Assessment of cognitive functioning using the Mini Mental State Examination in men with alcohol and crack cocaine use disorder

Abstract

Introduction:The consumption of substances has been associated with cognitive impairment. The Mini Mental State Examination (MMSE) is an easy-to-apply screening used to assess cognitive functions. Our aim was to evaluate the cognitive performance of individuals with alcohol and/or crack cocaine use disorder (AUD, CUD, and polysubstance use) using the MMSE, and to investigate the impact of substance use profile, and the moderation effect of educational level on MMSE performance.Method: Cross-sectional study with 508 inpatient men, diagnosed with substance use disorders (245 with AUD, 85 with CUD and 178 with polysubstance use). Cognitive performance was assessed using the MMSE scale (total and composite scores).Results: Individuals with AUD yielded worse MMSE total score and in the three MMSE components (p<0.001, oral/written language comprehension, p<0.001, attention/memory, and p=0.007, motor functions) when compared to individuals with polysubstance use. MMSE scores were positively correlated to education level (p<0.017), but not associated with age, recent and years of drug use. Education level moderated the impact of substance use on MMSE performance, especially in total score and language comprehension composite score. Individuals with lower education levels (≤ 8 years) had worse performance than those with higher education (≥ 9 years), mainly in individuals with AUD (p<0.001).Discussion: Individuals with lower education level and alcohol use are more prone to present cognitive impairment than crack cocaine users, especially involving language aspects. A better-preserved cognitive function could impact treatment adherence and might guide the decision of therapeutic strategies.