High-intensity and blackout drinking impact on next-day cognitive functioning among college-attending young adults

Background: Young adults (ages ~ 18–25) are at highest risk of heavy alcohol use relative to other age groups. Recent laboratory evidence revealed that alcohol use behavior is associated with brain morphometry among young adults. Scant research has focused on identifying whether young adults experience functional cognitive consequences after drinking and alcohol-induced memory loss (“blackout drinking”) events. We collected intensive 21-day data to examine acute effects of any alcohol use and higher risk use behavior on next-day cognitive functioning. Method: Participants were 304 (79% female) college-attending young adults who reported recent heavy drinking and blackout drinking. Participants completed a baseline survey and up to 21 daily diaries assessing prior-day alcohol use, self-reported cognition (prospective/retrospective memory lapses, general cognitive lapses), and performance-based cognition. Results: Multilevel models examined associations between any alcohol use, number of drinks, high-intensity drinking (8+/10+ drinks in a sitting for females/males), and blackout drinking on multiple next-day cognitive outcomes. All day-level drinking indicators were associated with a higher likelihood of next-day cognitive lapses. High-intensity drinking and blackout drinking were both associated with higher odds of retrospective memory lapses, and high-intensity drinking was associated with higher odds of prospective memory lapses. Blackout drinking was associated with poorer next-day working memory with manipulation. All other drinking indicators were unassociated with performance-based cognition. Conclusions: Overall, while high-intensity drinking and blackout drinking were both associated with more self-reported retrospective memory lapses, only high-intensity drinking was linked with self-reported prospective memory lapses and only blackout drinking was linked to performance-based cognition. These findings generally indicate that young adults experienced more cognitive lapses the morning after intense drinking and blackout drinking events. As a key indicator of longer-term cognitive outcomes is observed functional impacts in young adulthood, early prevention and intervention in this age group is warranted.