Alcoholic Dementia: Long-Term Effects of Heavy Drinking on Brain

Alcohol use disorder can lead to dementia

Medically reviewed by Nicholas R. Metrus, MD

Chronic alcohol use can cause memory and behavioral changes, often described as alcoholic dementia. There are many contributing factors and types of alcoholic dementia, including head trauma, liver failure, and alcohol-associated malnutrition.

If you or a loved one begins to develop signs of alcoholic dementia, it’s important to see a healthcare provider as soon as possible. Alcoholic dementia is gradually progressive, and it worsens over time. Medical treatment and getting treated for alcohol addiction may help prevent the condition from getting worse.

This article describes the causes of alcoholic dementia, symptoms, diagnosis, treatment, and coping.

<p>skynesher / Getty Images</p>

skynesher / Getty Images

Why Does Alcohol Lead to Dementia?

Alcohol leads to dementia in several ways. Alcohol consumption affects every organ in the body. Drinking alcohol in moderation has not been considered a cause of health problems or dementia. However, recent studies suggest that even moderate alcohol use can increase the likelihood of dementia.

How alcohol can contribute to dementia includes:

  • Toxins affecting the brain: Alcohol use is associated with inflammation, which may damage neurons in the brain, leading to dementia.

  • Wernicke-Korsakoff syndrome: This type of dementia is caused by alcohol-induced thiamine deficiency, which leads to brain damage.

  • Liver failure: Chronic alcohol use causes liver damage. The liver interacts with food and medications so that they can be used by the body and also aids the chemical process of removing waste material from the body. Liver failure leads to a buildup of toxins that harm the brain.

  • Malnutrition: Alcohol damages the stomach, intestines, pancreas, and liver, impairing the body’s ability to get nutrients from food that is eaten. Additionally, alcohol is filling, which makes it difficult to eat properly. Intoxication also may cause you to neglect your own healthy eating. The resulting nutrient deficiencies damage the brain and contribute to dementia.

  • Head trauma: Intoxication can cause accidents, falls, and injuries. Repeated head trauma can cause or worsen dementia.

  • Exacerbation of dementia: Alcohol use has been shown to worsen the neurological changes of Alzheimer’s disease, Lewy body disease, and other common types of dementia.

  • Pellagra: This disorder involves multiple organ systems, including the skin and the nervous system. The condition is linked to niacin deficiency, which can develop in association with alcohol.

Excessive alcohol use for many years is linked to alcoholic dementia, and some people can develop alcoholic dementia more rapidly than others.

Alcohol use disorder (AUD) is defined in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). Its diagnostic criteria include factors such as the frequency and amount of alcohol use, as well as behavioral features of addiction. All types of alcohol dementia are associated with AUD.

Not everybody who consumes excessive amounts of alcohol for long periods of time develops dementia. But there is no way to predict whether a person who consumes large amounts of alcohol will develop alcoholic dementia or not.



Alcoholic Dementia vs. Wernicke-Korsakoff Syndrome

While they are sometimes used interchangeably, alcoholic dementia and Wernicke-Korsakoff syndrome are not exactly the same. Wernicke-Korsakoff syndrome is a type of alcohol-associated dementia that’s caused by thiamine deficiency, but there are other types of alcoholic dementia.



Stages of Alcoholic Dementia Symptoms

Alcoholic dementia can occur at any age, and it is expected to worsen rapidly (within a few years) after the initial symptoms begin.

Some people may develop behavioral symptoms or problems with memory and decision-making before experiencing motor effects of alcoholic dementia, but the pattern of symptoms doesn’t necessarily follow a particular sequence.

Effects of alcoholic dementia can include:

  • Slurred speech

  • Impaired coordination

  • Difficulty walking

  • A wide based gait, which is a pattern of walking with the legs placed far apart

  • Problems with memory

  • Difficulty with decision making

  • Personality changes

  • Anxiety or depression

Getting an Alcoholic Dementia Diagnosis

A diagnosis of dementia requires a comprehensive physical and psychological evaluation. This includes cognitive testing, which involves assessing thinking and problem-solving skills.

Dementia has many causes, and it can be difficult to distinguish causes. Sometimes, physical changes such as movement disorders or coordination problems can help differentiate types of dementia.

In addition to a physical examination and medical history, your healthcare provider may order diagnostic testing to help reach specific causes for dementia symptoms.

The evaluation will include:

  • Consideration of whether you have AUD based on DSM criteria

  • A medical history to identify risk factors

  • Cognitive testing to examine thinking and problem-solving abilities

  • A physical exam, which will help identify signs of liver disease, skin changes, or nutritional deficiencies

  • Neurological examination, which will assess coordination, gait, and reflexes

Diagnostic testing may include:

  • Liver enzyme tests: Liver failure causes a pattern of liver enzyme changes that can be measured with blood tests.

  • Nutrient levels: Nutritional deficits, such as vitamin B12 deficiency, often cause anemia that can be identified with blood tests. Additionally, specific tests for nutrient levels can be requested as well.

  • Urine test: Urine tests can detect the presence of alcohol.

  • Electrolyte panel: Changes in mineral concentration can occur with dehydration or other effects of alcohol use.

  • Brain imaging studies: Brain imaging tests can visualize brain damage due to head trauma. Sometimes, signs of dementia can also be noted in these studies.

The results will help determine whether you or your loved one has AUD, dementia, or both.

Does Treatment Reverse Alcoholic Dementia?

Treatment may help prevent the progression of dementia that’s associated with alcohol use. Generally, treatment can’t repair areas of the brain that have been harmed by nerve cell damage or head trauma.

Therapy for alcoholic dementia can include management of AUD, nutritional supplementation to compensate for nutrient deficiencies, and exercises to help improve cognition (thinking abilities) and motor skills.

Additionally, medications that are indicated for treating dementia, such as Namenda (memantine), may be prescribed, but the benefits are not established for alcoholic dementia.

Programs to Treat Alcoholic Dementia and Dependance

If you or a loved one is living with AUD, it can be challenging to stop drinking. Alcohol withdrawal can be dangerous if you abruptly stop drinking after consuming large amounts of alcohol for a long time.

Alcohol is highly addictive for some people. A variety of programs can help you stop drinking. You should discuss your intentions with your healthcare provider, who can work with you to help plan your next steps toward recovery.

Options may include inpatient or outpatient detoxification from alcohol, and sometimes, medication is necessary to help a person stop drinking.

Medications prescribed for AUD include:

  • Antabuse (disulfiram): Alters your body’s reaction to alcohol and can lead to discomfort when you drink, discouraging drinking

  • Vivitrol (naltrexone): Prevents your body from feeling the pleasant effects of alcohol

  • Campral (acamprosate): Prevents unpleasant effects of alcohol withdrawal, so you will not want to use alcohol as a method of avoiding withdrawal symptoms

Side Effects of Withdrawal

Alcohol withdrawal can be unpleasant and, sometimes, it even is dangerous. You may need to stop drinking while being treated in an inpatient program if you regularly consume excessive alcohol.

You and your healthcare providers will have to decide on a plan to determine the safest steps as you begin the process of quitting alcohol.

Side effects of alcohol withdrawal may include:

  • Irritability

  • Fatigue

  • Anxiety

  • Nausea, vomiting

  • Sweating

  • Insomnia

  • Bad dreams

  • Tremors

  • Hallucinations

  • Seizures

  • Delirium

  • Loss of consciousness

The severity of these withdrawal symptoms varies by person. You could potentially experience any combination of these effects when withdrawing from alcohol.

If you are undergoing alcohol withdrawal in a supervised medical setting, your healthcare team will monitor your vital signs and your overall mental status throughout the process so interventions can be started when needed to maintain your safety.

Learn More: What to Know About Alcohol Abuse Treatment

Coping With Long-Term Effects of Alcoholic Dementia

If you or a loved one is living with alcoholic dementia, it can be extremely difficult to cope with—personally and for the family.

Usually, self-care is impaired with alcoholic dementia. People may also have motor difficulties due to impaired coordination and trouble walking, which can lead to safety concerns.

Memory and decision-making are also severely affected, which means that people living with this condition need help from trusted family or friends to manage home, finances, transportation, and more.

It can be beneficial to work with a social worker who is experienced in managing alcoholic dementia and who can guide you and provide you with advice, support, and resources as you cope with this condition.

People coping with alcoholic dementia—and their loved ones—may also benefit from working with a counselor or therapist who can help manage emotions, anxiety, and mood changes associated with this condition.

You may also find value in joining a support group for people who are living with alcoholic dementia or for caregivers so that you can meet with others who are coping with the same life stressors as you are. Sometimes, knowing what to expect and how others have managed challenges can help provide a source of comfort and community.



Life Expectancy


Alcohol-related dementia is associated with a low survival. According to one large epidemiological study, five-year survival after diagnosis of alcohol-related dementia was 53.4% for men and 63.4% for women, and the 10‐year survival was 29.5% for men and 38.3% for women. Note that the terms for sex or gender from the cited study are used.)



Summary

Alcoholic dementia encompasses several different alcohol-induced neurological conditions that can affect thinking skills.

This condition generally affects people who have alcohol use disorder (AUD). The most common causes of alcoholic dementia include head trauma, Wernicke-Korsakoff syndrome, liver failure, and the toxic effects of alcohol on the brain

Sometimes, nutritional supplementation can help prevent the progression of this type of dementia. Additionally, stopping alcohol use is a key factor in preventing additional damage that causes worsening of alcoholic dementia. It can be dangerous to stop alcohol abruptly, and it’s safer to go through alcohol detoxification under medical supervision.

Coping with alcoholic dementia can be difficult for a person who is experiencing it, as well as for their loved ones. You don’t have to go through this alone—seeking help from healthcare providers, as well as support groups, can help you as you learn how to manage your alcohol use and how to cope with the effects of alcoholic dementia.

Read the original article on Verywell Health.