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Alcohol-Induced Dementia: Effects and Treatment

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Dementia is a common side effect of heavy, long-term alcohol misuse. Evidence suggests that up to 78% of people who experience alcohol addiction have some degree of brain damage, which can include alcohol-induced dementia and other forms of dementia. The prevalence of dementia is as high as 24% in those who chronically misuse alcohol.1,2

In this article: 

What Is Dementia?

Dementia is a general term that refers to a decline in cognitive functions, including memory, problem-solving, decision-making, and language skills. Alzheimer’s disease is the most common form of dementia. Other types of dementia include vascular dementia, Lewy body dementia, frontotemporal dementia, and mixed dementia—a combination of two or more forms of dementia.3

Dementia is not a normal part of aging, though age and other factors can increase your risk of developing dementia. These risk factors include:3,4

  • Being 65 years of age or older
  • Having a family history of dementia
  • Being African American or Latinx
  • Having poor heart health, including high blood pressure and cholesterol levels
  • Having uncontrolled diabetes
  • Being a smoker
  • Suffering a traumatic brain injury
  • Misusing alcohol

Most types of dementia are incurable. However, treatment may improve symptoms and slow the progression of the disease. Medication therapy, speech therapy, and occupational therapy are used to treat dementia.4

What Is Alcohol-Induced Dementia?

Alcohol-induced dementia is any dementia caused by chronic alcohol use.

Heavy and chronic alcohol use can deplete the body’s thiamine stores and cause thiamine deficiency, which is a main underlying factor of alcohol-induced dementia. Thiamine is an essential nutrient that plays a major role in cognitive function and brain health. Thiamine deficiency affects an estimated 80% of people who suffer from alcohol addiction.5

Alcohol is also shown to shrink parts of the brain, decrease neuron activity, and cause oxidative stress—all of which contribute to cognitive problems and the potential development of alcohol-induced dementia.

Cerebellar degeneration is one form of alcohol-induced dementia. This form of dementia usually develops after at least 10 years of heavy alcohol misuse and affects more than 40% of those who experience alcohol addiction.7

Symptoms of cerebellar degeneration include:7

  • Wide-legged, unsteady walk
  • Tremors in the trunk of the body
  • Slow, jerking movements in the arms and legs
  • Slowed and slurred speech
  • Involuntary eye movements
  • Psychiatric symptoms

Types of alcohol-induced dementia also include a rare form of dementia called Wernicke-Korsakoff syndrome (WKS). WKS is a brain disorder caused by a thiamine deficiency. This brain disorder consists of two components: Wernicke’s encephalopathy (WE) and Korsakoff’s psychosis.6

WE is an acute, short-term, and life-threatening condition, characterized by the following symptoms:6

  • Loss of muscle coordination in the lower extremities
  • Confusion
  • Abnormal eye movements—such as eyelid drooping—caused by paralysis of nerves in the eyes
  • Alcohol withdrawal syndrome

An estimated 80-90% of those with alcohol addiction eventually develop Korsakoff’s psychosis, which is a chronic and debilitating condition caused by permanent damage to parts of the brain involved with memory.6,7

Korsakoff’s psychosis symptoms include:6

  • Severe memory loss
  • Hallucinations
  • Inability to form new memories
  • Making up stories
  • Abnormal behavior

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How Can Alcohol-Induced Dementia Affect Your Life?

Alcohol-induced dementia can affect your physical, psychological, and emotional health, impacting your quality of life. Over time, dementia can get progressively worse and require you to receive care from a caregiver or from a specialized facility.

Alcohol-induced dementia can affect your everyday life in the following ways.

Memory Loss

Dementia can cause short- and long-term memory loss. With short-term memory loss, you may forget recent events such as what you ate for breakfast and whether you brushed your teeth. If you develop long-term memory loss, you could forget the names of your loved ones or memories of childhood experiences.

Memory loss can trigger a wide range of difficult emotions, including sadness, frustration, and grief. Your memory loss can also affect your loved ones, especially if the loss includes shared memories or personal information.1

Poor Judgment and Decision-Making

Dementia can affect judgment and decision-making abilities. As the condition progresses, difficulties with judgement and decision-making may become apparent in many areas of your life, including your finances, driving habits, or career.

Poor judgement and decision-making skills can potentially endanger the well-being and livelihood of yourself and others. You may eventually need help from a caregiver who can assist you with certain tasks, such as paying household bills, running errands, and cooking.3

Speech and Communication Problems

Dementia can impair your ability to communicate with and understand others. As dementia begins to affect the language center of the brain, a person may repeat certain words and phrases or ask others to repeat themselves. You may also pause frequently when speaking to find the right words that convey what you’re trying to say.3

Difficulty with Problem Solving

We use problem-solving skills constantly throughout our daily activities. The effects of dementia may make simple “problems” that you could solve without much thought increasingly challenging. For example, dementia may make it difficult to complete tasks like tying and untying your shoes or knowing what to do when something on the stove starts burning. Dementia can affect your ability to reason and find solutions for both simple and complex problems, which may change which activities you can do without assistance.3

Poor Coordination and Motor Skills

Dementia affects the part of your brain responsible for balance and coordination. This can increase the risk of falls and injuries or contribute to losing your balance when navigating uneven paths and walkways. For many people suffering from dementia, their activity level begins to decrease as their motor skills become compromised. Decreased activity can  affect your overall physical health over time.1

Confusion and Disorientation

Dementia can cause feelings of confusion and disorientation. These feelings may come and go, causing you to forget where you are or what you were doing. Some people forget how to get home while they are out. Getting lost due to feelings of confusion or disorientation is a common sign of dementia.3

Irritability and Sudden Mood Swings

Dementia can contribute to a loss of emotional control. You may feel strong emotions related to your symptoms. You may also experience mood swings you cannot explain or feel unable to regulate your emotions in certain situations and react more strongly than you might have in the past. 9

Mood and mental health disorders, including anxiety and depression, can also co-occur with dementia.9

How Is Alcohol-Induced Dementia Treated?

Evidence suggests that the brain can recover from the effects of alcohol after you become abstinent from alcohol use. Abstinence from alcohol may improve poor motor skills related to dementia. However, brain health improvements can be compromised when heavy alcohol use is resumed or after periods of repeated binge drinking.1

Dementia and alcohol addiction can effectively be treated simultaneously using a variety of behavioral therapies and medical interventions.

Many alcohol rehab centers offer inpatient care for alcohol addiction and management of chronic conditions such as dementia. Treatment often begins with alcohol detox, which manages the physical symptoms of alcohol withdrawal. You or your loved one will be closely monitored by nurses and doctors to reduce symptoms and prevent complications using medication therapy8

Your care team may also work together to treat and reduce symptoms of dementia while you are going through alcohol withdrawal. For instance, your doctors may provide you with thiamine supplements to replenish this essential brain nutrient and reduce the severity of your dementia symptoms.8

Following alcohol detox, you can enter an addiction treatment program which uses therapeutic modalities to help you change negative behavior patterns related to addiction. Your treatment plan will focus on improving or delaying dementia progression. Cognitive behavioral therapy (CBT) and dual diagnosis therapy are some of the treatments that may be used to address both addiction and dementia. You may also receive relapse-prevention training, which helps you develop skills for handling triggers and situations that would lead to alcohol use in the past.9, 10

Talk to your doctor or the admissions staff at an alcohol rehab center to learn more about your treatment options if you or a loved one is suffering from alcohol addiction. The long-term effects of alcohol addiction, including dementia, may not set in for several years.

Even if you have no current symptoms, your risk of developing alcohol-induced dementia increases if you continue to misuse alcohol without getting help. Many health insurance plans help cover the cost of addiction treatment so you can get the help you need to address your alcohol addiction and prevent progressive complications.

Call 800-948-8417 Question iconWho Answers? to speak to a treatment specialist about nearby alcohol rehab centers and get help choosing a facility for yourself or a loved one. Our specialists can answer any questions you may have about addiction and discuss your available treatment options.

Resources

  1. Ridley, N.J., Draper, B., Withall, A. (2013, January). Alcohol-related dementia: an update of the evidence. Alzheimer’s Research and Therapy, 5(1),
  2. Sachdeva, A., Chandra, M., Choudhary, M., Dayal, P., & Anand, K.S. (2016, February 7). Alcohol-related dementia and neurocognitive impairment: a review study. International Journal of High-Risk Behaviors and Addiction, 5(3),
  3. Centers for Disease Control and Prevention. (2019). What Is Dementia?
  4. Medline Plus. (2020). Dementia.
  5. Martin, P. R., Singleton, C. K., & Hiller-Sturmhöfel, S. (2003). The role of thiamine deficiency in alcoholic brain disease. Alcohol Research & Health, 27(2), 134–142.
  6. Medline Plus. (2021). Wernicke-Korsakoff syndrome.
  7. National Center for Advancing Translational Sciences. Cerebellar degeneration.
  8. World Health Organization. (2009). Withdrawal Management. Clinical Guidelines for Withdrawal Management and Treatment of Drug Dependence in Closed Settings.
  9. Forstmeier, S., Maercker, A., Savaskan, E., Roth, T. (2015, November). Cognitive behavioural treatment for mild Alzheimer’s patients and their caregivers (CBTAC): study protocol for a randomized controlled trial. Trials, 16: 526.
  10. National Institute on Drug Abuse. (2018). Cognitive-Behavioral Therapy (Alcohol, Marijuana, Cocaine, Methamphetamine, Nicotine).
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