Understanding & Coping With Alcohol Dementia

It’s widely known and accepted that drinking too much alcohol is bad for your health. To many, such a statement might seem obvious. High blood pressure, heart disease, and cancer are among the best-known long-term side effects. Unlike these, long-term memory impairment is not something that many people would immediately associate with alcohol abuse.

Waking up with no memory of the night before after several drinks might not be uncommon, but many people don’t consider this a long-term issue until it’s too late and an odd night like this has turned into a regular occurrence, with dependence having taken hold. As a result, there has been a rise in cases of alcohol dementia diagnosed in recent years, as experts recognize the day-to-day impact on the brain of continued alcohol abuse.

It is thought that alcoholics are 3 times more likely than the average person to suffer dementia from associated brain damage and with 15 million people in the USA over the age of 12 reported as having an alcohol use disorder in 2019¹1.J. Rehm and O. S. M. Hasan, Alcohol use and dementia: a systematic scoping review – PMC, PubMed Central (PMC).; Retrieved September 19, 2022, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6320619/, the problem is only set to worsen.

Alcohol Dementia Explained

Excessive drinking causes damage to the structure and function of the brain, which in turn impairs decision making, concentration, the ability to learn and retain new things, and shifts in personality. Hallmarks of standard intoxication such as issues with balance, coordination, and impulse control are also common in those with alcohol dementia, though these symptoms appear permanently, rather than just when the person in question has drunk an excessive amount.

Unlike standard dementia, alcohol ‘dementia’ is not degenerative, and can often be reversed if diagnosed early enough. Alcoholics can still suffer from dementia-type symptoms even if they can perform actions that require mental acuity such as making deductions or playing games of logic like chess.

The most common type of alcohol dementia is Wernicke-Korsakoff Syndrome, or ‘wet brain’, which occurs when poor nutrition leads to a vitamin B1 (also known as thiamine) deficiency, as alcoholics will often prioritize their addiction over food²2.N. J. Ridley, B. Draper and A. Withall, Alcohol-related dementia: an update of the evidence – Alzheimer’s Research & Therapy, BioMed Central.; Retrieved September 19, 2022, from https://alzres.biomedcentral.com/articles/10.1186/alzrt157.

As a result of the B1 deficiency, the body struggles to process food into energy, which then impacts its ability to function. If Wernicke-Korsakoff’s is not treated timely and in full, it can develop into Korsakoff Psychosis, which further harms cognitive function and causes symptoms such as confabulation, where suffers routinely create elaborate detailed stories to cover gaps in their memories for those around them and themselves.

Korsakoff Psychosis is much more difficult to treat than Wernicke-Korsakoff Syndrome (WKS), so spotting the symptoms and seeking medical help as soon as possible is always recommended.

Treatment for Alcohol Dementia

Despite the treatable nature of Wernicke-Korsakoff Syndrome and other types of alcohol dementia, obtaining diagnosis and treatment can be difficult. Many doctors aren’t aware of all the signs of conditions such as these, and of those that are, some require a patient to have stopped drinking for several weeks, while some are happy to assess a patient so long as they are not intoxicated during the examination.

Diagnostics typically involve blood tests, neurological and cognitive function tests, as well as tests to check liver enzyme levels, B1 levels, and blood pressure.

Abnormal eye movement, especially when combined with low blood pressure and low body temperature, is a key indicator that someone might be suffering from Wernicke Korsakoff Syndrome. Along with the lack of widespread medical knowledge about alcoholic dementia, the other key barrier to getting someone treatment for the condition can be the patient themselves.

As with any alcoholic who may be struggling with addiction and need treatment, those suffering from alcohol dementia can be resistant to treatment. Mood, thinking, emotional and reasoning problems are all common with both alcoholism and dementia and can prevent the patient from understanding why they need to get help and treatment, or from keeping up the motivation to maintain sobriety.

A strong and supportive social network is emphasized as being vital for recovery, and distance from situations that the patient associates with alcohol. However, despite the difficulties presented, treatment, and complete cure for Wernicke Korsakoff Syndrome and alcohol dementia is achievable.

Will an Alcohol Rehabilitation Center help with Alcohol Related Dementia?

Initial treatment will most likely involve some hospitalization and medically monitored detox in an alcohol rehabilitation center, as treating alcoholism is central to treating the dementia symptoms. Many rehabilitation centers have complex needs teams with doctors that specialize in treating alcohol dementia.

Further treatments include 1:1 counseling, group or family therapy, and assistance in the patient learning or relearning life skills. Many of these treatments can be done as out-patients or in residential or assisted living centers once the initial medically supervised detox is complete.

For those with Wernicke-Korsakoff Syndrome, B1 (thiamine) supplements are often a necessary prescription to help the body convert food to energy, as well as the introduction of a balanced diet full of nutrients and alcohol abstinence.

It is important to note that in the case of Wernicke Korsakoff Syndrome, improving diet is not a substitute for sobriety and that a good diet and alcohol abstinence are both necessary for a patient’s best possible chance of recovery.

As those with alcohol dementia tend to be younger than most dementia patients, services that are offered for early-onset dementia patients can also be beneficial for alcohol dementia, especially in aiding in neurological and cognitive development and repair, thanks to the body’s relative youthfulness and physical capability.

In order to fully recover from alcohol dementia, maintenance of the regimens put in place during treatment beyond a patient’s discharge date is vital and can result in a significant increase in brain function and complex cognitive ability over time.

Alcohol Dementia is a Growing Problem

Overall, while alcoholism and alcohol dementia can be a daunting battle for those with substance abuse problems and their families, when diagnosed and treated early enough they are not life-threatening conditions³3.S. Sabia and A. Fayosse, Alcohol consumption and risk of dementia: 23 year follow-up of Whitehall II cohort study | The BMJ, The BMJ.; Retrieved September 19, 2022, from https://www.bmj.com/content/362/bmj.k2927, and a course of modified dementia treatment alongside standard rehabilitation for alcoholism is usually sufficient in providing cures for both issues.

Although not a commonly known or talked about problem, alcohol dementia is becoming more widespread, and increased awareness can help to spread prevention and cure, especially with a population whose alcohol dependence is only growing.

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