The interaction of chronic alcohol consumption and aging on brain structure and function

Prediction of brain age in individuals with and at risk for alcohol use disorder using brain morphological features

Brain age measures predicted from structural and functional brain features are increasingly being used to understand brain integrity, disorders, and health. While there is a vast literature showing aberrations in both structural and functional brain measures in individuals with and at risk for alcohol use disorder (AUD), few studies have investigated brain age in these groups. The current study examines brain age measures predicted using brain morphological features, such as cortical thickness and brain volume, in individuals with a lifetime diagnosis of AUD as well as in those at higher risk to develop AUD from families with multiple members affected with AUD (i.e., higher family history density (FHD) scores). The AUD dataset included a group of 30 adult males (mean age = 41.25 years) with a lifetime diagnosis of AUD and currently abstinent and a group of 30 male controls (mean age = 27.24 years) without any history of AUD. A second dataset of young adults who were categorized based on their FHD scores comprised a group of 40 individuals (20 males) with high FHD of AUD (mean age = 25.33 years) and a group of 31 individuals (18 males) with low FHD (mean age = 25.47 years). Brain age was predicted using 187 brain morphological features of cortical thickness and brain volume in an XGBoost regression model; a bias-correction procedure was applied to the predicted brain age. Results showed that both AUD and high FHD individuals showed an increase of 1.70 and 0.09 years (1.08 months), respectively, in their brain age relative to their chronological age, suggesting accelerated brain aging in AUD and risk for AUD. Increased brain age was associated with poor performance on neurocognitive tests of executive functioning in both AUD and high FHD individuals, indicating that brain age can also serve as a proxy for cognitive functioning and brain health. These findings on brain aging in these groups may have important implications for the prevention and treatment of AUD and ensuing cognitive decline.

The neuroimmune system - Where aging and excess alcohol intersect

As the percentage of the global population over age 65 grows, and with it a subpopulation of individuals with alcohol use disorder (AUD), understanding the effect of alcohol on the aged brain is of utmost importance. Neuroinflammation is implicated in both natural aging as well as alcohol use, and its role in alterations to brain morphology and function may be exacerbated in aging individuals who drink alcohol to excess. The neuroimmune response to alcohol in aging is complex. The few studies investigating this issue have reported heightened basal activity and either hypo- or hyper-reactivity to an alcohol challenge. This review of preclinical research will first introduce key players of the immune system, then explore changes in neuroimmune function with aging or alcohol alone, with discussion of vulnerable brain regions, changes in cytokines, and varied reactions of microglia and astrocytes. We will then consider different levels of alcohol exposure, relevant animal models of AUD, and neuroimmune activation by alcohol across the lifespan. By identifying key findings, challenges, and targets for future research, we hope to bring more attention and resources to this underexplored area of inquiry.

Chronic Ethanol Consumption Induces Osteopenia via Activation of Osteoblast Necroptosis

Chronic high-dose alcohol consumption impairs bone remodeling, reduces bone mass, and increases the risk of osteoporosis and bone fracture. However, the mechanisms underlying alcohol-induced osteoporosis are yet to be elucidated. In this study, we showed that excess intake of ethyl alcohol (EtOH) resulted in osteopenia and osteoblast necroptosis in mice that led to necrotic lesions and reduced osteogenic differentiation in bone marrow mesenchymal stem cells (BMMSCs). We found that EtOH treatment led to the activation of the RIPK1/RIPK3/MLKL signaling, resulting in increased osteoblast necroptosis and decreased osteogenic differentiation and bone formation both in vivo and in vitro. We further discovered that excessive EtOH treatment-induced osteoblast necroptosis might partly depend on reactive oxygen species (ROS) generation; concomitantly, ROS contributed to necroptosis of osteoblasts through a positive feedback loop involving RIPK1/RIPK3. In addition, blocking of the RIPK1/RIPK3/MLKL signaling by necrostatin-1 (Nec-1), a key inhibitor of RIPK1 kinase in the necroptosis pathway, or antioxidant N-acetylcysteine (NAC), an inhibitor of ROS, could decrease the activation of osteoblast necroptosis and ameliorate alcohol-induced osteopenia both in vivo and in vitro. Collectively, we demonstrated that chronic high-dose alcohol consumption induced osteopenia via osteoblast necroptosis and revealed that RIPK1 kinase may be a therapeutic target for alcohol-induced osteopenia.

The Phenomenon of Substance Abuse among the Elderly: Part I

Because substance abuse, already a major problem among elderly people, is expected to worsen significantly during the 1990s, healthcare providers must be better prepared to identify and deal effectively with this important area of geriatric care. We present an overview of the phenomenon of substance abuse among the elderly with particular attention to the abuse of alcohol and benzodiazepines, the two substances most commonly abused by elderly people. Traditionally, substance abuse among the elderly has gone largely unrecognized because of a low level of suspicion, misdiagnosis, and concealment. It is axiomatic that problems cannot be solved unless they are first identified and appropriately characterized. To respond to the increasing problem of substance abuse among the elderly, healthcare providers must recognize that elderly people are at particular risk for substance abuse, and because of their heterogeneity, they require individualized and diverse prevention and treatment approaches. Once the abuse is identified and properly characterized, specific prevention and treatment strategies can be developed and implemented.

Chronic High Dose Alcohol Induces Osteopenia via Activation of mTOR Signaling in Bone Marrow Mesenchymal Stem Cells

Chronic consumption of excessive alcohol results in reduced bone mass, impaired bone structure, and increased risk of bone fracture. However, the mechanisms underlying alcohol-induced osteoporosis are not fully understood. Here, we show that high dose chronic alcohol consumption reduces osteogenic differentiation and enhances adipogenic differentiation of bone marrow mesenchymal stem cells (BMMSCs), leading to osteopenia in a mouse model. Mechanistically, impaired osteo/adipogenic lineage differentiation of BMMSCs is due to activation of a phosphatidylinositide 3-kinase/AKT/mammalian target of rapamycin (mTOR) signaling cascade, resulting in downregulation of runt-related transcription factor 2 and upregulation of peroxisome proliferator-activated receptor gamma via activation of p70 ribosomal protein S6 kinase. Blockage of the mTOR pathway by rapamycin treatment ameliorates alcohol-induced osteopenia by rescuing impaired osteo/adipogenic lineage differentiation of BMMSCs. In this study, we identify a previously unknown mechanism by which alcohol impairs BMMSC lineage differentiation and reveal a potential rapamycin-based drug therapy for alcohol-induced osteoporosis. Stem Cells 2016;34:2157-2168.

Development of a Conceptual Model for Smoking Cessation: Physical Activity, Neurocognition, and Executive Functioning

PURPOSE

Considerable research has shown adverse neurobiological effects of chronic alcohol use, including long-term and potentially permanent changes in the structure and function of the brain; however, much less is known about the neurobiological consequences of chronic smoking, as it has largely been ignored until recently. In this article, we present a conceptual model proposing the effects of smoking on neurocognition and the role that physical activity may play in this relationship as well as its role in smoking cessation.

METHODS

Pertinent published peer-reviewed articles deposited in PubMed delineating the pathways in the proposed model were reviewed.

RESULTS

The proposed model, which is supported by emerging research, demonstrates a bidirectional relationship between smoking and executive functioning. In support of our conceptual model, physical activity may moderate this relationship and indirectly influence smoking behavior through physical activity-induced changes in executive functioning.

CONCLUSIONS

Our model may have implications for aiding smoking cessation efforts through the promotion of physical activity as a mechanism for preventing smoking-induced deficits in neurocognition and executive function.

Alcohol use across the lifespan: An analysis of adolescent and aged rodents and humans

Adolescence and old age are unique periods of the lifespan characterized by differential sensitivity to the effects of alcohol. Adolescents and the elderly appear to be more vulnerable to many of alcohol's physiological and behavioral effects compared to adults. The current review explores the differential effects of acute alcohol, predominantly in terms of motor function and cognition, in adolescent and aged humans and rodents. Adolescents are less sensitive to the sedative-hypnotic, anxiolytic, and motor-impairing effects of acute alcohol, but research results are less consistent as it relates to alcohol's effects on cognition. Specifically, previous research has shown adolescents to be more, less, and similarly sensitive to alcohol-induced cognitive deficits compared to adults. These equivocal findings suggest that learning acquisition may be differentially affected by ethanol compared to memory, or that ethanol-induced cognitive deficits are task-dependent. Older rodents appear to be particularly vulnerable to the motor- and cognitive-impairing effects of acute alcohol relative to younger adults. Given that alcohol consumption and abuse is prevalent throughout the lifespan, it is important to recognize age-related differences in response to acute and long-term alcohol. Unfortunately, diagnostic measures and treatment options for alcohol dependence are rarely dedicated to adolescent and aging populations. As discussed, although much scientific advancement has been made regarding the differential effects of alcohol between adolescents and adults, research with the aged is underrepresented. Future researchers should be aware that adolescents and the aged are uniquely affected by alcohol and should continue to investigate alcohol's effects at different stages of maturation.

Are tobacco and alcohol use related to Alzheimer's disease? A critical assessment of the evidence and its implications

Elucidation of the association of tobacco and alcohol use with Alzheimer's disease (AD) may advance etiological hypotheses and provide a theoretical basis for treatment. There is currently no cure or effective treatment for AD, and no cause has been established. Pharmacological evidence supports a plausible biological mechanism for the involvement of tobacco use: nicotine compensates for some of the cholinergic deficits observed in AD. Epidemiological evidence, however, is inconsistent, although recent meta-analyses also support a protective effect. Although smoking per se is certainly not advocated, further investigation of a potential protective effect of nicotine on AD is warranted. Pharmacological studies implicate alcohol use as a possible risk factor for AD; the epidemiological studies are again inconclusive. Alcohol consumption is associated with daily smoking and smokers are, in turn, more likely to consume alcohol. Since tobacco use may decrease the risk of developing AD and alcohol use may increase it, it is important to consider these two substances together: the effect of one may negate the other. This literature review critically evaluates the evidence for an association of tobacco and alcohol use with AD and identifies key issues for further research.

Developmental expression of the beta-amyloid precursor protein and heat-shock protein 70 in the cerebral hemisphere region of the rat brain

Alzheimer's disease (AD) is characterized by depositions of the amyloid beta protein (A beta) in the brain in the form of extracellular plaques and cerebrovascular amyloid. A beta (approximately 4 kDa) is derived from a family of large (approximately 110 kDa) beta-amyloid precursor proteins (APP), which are integral membrane glycoproteins. Although a connection between AD and alcoholism has recently been suggested, this relationship has not been explored at the molecular level. Our hypothesis is that APP has a role in brain development and that abnormal APP levels may be involved in dementia associated with AD and alcoholism. We compared the profile of total APP levels between ethanol naïve alcohol-preferring (P) and alcohol-nonpreferring (NP) rats. We also investigated the possibility that APP levels can be regulated in an age-dependent manner in young rats. We studied the distribution of two proteins in the cerebral hemisphere region of the rat brain at various developmental periods. Six groups composed of the following different ages of rats were used: 7, 14, 21, 36, 43, and 78 (postnatal) days. Cell extracts from different regions of the brain were subjected to Western immunoblotting using mAb22C11. Our results suggest that levels of high-molecular-weight APP bands were greater in brain extracts from 7-day-old P rats than in other samples tested, and that the distribution of APP levels was more uneven in brain extracts from different ages of P than from NP rats. These initial results suggest that APP may play an important role in the early development of the rat brain and the alcohol-preferring trait may influence APP processing in the developing brain.

Synaptic reorganization in the hippocampal formation of alcohol-fed rats may compensate for functional deficits related to neuronal loss

We have examined the behavioral and neuroanatomical effects of long-term alcohol intake in rats ingesting a 20% solution of ethanol for 30 weeks. Previous studies have shown that this treatment provokes neuronal degeneration in the hippocampal formation, which occurs in parallel with remodeling processes. Spatial reference and working memory of alcohol-fed rats were evaluated during last 4 weeks of treatment by comparison of their performance with age-matched controls on the Morris water maze. Alcohol consumption did not affect the performance of rats in the reference memory task as indicated by the measures derived from the acquisition trials and from the probe-trial, which were highly similar for alcohol-fed and control animals. Also, performance in the working memory task was not significantly altered in alcohol-treated animals. No treatment-related changes in swim speed or impairments of sensorimotor abilities, tested in the visible platform task, were detected. Stereological methods were applied to evaluate the damage inflicted by alcohol intake in the structure of the hippocampal formation. In the alcohol-treated animals, there was a noticeable cell loss in the granular layer of the dentate gyrus (10%), and in CA3 (18%) and CA1 (19%) hippocampal subdivisions. In spite of the neuronal loss, the total number of synapses between mossy fibers and CA3 pyramids was unaffected by alcohol treatment suggesting that new synaptic contacts were formed between the surviving neurons. We show that, regardless the marked hippocampal cell loss in rats exposed to chronic alcohol intake, the reorganization that takes place at the synaptic level may alleviate the expected functional deficits.

Thiamin deficiency and Korsakoff's syndrome: failure to find memory impairments following nonalcoholic Wernicke's encephalopathy

Prolonged alcohol consumption is associated with a variety of neuropsychiatric conditions, including the dense amnesic disorder known as Korsakoff's syndrome. Korsakoff's syndrome is frequently diagnosed in alcoholics after an episode of acute thiamin deficiency. The accepted view within the medical literature is that the etiology of this disorder lies in thiamin deficiency or Wernicke's encephalopathy. However, examination of the published reports of pure thiamin deficiency unaccompanied by chronic and excessive consumption of alcohol shows that, in this group of patients, the rate of progression to Korsakoff's syndrome is low. This result suggests that the memory impairments associated with alcohol-related brain damage cannot be attributed to thiamin deficiency alone. The etiology of alcohol-related cognitive impairments such as Korsakoff's syndrome is still poorly understood but several lines of evidence suggest multiple causal factors interact to produce deficits in performance. Animal models that manipulate only a single putative etiological factor are unlikely to elucidate the multiple influences that lead to Korsakoff's syndrome. A study of the natural history of alcohol-related brain damage is needed that will allow an assessment of individual risk factors and their interactions.

Intermediate length neuropsychological screening of impairment among psychoactive substance-abusing patients: a comparison of two batteries

Two intermediate-length neuropsychological test batteries-the Brain Age Quotient-T Scored (BAQ-T) and the Neuropsychological Screening Battery (NSB)-were used to evaluate the cognitive functioning of substance-abusing patients. Patients entering residential treatment for substance abuse (n = 30) performed significantly worse on both batteries compared to demographically similar participants from a nonclinical control group (n = 30). Both batteries categorized over one third of the substance-abusing patients as cognitively impaired; the chance-corrected agreement (kappa) of the BAQ-T and NSB in classifying participants as either cognitively impaired or intact was satisfactory. The comparative merits and limitations of each battery are discussed.

Medical manifestations of alcoholism in the elderly

Alcoholism may lead to a great many physical and mental problems in individuals of any age. Elderly alcoholics often have additional problems resulting from the interaction of age related changes in physiology and "heavy" alcohol intake. Some of the more important problems are: Impairment of the immune system with decreased ability to deal with infection or cancer. Increased incidence of hypertension, cardiac arrhythmia, myocardial infarction, and cardiomyopathy. Increased incidence of stroke. Alcohol dementia. Increased incidence of esophageal and other cancers. Cirrhosis and other liver disease. Malnutrition. There seems to be no area in which even moderate alcohol intake is of definite benefit, and some areas in which even small amounts are detrimental.

Diagnosis and assessment of substance abuse in older adults: current strategies and issues

Alcohol and substance abuse in older adults until recently has received little empirical attention in the literature. However, in light of the increasing number of older adults in the population, clinicians and researchers alike are recognizing the importance of evaluating specific assessment and treatment strategies for such older substance abusers. Because distinctive biological, cognitive, and psychosocial variables appear to be correlated with substance abuse in older adults, evaluation and intervention methods employed with younger cohorts may be inappropriate or ineffective with individuals 55 and over. Our article, therefore, examines these characteristics as they pertain to the unique problems and service needs of the elderly. Relevant diagnostic and assessment strategies are reviewed. Finally, suggestions for future work in this area are outlined.

The relationship between length of stay in drug-free therapeutic communities and neurocognitive functioning

The relationship between neurocognitive functioning and length of stay in drug-free therapeutic communities (TCs) was investigated. The Wechsler Adult Intelligence Scale (WAIS) was administered to 495 patients admitted to a therapeutic community. It was hypothesized that Digit Symbol and Block Design, which have been found to be more sensitive to diffuse neuropsychological impairment than other WAIS subtests, would be significant predictors of length of stay. A hierarchical regression analysis was performed, and both subtests were found to be predictive of time-in-residence. These findings are congruent with recent investigations that have found a relationship between cognitive impairment and treatment process and outcome in substance abuse treatment.

Elevated cytosolic calcium in cerebrocortical nerve terminals of rats during prolonged ethanol ingestion

Increases in cytosolic free calcium concentrations ([Ca++]i) may underlie acute neuronal degeneration during ischemic or anoxic episodes, seizures and excitotoxin treatment. With quin-2 and fura-2 fluorescent probes, we have obtained evidence for elevated [Ca++]i in cerebrocortical terminals of adult rats following chronic consumption of ethanol-containing liquid diets for "neurotoxic" durations. Compared to isocaloric carbohydrate-fed controls, ethanol-fed rats had significantly higher [Ca++]i in P2 synaptosomal fractions after 4 months of diet intake, and in purified cerebrocortical synaptosomes after diet ingestion for 10 months. In addition, [Ca++]i in the synaptosomal fractions of ethanol-fed rats from either exposure time were markedly resistant to K(+)-dependent potentiation. Persistently increased synaptic [Ca++]i and a blunted response to K+ depolarization following chronic ethanol ingestion lead us to associate impaired Ca++ homeostasis in the neurodegenerative processes of alcoholism.

The influence of cholesterol on synaptic fluidity and dopamine uptake

The present study examined how the synaptic cholesterol/phospholipid ratio influences membrane fluidity and a transmembrane process of the dopaminergic system, dopamine uptake. Fluorescence polarization of DPH was used as a measure of membrane fluidity. The cholesterol content of synaptosomal and synaptic plasma membranes was altered using a lipid transfer protein. The results of the present study demonstrate that the transmembrane process of dopamine uptake may be inhibited by an elevated synaptic cholesterol/phospholipid ratio, which correlates with increased fluorescence polarization. Specifically, a 10-30% increase in the cholesterol/phospholipid ratio resulted in an approximately 20% increase in fluorescence polarization, a 3- to 6-fold increase in Km, a 4-fold increase in Vmax, and a marked decrease in the Vmax/Km (the first order rate constant for dopamine uptake at low substrate concentrations).

Prevalence of the Korsakoff syndrome in The Hague, The Netherlands

An epidemiological survey of the Korsakoff syndrome was made in The Hague, The Netherlands, by interviewing workers of all relevant health care organisations in that city. A prevalence of 4.8 per 10,000 inhabitants was found. The mean age of patients was 62 years. Seventy-five percent of all patients had already been hospitalised for several years. Physical and mental health, as judged by other medical diagnoses, was poor.

Ethanol challenge alters amino acid neurotransmitter release from frontal cortex of the aged rat

In two groups of male rats having an average age of either 90 days or two years, guide cannulae for bilateral push-pull perfusion were implanted stereotaxically to rest upon the superficial frontal cerebral cortex. On post-operative recovery, either 1.5 or 3.0 g/kg 20% ethanol (V/V) was given by intragastric gavage to each unrestrained rat. Sequential samples of venous blood were obtained from the tail and analyzed for alcohol levels by gas chromatography. A set of push-pull perfusions of the cortical sites was carried out with an artificial CSF before gavage and at 25, 50 and 150 min after the administration of ethanol. An individual perfusion was continued for 5.0 min at a rate of 25 microliters/min. Using high performance liquid chromatography with electrochemical detection (HPLC-EC) each sample of perfusate was then assayed for its content of glutamate (Glu), aspartate (Asp), glutamine (Gln), glycine (Gly), taurine (Tau) and GABA with homoserine used as the internal standard. The results showed that the 3.0 g/kg dose of ethanol resulted in a higher level of blood ethanol in the older animals, which persisted over the 150 min time interval. Further, the 1.5 g/kg dose of ethanol administered to the older rats reduced the cortical activity of Glu and Gln relative to the younger animals. In addition, the 3.0 g/kg dose augmented the cortical efflux of Tau in the aged rats. Neither dose of ethanol affected the efflux of Asp or Gly from the perfused frontal cortex of either the young or old group, nor was the release of GABA detectable under either the control condition or following treatment with ethanol.(ABSTRACT TRUNCATED AT 250 WORDS)

Chronic alcohol consumption induces lipofuscin deposition in the rat hippocampus

Previous investigations have suggested that chronic alcohol consumption accelerates a number of age-related changes in the cerebellar cortex and hippocampal formation. In the cerebellum, alcohol-feeding has been shown to accelerate the intracellular deposition of lipofuscin. In order to determine whether alcohol administration has a similar effect on hippocampal lipofuscin deposition, we studied the pattern of lipofuscin deposition in alcohol-fed rats for periods of 1, 3, 6, 12 and 18 months and compared the results with those obtained in the respective pair-fed controls. A precocious and progressive deposition of lipofuscin pigment was found in both CA1 and CA3 neurons in Ammon's horn hippocampal fields after 3 and 6 months of alcohol feeding, respectively. These results parallel those observed during normal aging and reinforce the hypothesis of a close link between chronic alcohol consumption and a premature nerve cell aging.

Membrane fluidization increases low-affinity muscarinic receptor binding in brain: changes with aging

Specific cholinergic muscarinic receptor binding was determined with L-[3H]quinuclidinyl benzilate ([3H]QNB) in homogenates from crude synaptosomal pellets prepared from mouse whole-brain homogenates. Specific total (high- and low-affinity) binding was determined in the absence of the agonist carbachol and low-affinity binding in its presence. These membrane preparations were fluidized by adding in vitro aliphatic alcohols ranging from ethanol to hexanol and by increasing the incubation temperatures. At 23 degrees C hexanol (14.7 mM) nearly doubled the low-affinity binding in the presence of carbachol (0.32 mM) and decreased high-affinity binding by the same amount. This suggested a change of muscarinic receptors from high- to low-affinity conformation. Increase of incubation temperature from 24 degrees C to 37 degrees C nearly tripled low-affinity binding. Brain homogenates from female C57BL/6J mice, ages 6, 12, 18, and 30 months, showed a progressively lower stimulation by hexanol of low-affinity [3H]QNB binding in the presence of carbachol. We postulate that this diminished change with age of [3H]QNB-receptor binding in response to alcohols may be a result of increasing membrane rigidity with advancing age. Rigidity of membranes may link aging at the membrane level, synaptic receptors, and impaired learning behavior.

Lipofuscin granules in cerebellar interneurons after long-term alcohol consumption in the adult rat

Lipofuscin deposition in nerve cells is one of the most reliable and consistent neurocytological features correlated with ageing. Purkinje cells of long-term alcohol-fed rats show large agglomerates of lipofuscin granules after six months of alcohol experiment, whereas in normal biological ageing, this happens only after 25 months of age. Cerebellar interneurons have specific patterns of lipofuscin accumulation during ageing concerning both its morphological type and chronology of deposition. We studied the effects of chronic alcohol treatment on cerebellar interneurons taking particular account of lipofuscin pigment accumulation. Control and alcohol-fed groups for 1, 3, 6, 12 and 18 months were used. A precocious and progressive accumulation of lipofuscin granules occurred in granule, Golgi and basket cells. Stellate cells remained pigment-free. The lipofuscin deposited in the granule and Golgi cells was of the granular type, whereas that of basket and stellate cells was lamellar (fingerprint-like pattern). These results parallel those observed during normal ageing, and reinforce the hypothesis of the existence of a close relationship between chronic alcohol consumption and precocious nerve cell ageing.

Peripheral neuropathy, cerebral atrophy, and intellectual impairment in chronic alcoholics

Peripheral neuropathy, cerebral atrophy, and intellectual impairment was investigated in 46 males with alcoholic nervous system damage. An overall correlation was found between peripheral neuropathy and cerebral atrophy and between several of the individual neurophysiological and neuroradiological variables examined. There was also a correlation between cerebral atrophy and intellectual impairment. The findings support the view that alcohol in itself is toxic to central and peripheral nervous tissues, although a dose-response dependence could not be established.

Neurobiological relationships between aging and alcohol abuse

Both biological aging and chronic exposure to alcohol may cause impaired learning and memory in man and animals. The chains of processes beginning with molecular changes that in turn alter electrophysiology and morphology and finally culminate in changes of behavior (individual and social) are largely unknown. While these chains originating with molecular events leading to the same behavioral end result may be totally different, they may also overlap at any one of these levels of biological organization, accentuate, attenuate each other, to branch again and to develop parallel to each other. There is currently some evidence from observations in humans and animals that both aging and chronic alcohol toxicity induce the following changes: brain atrophy measured in vivo by computerized tomography, histological loss of the dendritic tree of neurons in various brain regions including hippocampus and cerebellum, and a variety of chemical changes of brain synaptic function, such as loss of benzodiazepine receptors.

Cross-cultural aspects of alcoholism in the elderly

Thus far, we know relatively little about alcoholism among the elderly across cultures. However, extrapolation from available reports suggests certain common features across cultures. These include an inverse relationship between age and problem-producing dosages, increased risk of elderly alcoholics to trauma, greater efficacy of milieu changes with age, and a concentration of elderly alcoholics in cities. Conversely, certain other aspects of aging that vary across cultures may influence alcoholism in the elderly. These include the biological concomitants of aging, social status and the role of the elderly in the society (including integration or isolation of widowed persons), dealing with problematic behavior in the elderly, and patterns of alcohol use by the elderly. Future strategies for researching alcoholism among the elderly are suggested. It is suggested that cultural norms and values, as well as social policy, ameliorate or exacerbate alcohol-related problems among the elderly.

Reduced resistance to progressive extinction in senescent rats: a neuroanatomical and behavioral study

The behavior of senescent rats and mature-young rats was compared in a learning task which consisted of the acquisition of a visual discrimination task, its reversal, the induction of a progressively increasing extinction, relearning and, finally, a complete extinction training. It was found that young and old rats were statistically indistinguishable during all parts of the task, except the progressively increasing extinction. Here, the senescent animals made a significantly higher number of errors than the mature-young ones. Neuroanatomically, ventricular dilation, commissural changes and neuronal loss were observed in senescent rats. The significantly reduced number of neurons in the medial nucleus of the amygdala in old rats compared to young was not directly related to the changed behavior in the progressively increasing extinction part of the visual discrimination task. Based on the anatomical connections of the amygdala and its possible functions in learning and memory, the hypothesis is made that the medial amygdaloid nucleus is involved in the learning of changing response-reinforcement contingencies.

Lipofuscin granules in Purkinje cells after long-term alcohol consumption in rats

The increased number of lipofuscin granules in Purkinje cells from chronic alcohol-fed rats was studied by morphometric methods. These granules were autofluorescent and had marked acid phosphatase activity. No significant changes were found in the mean nuclear and perikaryon volumes when alcohol-fed and control groups were compared. The number of lipofuscin granules per unit of surface area of cell cytoplasm (Na) and their volumetric density (Vv) were significantly greater in alcohol-fed groups than in controls. These values were also significantly different when the 6- and 12-month control groups were compared. Na and Vv values in alcohol-fed groups increased progressively. The increased number is probably related to disturbances in neuronal cell metabolism. The importance of age and malnutrition in the formation of these granules was also considered.

A comparison of the effects of long-term alcohol abuse and aging on the performance of verbal and nonverbal divided attention tasks

The purpose of this study was to assess two versions of the hypothesis that alcohol abuse results in premature aging of the brain and of cognitive functioning. The performances of detoxified long-term alcoholic was compared with that of nonalcoholic controls on three divided attention tasks known to be sensitive to aging. While both forms of the premature aging hypothesis predicted that alcoholics should perform more poorly than controls, the hypotheses differed in their predictions of the interactions between the effects of alcohol and normal aging. The results showed that while all three tasks were sensitive to age, only two were affected by long-term alcohol abuse. On one of the tests affected by both age and alcohol abuse, the performance of both young and old alcoholics was equally impaired whereas on the other, only the older alcoholics had significant difficulties. Based on these findings it was concluded that there was only partial overlap between the effects of alcohol and aging, and that neither of the two forms of the premature aging hypothesis could predict the observed pattern of results.

Sleep related breathing disorders in older men: a search for underlying mechanisms

The incidence of sleep-related breathing disorders (SRBDs) associated with hemoglobin desaturation was determined by nocturnal polygraphic evaluations in 26 healthy men, aged 55-70 years. Sixteen subjects (62%) had abnormal rates of at least 12 episodes per hour of sleep: 8 had occlusive, and 8 had central apnea or hypopnea. During waking ten of 16 SRBD subjects and only one subject without SRBDs exhibited either an elevated nasopharyngeal airway resistance (n = 4) or a reduced ventilatory response to hypercapnia (n = 4) and/or hypoxia (n = 3). However, these abnormalities were not related to the type or severity of SRBDs, and 6 subjects with SRBDs demonstrated no respiratory defect. We conclude that SRBDs have a very high incidence in older males and are not usually secondary to pulmonary cardiac, neurological, or behavioral disorders. Additionally, we hypothesize that abnormalities in ventilatory control or upper airway resistance contribute to SRBDs, but depression of brain stem reticular formation activity during sleep plays a primary role in these disorders. Factors related to both aging and SRBDs are reviewed. These include reduced chemoreceptor responses, altered steroid hormone metabolism, and use and metabolism of hypnotic drugs and alcohol.