An additional question for future investigation involves the extent to which older treatment-naïve alcoholics are able to maintain normal cognitive processes. Our TNAD sample was relatively young (mean age = 31.5). There is mounting evidence, reviewed by Fein and Di Sclafani (2004a), that cerebral reserve capacity (which erodes as a function of age) plays an important role in determining the onset and progression of clinical manifestations of neurodegenerative diseases (including those of chronic abuse of substances). Since normal aging results in a loss of reserve capacity, aging may unmask cognitive deficits in TNAD that are compensated for in younger middle-aged samples.
