The debate still rages whether alcohol dementia is accurately classified as an official form of dementia or as a symptom of chronic alcohol abuse. On the one hand, it certainly fits the criteria of memory loss, the lack of fine motor skills and the inability to learn and retain new information. On the other hand, unlike traditional forms of dementia, the symptoms do decline when the patient stops drinking and starts treatment before permanent brain injury occurs.
Many highly functioning alcoholics are able to keep their drinking habits a secret for long periods, which is why alcohol dementia can be hard to diagnose. Once a doctor is aware of the long-term alcohol abuse, the symptoms suddenly become clearer and treatment is possibility. From a friend and family perspective, key symptoms of alcohol dementia include:
- Short term memory loss – Alcohol abuse is one of the leading causes of memory loss in America. This is because high blood alcohol levels damage certain parts of the brain, most noticeably the frontal lobe, which is where conscious thought and short term memory is stored, as well as the temporal lobe which is the location for speech and motor movement. Patients will still be able to remember long term facts but will find it hard to retain new information and may become easily confused during a conversation.
- Mobility problems – At the peak of the alcohol abuse, alcohol induced dementia is linked to ataxia, that is, the link between brain and body becomes weakened and sufferers will find simple tasks such as walking and eating much harder. Observers may notice a shaking or unsteadiness in the arms and legs as a result of the ataxia and this symptom should be reported to a doctor straight away.
- Confabulation – This is the medical term for chronic lying and it is one of the key signs of alcohol dementia. Patients who abuse alcohol make up stories initially to cover the gaps in their memories and over time they come to believe the lies to be true. Early research into this field called this condition Korsakoff psychosis, as patients would happily construct fantasy worlds. The word psychosis has fallen out of fashion however as clinicians argued that patients didn’t see their fantasy world in the present, only as memories of the past.
It is clear that chronic alcohol abuse is the root cause of alcohol dementia but it is important to understand the science why regularly consuming large amounts of liquor causes brain damage.
Research shows that neurological disorders caused by alcohol stem from a lack of thiamine, also known as vitamin B1, in the brain. Vitamin B1 occurs naturally in many fruits and vegetables so it is very rare for someone to suffer a deficiency from their diet. However, alcoholics tend to eat very little and very poorly so, sometimes, a poor diet causes the thiamine deficiency.
In other cases, the sheer amount of alcohol consumed affects the stomach and intestines’ ability to absorb nutrients. In these cases, vitamin deficiency symptoms occur along with the dementia.
Most forms of alcohol dementia are actually cases of Wernicke-Korsakoff Syndrome. This is two separate diseases that are linked and are both caused by sustained alcohol abuse:
- Wernicke’s encephalopathy – This is a form of alcoholic encephalopathy, which occurs without any warning. Fortunately, some very noticeable symptoms happen including jerky eye movements, drowsiness even in the middle of the day and poor balance due to the onset of ataxia. Wernicke’s disease treatment is through medication and making the encephalopathy alcoholic patient withdraw entirely from alcohol. Early intervention prevents long-term brain damage and can reverse symptoms often in the course of a week.
- Korsakoff’s syndrome – Korsakoff’s syndrome appears after Wernicke’s and is the name for the symptoms of the long-term brain damage that comes from untreated Wernicke’s encephalopathy. Symptoms include memory loss, agitation and behavior changes such as irritability and irrational aggression. Again, treatment is possible if the symptoms are caught early enough and many doctors will prescribe higher levels of thiamine to help boost the patient’s brain function. It’s unclear if this makes a significant difference to the time it takes the symptoms to disappear but appears to reduce the chances of Korsakoff’s occurring again.
The hardest part about dealing with someone with alcohol dementia is making them realize that they have a problem in the first place. The confabulation symptom means that they will have fully justified reasons for their change in memory capacity and behavior so people close to the patient may have to find ways of recording evidence for the doctor and as proof for the patient themselves.
If the condition goes untreated for too long, it can develop into other more serious forms of dementia and mental illness, so it’s important to get help as soon as possible regardless if it is viewed as dementia or as a symptom of chronic alcoholism.