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Dementia is a brain disorder that causes a progressive loss of cognitive function. It affects memory and impairs your ability to think and make decisions. Often, it gets to the point where it interferes with your daily life.
Alcohol-related dementia (ARD), also known as alcoholic dementia and alcohol-induced dementia, is an umbrella term for any dementia caused by heavy drinking. Some examples of alcohol dementia are:
Numerous studies explore the link between alcohol and dementia. According to French research, alcohol is associated with 38.9 percent of early-onset dementia cases, and 17.6 percent of dementia patients had alcohol use disorders.1
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Alcohol-related brain damage seems to be the common cause of alcoholic dementia. One study shows that up to 78% of alcoholics exhibit signs of alcohol-related brain injuries.2
So how does alcohol cause brain damage and dementia? Here are some possible explanations:
Ethanol is the main chemical component of alcoholic drinks. Whether you’re drinking wine, beer, or alcohol, the body metabolizes the ethanol into acetaldehyde. Acetaldehyde has a neurotoxic effect on the brain.
Alcohol damages the frontal lobes - the same parts of the brain that get damaged with dementia. Evidence suggests a loss of white matter and neurons (brain cells) in these areas, as well as a reduction in brain size (brain atrophy).
Long-term alcohol use and alcohol addiction are associated with various health risks. Some of which can lead to brain damage and other forms of dementia. These include:
Hypertension or high blood pressure is a vascular condition that develops with heavy drinking. It causes blood vessels to constrict and become narrow, which then reduces blood flow to the brain. This can deplete the brain of its much-needed oxygen and slowly damages it over time. Eventually, this can lead to vascular dementia.
Excessive alcohol consumption gradually develops into liver disease. This impairs the liver’s ability to filter toxins and dispose of them. Toxins like ammonia build up in the bloodstream and make their way to the brain. These toxins cause permanent or temporary brain injury, resulting in hepatic encephalopathy — a known risk factor of dementia.1
Some researchers argue that while it causes symptoms similar to Alzheimer’s, it doesn’t meet the criteria for dementia.3 However, there is evidence that liver disease causes brain lesions and cognitive decline, even without hepatic encephalopathy.4,5
Drinking alcohol has immediate effects on the body. They can put you at risk for falls, motor vehicle accidents, and other incidents that may result in traumatic head injuries — such as getting into fights.
Some physical effects of alcohol include:
Traumatic brain injury (TBI) disrupts the brain’s nerve fibers and neural networks, thus increasing your risk for neurodegenerative disorders like Alzheimer’s disease.6 Research further shows that it only takes one head injury for dementia to develop in later years. The more head injuries a person sustains, the greater their risk.7
Moreover, a head injury can increase your risk for epilepsy, which has also been associated with alcohol-related dementia.
Drinking too much alcohol causes inflammation of the stomach’s inner lining, preventing the absorption of nutrients such as thiamine. People with alcohol use disorders also tend to have poor diets, so they’re more likely to have vitamin deficiencies.
Thiamine (Vitamin B1) provides energy to the brain, facilitates the transmission of nerve impulses, and maintains the structural integrity of membranes that protect nerves. Given its role in brain function, a deficiency would likewise result in neurological problems.2
The problems caused by vitamin B1 or thiamine deficiency include:
These conditions produce symptoms that are similar to dementia, which is why they’re sometimes referred to as alcohol-related dementia.
Drinking to the point of intoxication disrupts brain function. It interferes with neurotransmitters which are responsible for controlling the excitability of brain cells. This excitability of neurons is what triggers seizures in patients with alcohol dementia. People with epilepsy and chronic alcoholics in withdrawal are especially vulnerable.8
The problem with seizures is that they can damage the hippocampal area of the brain. This can affect a person’s memory and can lead to dementia.9
The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) describes alcohol dementia as a condition that results in multiple cognitive deficits. Among its symptoms are:
A person with alcohol-induced dementia will exhibit these symptoms even when they aren’t intoxicated or undergoing withdrawal. They will also suffer a significant decline in function.
That being said, alcohol dementia can produce a range of symptoms. It depends on which areas of the brain are affected and how severe the condition is. Below are common types of alcoholic dementia and some early signs you can watch out for.
People with Alzheimer's will struggle to make sense of their environment. Memory lapses are also common in the early stages of this condition. For instance, they might forget about a recent conversation or ask the same question repeatedly.
Other early signs of Alzheimer’s include:
Alzheimer’s dementia is progressive. Someone who has mild Alzheimer’s may appear healthy at first. But as their condition worsens, so do a person’s symptoms.
Symptoms of vascular dementia sometimes overlap with Alzheimer's disease and other forms of dementia. However, each person can have different symptoms depending on which part of the brain has reduced blood flow.
People with vascular dementia also tend to struggle more with problem-solving skills and thinking speed rather than memory loss.
Other vascular dementia symptoms include:
The symptoms of vascular dementia may occur gradually or appear suddenly, such as after a mild stroke.
This condition usually starts with thiamine deficiency. If it isn’t treated, it can develop into Wernicke’s encephalopathy.
The signs of Wernicke encephalopathy include:
Wernicke encephalopathy can progress into Korsakoff if left untreated. However, Korsakoff syndrome may also occur independently or simultaneously with Wernicke.
The signs of Korsakoff syndrome include:
When these symptoms overlap, it is known as Wernicke-Korsakoff Syndrome. This can further progress into Korsakoff psychosis.
Based on a cross-study analysis, the following increases your risk for alcohol dementia:2
The presence of more than one risk factor increases the chances of developing alcohol-related dementia. Generally speaking, however, anyone with an alcohol disorder is at risk. This includes people who struggle with alcohol use and addiction.
The risk for dementia increases as you grow old. But contrary to popular belief, it isn’t a normal part of aging.10
For instance, the average older adult may forget things from time to time. In comparison, someone with dementia will slowly forget how it's like to perform basic activities.
At most, the memory problems caused by normal aging will inconvenience you. Dementia impairs cognitive ability in a way that it becomes difficult to function properly.
Unless a person stops drinking alcohol, alcohol-related dementia only worsens with time. It can lead to permanent brain damage which consequently, causes them to cease normal functioning.
People with severe dementia symptoms might not be able to:
These can lead to complications that reduce a person's quality of life, such as:
Some types of alcohol dementia cause a person to lose their sense of smell and taste. As food becomes tasteless and they are left to fend for themselves, they might not eat as often, or they might not eat at all. This can lead to nutritional deficiencies, which further aggravate their condition.
Keep in mind that dementia severely affects memory. For example, a person with dementia might not remember what food is for or how to use a spoon.
A person with severe dementia may suffer from mood swings and a confused mental state, so they are easily agitated. Since they can’t make sense of things, situations can quickly escalate into violence where they might hurt themselves or others.
Alcoholic dementia increases the risk for falls by 2 to 8 times.11 This can be a problem for elderly individuals with degenerative bone disorders. Falls can easily cause fractures if they have osteoporosis or osteoarthritis.
Pneumonia and urinary tract infections (UTIs) are prevalent in older adults. Since people with dementia tend to have poor hygiene, their chances of being infected are greater. Infections can also go unnoticed since they can’t express themselves. These infections can spread into the blood and travel throughout the body, which can cause sepsis.
Consequently, infections such as pneumonia and sepsis can increase a person’s risk for dementia.12 So if you have alcohol-related dementia, they can potentially worsen your condition.
Up to 55 percent of dementia patients have a history of abuse. They are often abused by family members who may be overwhelmed with having to care for them. However, healthcare workers may also abuse them while they’re seeking treatment. 13
Wernicke's encephalopathy can progress into Korsakoff psychosis, which is both severe and untreatable. Patients who have this condition will develop amnesia. They won't be able to recall new information and memories from before its onset.
When it comes to alcohol dementia, medical professionals aim to prevent dementia symptoms from becoming worse. Patients must undergo substance use treatment so they can successfully quit alcohol.
Patients with Wernicke’s encephalopathy and Korsakoff syndrome may be given oral thiamine in addition to receiving addiction treatment. Oral thiamine treats the vitamin deficiencies which resulted from alcohol misuse.
Numerous studies show that quitting drinking reverses alcohol-related dementia. It helps with the partial recovery of white matter and damaged brain cells, improving a person's motor skills and cognitive abilities.14
Thiamine supplements also reduce the impact of alcohol-related brain injury in patients with Wernicke-Korsakoff Syndrome. This helps improve their brain function and reverse acute symptoms.15
Researchers agree that alcohol-related dementia isn't completely reversible. People who fail to get immediate treatment may eventually develop permanent brain damage.14,15
Alcohol treatment takes several weeks to start taking effect. After 6 to 7 weeks, the brain starts regaining its volume, and the patient will exhibit neuropsychological improvements.16
However, the duration of thiamine treatment isn’t standardized. Some medical practitioners suggest a short-course treatment that lasts for 3 to 5 days.17 Others recommend taking thiamine supplements for an extended period, even after the patient has recovered.14
If you have an alcohol disorder, medical professionals recommend seeking treatment as soon as possible. Below are six signs of alcoholism you can watch out for:
Those with more severe alcohol use can initially opt for medication-assisted treatment (MAT). Medications can reduce alcohol withdrawal symptoms and help prevent relapse during early recovery. Afterwards, they can proceed with addiction treatment.
Recovering individuals and chronic alcoholics may also get additional support from sober living homes. Alternatively, you can join self-help groups such as Alcoholics Anonymous (AA). These peer-based systems help patients sustain long-term sobriety after receiving substance use treatment.
Alcohol-related dementia isn’t the only consequence of long-term alcohol use. By causing extensive damage to the brain, alcohol can either lead to mental health problems or worsen pre-existing conditions such as anxiety, depression, and bipolar disorders.
Alcohol is a dangerous and addictive substance with long-term consequences. Thankfully, most of these complications can be alleviated with early diagnosis and substance use treatment. If you have an alcohol problem, or if you suspect misuse in a loved one, find a health professional that can provide medical advice.
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