The objective of this study was to examine the independent and interactive effects of lifetime patterns of drinking and smoking on cognitive performance in the elderly. A sample of 395 individuals with varying histories of alcohol and cigarette use was drawn from the Charlotte County Healthy Aging Study, a community-based, cross-sectional study of randomly selected older adults of age 60 to 84. Dependent variables were the results of a neuropsychological battery that provided measures of general cognitive ability, executive function, and memory. Specifically, we examined (1) differences in performance among groups of abstainers, drinkers, and smokers, (2) the effects of lifetime drinking and smoking dose on cognition within the group of users, and (3) the effects of intensity of drinking and smoking on cognition. Potential methodological confounds, such as age, education, and medical history, were controlled by means of sampling and covariance procedures. Analyses failed to provide evidence for a beneficial J-curve or threshold effect for drinking, but did not reveal any detrimental effect. No detrimental effect of smoking was found in any analysis; nor was there any evidence of an interaction between alcohol and cigarette use on any cognitive measure. (JINS, 2002, 8, 811–818.)

Effective pragmatic comprehension of language is critical for successful communication and interaction, but this ability is routinely impaired following Traumatic Brain Injury (TBI) (1,2). Individual studies have investigated the cognitive domains associated with impaired pragmatic comprehension, but there remains little understanding of the relative importance of these domains in contributing to pragmatic comprehension impairment following TBI. This paper presents a systematic meta-analytic review of the observed correlations between pragmatic comprehension and cognitive processes following TBI. Five meta-analyses were computed, which quantified the relationship between pragmatic comprehension and five key cognitive constructs (declarative memory; working memory; attention; executive functions; social cognition). Significant moderate-to-strong correlations were found between all cognitive measures and pragmatic comprehension, where declarative memory was the strongest correlate. Thus, our findings indicate that pragmatic comprehension in TBI is associated with an array of domain general cognitive processes, and as such deficits in these cognitive domains may underlie pragmatic comprehension difficulties following TBI. The clinical implications of these findings are discussed.

In this retrospective cohort study we examined the independent and interactive effects of drinking and smoking on cognition in a sample of 3361 males, ages 31 to 49, with varying lifetime histories of alcohol and cigarette use. Dependent variables were neuropsychological measures of global and specific cognitive abilities. Comparison of the ability scores of seven groups, defined by their drinking and smoking histories, explained only 5.4% of the multivariate variance in cognitive ability and less than 2% in any individual cognitive measure. Regression analyses for current drinkers and smokers showed only a single significant, but negligible, effect of pack-years of smoking on a measure of global cognitive ability. Differences in cognitive function in groups defined by intensity of alcohol and cigarette use revealed no significant effect for drinking and a significant, but very small, effect for smoking. (JINS, 2002, 8, 683-690.)