Neuropsychological Function of Older Adults: Role of Alcohol Use and Socioeconomic Inequality

Roughly one quarter of the global population consumes alcohol, contributing to nearly 3 million deaths per year (WHO). Despite such prevalence, the long-term neurological consequences of its use remain under-recognized. Prior research has linked alcohol use disorder (AUD) to structural changes in the brain, as well as abnormal vascular pathology and cognitive impairment (Justo et al., 2025; Zhornitsky et al., 2021). Neuropsychological models such as the Right Hemisphere Hypothesis and the Premature Aging Hypothesis suggest that chronic alcohol use produces disproportionate deficits in visuospatial and nonverbal cognitive functioning, often mimicing non-alcohol-related right hemisphere deficits and accelerated aging (Evert & Oscar-Berman, 1995). Recent evidence further suggests that socioeconomic status (SES) can influence vulnerability to alcohol-related cognitive impairment through variability in cognitive reserve, vascular health, nutrition, and health care access. Lower SES is associated with a higher risk of vascular dementia and cognitive dysfunction (Wang et al., 2023). It was predicted that individuals from lower SES backgrounds with a history of alcohol use would exhibit greater cognitive impairment, specifically in visuospatial tasks associated with right hemisphere functioning. A data set was compiled from 118 older adult clinical trial participants, including alcohol use history, toxic exposures, and substance use disorders. Specific metrics included the type of exposure, duration of use, and frequency of alcohol use. Cognitive functioning was assessed using two standard neuropsychological evaluations: the Montreal Cognitive Assessment (MoCA) and Rey-Osterrieth Complex Figure (Rey-O). Socioeconomic status was assessed using the area deprivation index (ADI), a neighborhood-level measure derived from the U.S. census data, incorporating factors such as income, education, employment, and housing quality. Results of this study are still in progress, with visuospatial tasks and other cognitive measures (Rey-O) still being collected and calculated. An independent-samples t-test showed that lower educational attainment performed significantly worse than higher educational attainment on the MoCA, p = .043, verbal fluency, p = .020, and category fluency, p = .008. Preliminary findings suggest that educational attainment is significantly