My belief, as a parent and a therapist, is that there’s not enough time given to discussing certain subjects with our kids. One of those subjects is alcohol. Many of us were taught to ‘be responsible’, with little emphasis on what that really means. We asked a lot of questions, most of them beginning with the word “Why”. In return many of us were given short answers leaving us vulnerable. It’s only after we have learned the painful truth that we begin to question our decisions.
One of the main misconceptions about alcohol use that people should know about is the connection between drinking and dementia. Below we will explain how these two experiences are connected, and arm you with valuable information.
Can Drinking Alcohol Cause Dementia?
While the short answer to this question is yes, short answers are known for leaving out valuable information. Drinking unhealthy amounts of alcohol over an extended period of time can cause alcohol-related brain damage that could have short or long term effects on your memory. It can lead to a particular condition known as Wernicke-Korsakoff syndrome. Of course, there’s no way of knowing for sure if someone will develop alcohol-related dementia. A combination of genetics, health history, and drinking habits are all factors in the onset of Wernicke-Korsakoff syndrome. It’s never too early to take preventive steps towards reducing your alcohol intake and preventing permanent memory damage.
What is Dementia?
Dementia is the global loss of intellectual functioning and is the result of either brain injury or disease. You might be asking yourself, what does ‘the global loss of intellectual functioning’ look like? This is a very good question, and is the first thing I discuss when I am working with family caregivers who wish to keep their loved one with dementia in the home.
After working with family caregivers for almost 20 years, I can tell you that, unfortunately, almost every person who has dementia will experience these devastating effects. They include:
- Amnesia: loss of both short term and long-term memory
- Apraxia: inability to perform tasks involving our motor skills
- Expressive Aphasia: inability to express your thoughts
- Receptive Aphasia: inability to understand what is being spoken to you
- Agnosia: inability to make associations with our 5 senses
Currently, more than 55 million people live with dementia every day, with almost 10 million cases diagnosed each year.¹ To put this into perspective, by the time we reach age 65, 1 in 8 of us will have dementia, and this number climbs to 50% by the time we are 80. Perhaps the most startling statistic is that 9% of people diagnosed are younger than 65.
Studies have shown that there are things we can do to reduce our own level of risk. These include getting regular exercise, eating a healthy diet, controlling our weight, monitoring our blood pressure, maintaining our cholesterol and blood sugar levels, not smoking, and avoiding harmful use of alcohol.
What is Alcohol-Related Dementia?
Alcohol-related dementia is an unusual form of dementia that combines two different types of disorders. Drinking too much alcohol over a long period of time can lead to a condition known as Wernicke’s Encephalopathy, or Wernickle’s Syndrome. Common symptoms include sudden onset of confusion, loss of balance, problems with eye movement and drowsiness. If left untreated, Wernicke’s develops into Korsakoff’s, a type of amnesia which affects our short-term memory and develops in about 80-90% of people who have been diagnosed with Wernicke’s.² Those who have developed both conditions are considered to have Wernicke-Korsakoff syndrome.
Wernicke-Korsakoff Syndrome
So what exactly causes Wernicke-Korsakoff syndrome? The primary cause is that alcohol use can create a lack of thiamine in the body. Also known as vitamin B1, thiamine can be found naturally in rice, wheat, and flour and is primarily responsible for converting carbohydrates into energy. Thiamine is not stored in the body so it must be continuously replenished by eating the proper foods. Without it, our nervous system could not function properly. Thiamine also facilitates muscle contraction, cardiovascular function, digestion, and healthy skin, hair, eyes, and mouth.⁴
When you drink excessively over time, your gut and digestive system become inflamed, significantly impairing your body’s ability to absorb important nutrients, like thiamine. Up to 80% of people who drink heavily develop some form of thiamine deficiency, which can lead to Wernicke-Korsakoff syndrome if left untreated.
Support Group: Navigating long-term sobriety together
Risk Factors for ARD
The primary risk factor for alcohol-related dementia (ARD) is unhealthy alcohol use. Heavy alcohol use is defined as three or more drinks a day for a woman and four for a man. Binge drinking is defined as four or more drinks within a two-hour period for women, and five or more for men. Both binge drinking and heavy drinking are considered to be risk factors for ARD.
In addition to excessive drinking, there are a few other factors that may make someone additionally at risk for ARD. These include:
- Malnourishment
- Kidney dialysis
- HIV
If you’re concerned you may be developing a thiamine deficiency, some symptoms to watch out for include:
- Mental confusion that persists, even when you stop drinking
- Problems with your vision
- Low blood pressure
- Lack of muscle coordination
- Hypothermia
Alcohol-Related Dementia Symptoms
As mentioned above, Wernicke-Korsakoff syndrome is the combination of two conditions. Looking out for initial symptoms of Wernicke’s syndrome can help you halt the progression into Wernicke-Korsakoff syndrome. These signs include:
- Lack of coordination and balance
- Confusion, otherwise known as delirium
- Difficulty walking
- Drowsiness
- Extreme loss of body heat or hypothermia
- Heart issues and hypertension
- Poor muscle control or ataxia
Eye issues are also common, including:
- Abnormal eye movement (nystagmus)
- Double vision
- Drooping eyelids
- Eye muscle weakness
Symptoms of Wernicke-Korsakoff syndrome are very much the same as Wernicke’s, however; it’s at this stage that a person not only loses their ability to remember past events, but they also lose their ability to form new ones as well. This is because Korsakoff’s syndrome causes damage to cells which support both the spinal cord and two areas of the brain responsible for memory known as the thalamus and hypothalamus.
Symptoms of Wernicke-Korsakoff syndrome include:
- Amnesia or inability to form new memories
- Behavioral changes, such as agitation or anger
- Delirium and disorientation
- Fatigue or lethargy
- Hallucinations, especially in those withdrawing from alcohol
- Lack of focus
- Unsteady gait
Another common symptom of Wernicke-Korsakoff syndrome is a behavior known as confabulation where the person will invent things to cover their own memory loss. People often become confused and disoriented to person, time and place. This can render them incapable of seeking treatment on their own.
ARD Treatment: Can Alcohol-Related Dementia Improve?
The most common treatment for Wernicke-Korsakoff syndrome is high doses of thiamine. Another key to treatment is proper nutrition and hydration. However, it’s very important for individuals to start thiamine replacement before beginning nutritional replenishment. In some cases, drug therapy is also recommended.
Stopping alcohol use is also key to treating alcohol-related dementia, and for preventing further nerve and brain damage. There are many treatment options for stopping alcohol use, including medication to curb cravings, support groups, and alcohol therapy with therapists such as myself. At Monument, you can access these treatments from the comfort of your own home.
Prognosis for Dementia Caused by Alcohol
The best health outcomes occur when Wernicke’s syndrome is treated as soon as possible. Wernicke’s can be reversible if diagnosed in time and treated with high doses of thiamine.
Once the condition developed into Wernicke-Korsakoff syndrome, the survival rate of patients is unfortunately low. Pursuing treatment of alcohol use disorder and early diagnosis of thiamine deficiency are the most crucial interventions one can take to improve their prognosis.
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Alcohol-related dementia can seem like a scary topic. Gaining awareness about the dangers of Wernicke-Korsakoff syndrome is already a powerful step towards taking care of your health. The best way to prevent alcohol-related dementia is to change your relationship with alcohol. At Monument, we’re here to provide you with personalized care every step of the way. You can do this.
Sources:
- Medical Council on Alcohol and Oxford University Press. “Long-Term Mortality of Patients with an Alcohol-Related Wernicke-Korsakoff Syndrome, https://pubmed.ncbi.nlm.nih.gov/28340112/.” Accessed Jan 12, 2023.
- Medline Plus. “Wernicke-Korsakoff syndrome, https://medlineplus.gov/ency/article/000771.htm.” Accessed Jan 12, 2023.
- World Health Organization. “Thiamine deficiency and its prevention and control in major emergencies, https://www.who.int/publications/i/item/WHO-NHD-99.13.” Accessed Jan 12, 2023.
- National Institutes of Health. “Thiamin, https://ods.od.nih.gov/factsheets/Thiamin-HealthProfessional/.” Accessed Jan 12, 2023.
- Alcohol and Drug Foundation. “Alcohol and thiamine, https://adf.org.au/insights/alcohol-related-thiamine-deficiency/.” Accessed Jan 12, 2023.
About the Author
Reed was voted Professional Caregiver of the Year in 2005 for Family Caregiver Support. He is also a published author, public speaker & industry leader in pioneering behavioral techniques, and strategies for family caregivers. His other accomplishments include Certified Professional Guardian, Advisor/Consultant for the University of Washington, and Federal Fiduciary for the Veterans Administration.