Alcohol dementia

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Alcohol dementia, which is sometimes associated with Wernicke-Korsakoff syndrome, is a form of dementia caused by long-term or excessive drinking resulting in neurological damage and memory loss. Other names for the condition are alcoholic dementia, alcohol related dementia^[1] and alcohol-induced persisting dementia. Alcohol dementia causes serious cognitive problems in many alcoholics and up to 10% of patients diagnosed with dementia have a history of prolonged alcohol abuse.^[2]

Symptoms and diagnosis

The symptoms of alcohol dementia are essentially the same as the symptoms present in other types of dementia, making alcohol dementia difficult to diagnose. There are very few qualitative differences between alcohol dementia and Alzheimer’s disease and it is therefore difficult to distinguish between the two.^[3] Some of these warning signs may include memory loss, difficulty performing familiar tasks, poor or impaired judgment and problems with language. However the biggest indicator is friends or family members reporting changes in personality.^[4]

Anyone who drinks excessive amounts of alcohol over a long period of time is at risk of succumbing to alcohol related dementia.^[3] Some people are at a greater risk than others. A male who drinks six or more alcoholic drinks a day is placing himself at a greater risk; the same goes for females who have four or more alcoholic drinks daily.^[3] However, this type of drinking would have to be sustained for a substantial amount of time.

It is a common myth that only the elderly are afflicted with types of dementia. This is particularly untrue regarding alcohol dementia, the onset of which can occur as early as age thirty,^[3] although it is far more common that the dementia will reveal itself anywhere from age fifty to age seventy.^[3] The onset and the severity of this type of dementia is directly correlated to the amount of alcohol that a person consumes over his or her lifetime.

Alcohol has a direct effect on brain cells. The front part of the brain is where most of the brain cells are affected, resulting in poor judgment, difficulty making decisions, and lack of insight. Long-time alcohol abuse can often lead to poor nutrition problems causing parts of the brain to be damaged by vitamin deficiencies. These problems could also cause personality changes in some people.^[5]

Criteria for diagnosis

Criteria for alcohol-induced persistent dementia in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV)

A. The development of multiple cognitive deficits manifested by both:

1. Memory impairment (impaired ability to learn new information or to recall previously learned information)
2. One (or more) of the following cognitive disturbances:

• a) Aphasia (language disturbance)
• b) Apraxia (impaired ability to carry out motor activities despite intact motor function)
• c) Agnosia (failure to recognize or identify objects despite intact sensory function)
• d) Disturbance in executive functioning (i.e. planning, organizing, sequencing, abstracting)

B. The cognitive deficits in criteria A1 and A2 each cause significant impairment in social or occupational functioning and represent a significant decline from a previous level of functioning.

C. The deficits do not occur exclusively during the course of a delirium and persist beyond the usual duration of substance intoxication or withdrawal.

D. There is evidence from the history, physical examination, or laboratory findings that deficits are etiologically related to the persisting effects of substance use (e.g. drug of abuse; medication).

Treatments

If the symptoms of alcohol dementia are caught early enough, the effects may be reversed. The person must stop drinking and start on a healthy diet, replacing the lost vitamins, including, but not limited to, thiamine.^[3] Recovery is more easily achievable for women than men, but in all cases it is necessary that they have the support of family and friends and abstain from alcohol.^[3]

There is a case study of a patient who was treated with memantine; the patient was a 71 year old female who was treated with memantine for five weeks, at a dosage of 30 mg/daily to help improve memory and cognitive functioning.^[6] After the five week treatment the patient had shown improvement on the Mini-Mental State Examination from 18 to 22 points and her tests on the CERAD (Consortium to Establish a Registry for Alzheimer’s Disease) improved from zero to five on the Wordlist Recall and six to eight on the Drawing test.^[6] This is the only study of its kind but has promising outcomes for further research.

Well-known sufferers

According to her family, the socialite Leonore Lemmon spent the last few years of her life suffering from alcohol dementia, before dying in 1989.

References

External links

• Alcoholism & Substance Abuse: Alcohol Dementia
• Alzheimer's Society factsheet — What is Korsakoff’s syndrome?
• Kato N (June 1991). "[Clinical concept of alcoholic dementia]" (in Japanese). Arukoru Kenkyuto Yakubutsu Ison 26 (3): 119–33. PMID 1892448. 

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