Comprehensive assessment of alcohol‐related brain damage (ARBD): gap or chasm in the evidence?

Abstract

Accessible Summary: Alcohol-related brain damage (ARBD) causes a broad range of both neurological and neurocognitive impairment  Mental health nurses are required to provide programs designed to facilitate individuals with chronic alcohol dependency to radically change their drinking behaviour, invariably with an abstinence focus. No evidence was found that related to the nutritional and physical intervention needs of this group. Most instruments used to access domains relevant to ARBD in terms of providing a comprehensive assessment have not been validated in this group Abstract Alcohol-related brain damage (ARBD) is primarily caused by chronic alcohol misuse and thiamine deficiency and results in a broad range of impairments. Despite the increasing incidence of ARBD in the UK in recent decades, it is currently underdiagnosed, managed inappropriately and treated inadequately. Moreover, information about assessments for individuals with ARBD is currently absent from clinical guidelines and policy documents.The aim of this paper was to review the evidence relating to the neurological, neuropsychological, psychosocial, physical and nutritional assessment of individuals with ARBD, to identify appropriate assessment tools which could be used to measure and monitor the impact of ARBD over time. A systematic online database search revealed a total of 160 separate references, 133 of which were rejected and 2 of which could not be accessed. 25 papers were included in the review, including 6 neuroimaging studies, 17 neuropsychological studies and 2 studies using psychosocial methods of assessment. A lack of evidence for nutritional and physical assessment of individuals with ARBD was found. The review findings are inconclusive, most instruments currently used in ARBD research have not specifically been validated for use within an ARBD context. Further research is required to identify comprehensive methods of ARBD assessment.

Neurocognitive, psychosocial and functional status of individuals with alcohol-related brain damage (ARBD) on admission to specialist residential care

“…Research into the psychosocial functioning of individuals with ARBD is currently scarce (Horton et al, 2014a). Nevertheless, anxiety and depression are recognised to be common comorbidities in this population (MacRae & Cox, 2003;Wilson et al, 2012).…”

“…These tests generally measure three main neurocognitive domains, including general cognitive and intellectual functioning, memory impairment and executive functioning (Horton et al, 2014a). Nevertheless, the current approach to neurocognitive assessment in ARBD research is inconsistent and diffuse, suggesting that an integrated and comprehensive means of measuring neurocognitive functioning in ARBD should be sought.…”

“…These instruments have not, however, been validated for use in ARBD context, and they have variable reliability and validity when used in wider research contexts (Horton et al, 2014a). One instrument that may be useful for assessing people with ARBD is the Hospital Anxiety and Depression Scale (HADS; Zigmond & Snaith, 1983).…”

Neuro-Advancements and the Role of Nurses as Stated in Academic Literature and Canadian Newspapers

“…When placed in relation to nurses, the roles of nurses were primarily in relation to occupational roles with interacting with the disability community, such as helping to improve patient care [200] and outcomes [201], utilizing neuro-advancement for appropriate patient monitoring [163], the community learning disability epilepsy nurse specialist [202], and mental health nurses [203][204][205]. The abstracts did not indicate in-depth engagement with the role nurses have in relation to disabled people, especially the social aspects of the lives of disabled people, and the potential impacts of neuro-linked assistive technologies on such social aspects were missing.…”

Deterioro cognitivo y dependencia alcohólica, implicaciones clínicas

“…Thiamine deficiency: poor nutrition, malabsorption in the digestive tract, and liver failure present in patients with alcohol dependence determine the onset of a severe condition: Wernicke's encephalopathy (WE), which, if left untreated, can become chronic and give rise to Korsakoff's syndrome (KS) (Horton et al, 2015). WE is characterized by a confusional state, with vision and gait disorders.…”