Substance Related Cognitive Dysfunction in Aging

Neurocognitive impairment secondary to substance use can be especially challenging to identify and diagnose in older adults. Metabolic and physical changes due to aging and psychosocial and psychiatric vulnerabilities unique to older adults as well as clinician biases may complicate the diagnosis of substance use in aging. Furthermore, the influence of acute substance use or withdrawal on the central nervous system of older adults can result in neuropsychiatric symptoms that mimic common neurodegenerative illnesses. This chapter will focus on helping clinicians identify substance use in older adults, with an emphasis on alcohol and prescription medication use disorders and their resulting cognitive sequelae.