Recovery During Sustained Abstinence in Alcohol Use Disorder: Cognition, Day-to-Day Functioning, and Quality of Life

Background: Long-term excessive alcohol use can result in persistent cognitive impairments that negatively affect daily functioning and quality of life. It remains unclear whether cognitive recovery contributes to functional improvement following sustained abstinence. This study examined changes in cognition, day-to-day functioning, and quality of life in abstinent patients with alcohol use disorder (AUD) and (suspected) alcohol-induced neurocognitive disorder. Methods: Assessments were conducted after at least six weeks of abstinence (T0) and at treatment completion (T1; median follow-up 3.1, IQR = 3.8). Of the total sample of 245 patients, 143 had follow-up data, and 69 completed the full assessment battery at both time points. Longitudinal changes were examined using mixed-effects models. Results: Significant improvements over time were observed for the MoCA (β = 0.10), CFQ (β = -0.13), MANSA-12 (β = 0.11), and PCRS (β = 0.09; all FDR-adjusted p < 0.05). Greater improvements in MoCA scores were associated with steeper improvements in MANSA-12 scores (β = 0.17, p < 0.03), but not with changes in HoNOS-65+ or PCRS scores. Discussion: While sustained abstinence was associated with functional improvements over time, cognitive recovery appeared to be particularly relevant to improvements in perceived quality of life. Conclusion: Our findings show that outcome measurement during recovery provides relevant information, which may help to tailor ongoing interventions and future treatment selection in individuals with alcohol-related cognitive disorders.