Differences observed between right and left hemisphere functional decline in alcoholics appear to be related to differential task demands rather than to a specific disruption of one type of cognitive ability. Evidence from brain imaging studies (not reviewed here), as well as postmortem examination of alcoholics’ brains, supports the view that the damage is diffuse and involves many cortical and subcortical regions. Although evidence indicates that non-Korsakoff alcoholics have somewhat more vulnerability of the frontal lobes than other brain regions to structural damage, there is no substantial evidence that alcoholics have cognitive impairments similar to nonalcoholic patients with frontal lobe damage. The evidence to date for the frontal system model of cognitive impairment in non-Korsakoff alcoholics is at best mixed and probably indistinguishable from the diffuse brain dysfunction model. Finally, the idea that alcoholism is associated with premature aging is not strongly supported in the literature.
