Does Alcohol Abuse Lead to Dementia?

Alcohol abuse can lead to dementia in several ways. Although some types of alcohol-related dementia can be reversed, others can be permanent if not treated early enough. 

What Is Alcohol-Related Dementia?

Alcohol-related dementia is a form of cognitive impairment caused by prolonged, heavy alcohol consumption. Heavy alcohol use can also cause a condition called Korsakoff syndrome which causes dementia. Additionally, alcohol can increase your risk of Alzheimer’s disease, the main cause of dementia in older adults. Regardless of how it occurs, dementia often involves memory loss, impaired thinking and difficulties with problem-solving or language. It can lead to progressive impairment, impacting your quality of life and often being fatal.

How Does Alcohol Cause Dementia?

The way that alcohol causes dementia differs on the specific type of dementia. Alcohol is toxic, potentially harming your brain tissue and nerve cells. Chronic heavy drinking can affect your brain by reducing brain volume and damaging nerve cells, which are chemicals that transmit messages within the brain. This is what is thought to lead to alcohol-related dementia and an increased risk of Alzheimer’s disease.

Long-term heavy drinking can also lead to a deficiency of thiamine, or vitamin B1. Low levels of this critical nutrient can lead to a brain disorder called Wernicke-Korsakoff syndrome. Initially, this condition is curable; however, as time progresses, it results in a permanent form of dementia. 

Wernicke-Korsakoff Syndrome

Wernicke-Korsakoff syndrome (WKS) is a severe, potentially fatal brain disorder almost always due to alcohol abuse. WKS is a two-stage disease. The first stage, Wernicke’s encephalopathy, is reversible if it is treated quickly and causes: 

• Confusion
• Coordination problems
• Abnormal eye movements

If left untreated, Wernicke’s encephalopathy leads to Korsakoff’s syndrome, an irreversible form of dementia caused by alcohol. This stage is characterized by: 

• Severe memory problems
• Hallucinations
• Inability to form new memories
• Confabulation (making up memories to fill in blanks) 

Symptoms of Alcohol-Induced Dementia

Alcohol symptoms are similar to other forms of dementia but can differ widely based on how alcohol creates dementia. Common symptoms of alcohol-induced dementia can include:

• Memory loss
• Inability to form new memories
• Finding basic tasks confusing
• Having difficulty following a conversation
• Hallucinations
• Making up memories to fill in blanks in memory (confabulations)
• Being confused as to the time or place
• Forgetting people that you were once close to

Who Is Most Likely To Develop Alcohol-Related Dementia?

Those who drink heavy amounts of alcohol over a long period are at the highest risk of developing alcohol-related dementia. Those who consistently consume more than the recommended limit of alcohol may be at risk, whether they have an alcohol addiction or not.

While the frequency and intensity of alcohol use are the main factors influencing the development of alcohol-related dementia, those who are more at risk for Alzheimer’s disease or those with another underlying neurological condition may also be at a higher risk. The risk also increases with age as exposure to alcohol and aging effects increase.

Can Alcoholic Dementia Be Reversed?

The ability to reverse alcohol-induced dementia depends on the condition’s cause, the willingness to stop drinking alcohol and how far the condition has professed. In some cases, particularly when diagnosed early, not drinking alcohol and maintaining a healthy diet can greatly improve cognitive function. However, in severe cases or with continued alcohol use, dementia can become permanent. Someone with questions about a specific situation should consult a doctor about their circumstances.

Treatment for Alcohol-Related Dementia

The first and most crucial step in treating alcohol-related dementia is stopping alcohol. Even if the dementia is permanent, stopping alcohol use can help prevent further damage. If the alcohol-related dementia is related to Wernicke-Korsakoff syndrome, supplementation with thiamine can help to prevent or reverse damage depending on how early in the condition it is given.

In addition to stopping alcohol and treating thiamine deficiencies, cognitive rehabilitation can be helpful. This involves working with a therapist on specific skills to improve memory, attention and problem-solving. Medications can be used in some cases to treat symptoms of dementia. Treatment for more advanced forms of dementia may include 24-hour care and supervision to ensure safety and that all needs are met. Each case of alcohol-related dementia is ultimately unique, and treatment plans should be individualized based on the person’s condition, needs and preferences.

While alcohol might seem like a harmless social indulgence, chronic, heavy drinking can lead to alcohol-related dementia and permanently affect your life and the lives of those who care about you. Understanding this risk is a crucial step in making informed decisions about alcohol use, helping you optimize your brain health and avoid the dementia alcohol can cause.