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 programmes designed to facilitate individuals with chronic alcohol dependency to radically change their drinking behaviour, invariably with an abstinence focus. No evidence that related to the nutritional and physical intervention needs of this group was found. Most instruments used to access domains relevant to ARBD in terms of providing a comprehensive assessment have not been validated in this group. 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 that 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 two of which could not be accessed. Twenty-five papers were included in the review, including six neuroimaging studies, 17 neuropsychological studies and two 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.