increasing number of reports now suggest a J-shaped rela- tionship between cognition and amount of alcohol consumed, suggesting that low to moderate drinking can be benefcial for cognition than non-drinking or heavy drinking. 8–10 In contrast, there are several studies that shows that these benefts are limited and condition-specifc. 11 Launer et al. 12 found that cognitive function was improved by alcohol only in patients of cardiovascular diseases or diabetes mellitus, while some have reported a beneft only in elderly women. 13,14 Some studies, moreover, found that light-to-moderate alcohol intake reduced the chances of dementia. 15 Several attempts were done to defne a safe dose for alcohol but has been inconsistent. A review of 19 published studies have shown that 5 or 6 “standard drinks” per day caused “cognitive ineffciencies”, 7 to 9 drinks caused “mild cognitive defcits”, and 10 or more drinks caused impaired cognition of a degree which is found in frank alcoholics. The relation between duration and lifetime quantity of drinking and cognition is somewhat not very clear. Some studies said that cognitive performance worsens directly in proportion to the amount and duration of alcohol intake. 16 Some have suggested that cognitive defcits may be found only in those who drink regularly for 10 years or more. 17,18 Although further research is needed to determine how a person’s pattern of drinking is related to cognitive impairment, some defcits are possible even in people who are not heavy drinkers. Structural imaging evidences consistently revealed that alcoholics’ brains are smaller and less dense than non-alcohol users. 19,20 Loss of brain volume is specifc in two areas: the outer layer (i.e., the cortex) of the frontal lobe, a major centre of higher mental functions ; 20–22 and the cerebellum. It is supported by functional imaging studies, which revealed altered brain activity in both these areas. 23 Functional imaging is also sensitive enough to detect these abnormalities even prior to structural imaging techniques, or even when major cognitive problems are not prominent. Thus functional imaging may be useful for detecting early stages of cognitive decline. 23 It is diffcult to exactly measure cognitive abilities and to relate these abilities to any brain irregularity. 24 This has lead to development of better techniques for measuring cognition. Beatty and colleagues 16 showed that cognitive impairment may be caused due to use of alcohol, by damage to multiple brain areas like prefrontal circuits. It has been seen that some of these impairment is reversible when abstinent. 25 Newly detoxifed alcohol users show mild but signifcant defcits in MOJ Addict Med Ther. 2018;5(6):262‒264. 262 © 2018 Dalal et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and build upon your work non-commercially. Cognitive problems in alcohol use: a review Volume 5 Issue 6 - 2018 PK Dalal, 1 Anamika Das 2 1 Department of Psychiatry, King George’s Medical University, India 2 Junior Resident, Department of Psychiatry, King George’s Medical University, India Correspondence: Dalal PK, Professor and Head, Department of Psychiatry, King George Medical University Tel 0522-2258805, Fax 0522-2258805, India, Email Received: October 31, 2018 | Published: December 19, 2018 Abstract Alcohol use has increased in the recent years which have lead to several problems world- wide. Effect on cognition is such an area which has not been studied much but there has been ample evidences regarding it. Various studies show the effect of alcohol on cognitive performances which depends on various factors like age, sex, amount and pattern of drinking and the related medical co-morbidities. Various results have been obtained depending on the amount of alcohol consumed and relationship has been seen on their effect on medical co-morbidities. Despite a substantial amount of research in the feld no robust data could be validated due to lack of defnition of a standard drink across studies of various countries. Nevertheless it has been seen that alcohol does have a detrimental effect on cognition which has even been proved indirectly by functional studies. With present methods of cognitive ability testing and other functional imaging studies being used we are hopeful that in recent future we will be able to pinpoint the problems caused and thus have a future direction for necessary interventions. Keywords: alcohol, cognition, binge drinking, j-shaped relationship, visuo-spatial abilities, working memory MOJ Addiction Medicine & Terapy Mini Review Open Access