Chronic excessive alcohol consumption may lead to structural and functional damage of the brain. Alcohol-related cognitive impairments are well-established and confirmed by neuropsychological and neuroimaging studies. However, the influence of each neuropathological mechanisms is still under discussion. This topic is increasingly becoming focus of attention in psychiatry.

Review the neuropathology, clinical features, neuropsychology and management of alcohol-related cognitive impairments.

Evaluate clinical impact, management and prognosis of alcohol-related cognitive impairments.

A literature search was performed on PubMed and Medscape database.

According to our literature research, there is a debate concerning the relative contributions of the direct toxic effect of alcohol and the impact of thiamine deficiency on the alcohol-related cognitive impairments. Research about this issue is challenging, considering the multiple patterns of alcohol abuse, the personal and lifestyle factors, and the vulnerability of specific brain regions. The cognitive decline is linked to neuroanatomical alterations and primarily affects executive functions, episodic memory, and visuospatial capacities. These deficits may range from mild to severe but usually remain undiagnosed, unless they are specifically investigated. Maintenance of lasting abstinence is associated with cognitive recovery, but some impairments may persist and interfere with the prognosis.

Recognizing and screening for alcohol-related cognitive impairments is crucial to offer significant benefits to patients by optimising management strategies.

The authors have not supplied their declaration of competing interest.