Alcoholic Dementia: Symptoms, Risks & Prevention

Dementia caused by drinking can lead to confusion, memory problems and more. While some treatment options exist, stopping alcohol use is the first step.

Drinking alcohol can increase your chances of getting dementia, a type of brain damage that usually happens as you age. If you drink a lot, it’s important to know about this risk. The best way to protect your brain in the long run is to stop drinking alcohol.

What Is Alcoholic Dementia?

“Alcoholic dementia” is an unofficial term for brain problems caused by drinking alcohol. It can mean different things, like: 

• Brain damage from alcohol that can improve if you stop drinking
• A type of dementia called Korsakoff syndrome, which is often caused by drinking too much
• Alzheimer’s disease, a common type of dementia, that can be more likely if you drink a lot

Wernicke-Korsakoff Syndrome

Wernicke-Korsakoff syndrome is a type of brain damage that can lead to dementia. It occurs when you don’t have enough thiamine (vitamin B1) because of heavy drinking.

This syndrome has two parts. The first part, called Wernicke encephalopathy, causes swelling in the brain. This can be fixed if you get more thiamine. The second part, called Korsakoff syndrome, is a type of permanent dementia. It causes problems like hallucinations, memory loss and learning problems.

Early Signs of Alcoholic Dementia

The type of alcohol-related dementia someone is experiencing will determine what early signs occur. Some early signs of dementia may include:

• Memory problems
• Confusion that occurs regularly
• Difficulty focusing
• Changes in personality
• Decreased problem-solving ability
• Struggling with everyday tasks

If someone is experiencing early signs of dementia, they should seek medical care as soon as possible. Dementia related to alcohol use may be treatable in some circumstances.

How Alcohol Causes Dementia

Alcohol can lead to dementia in three ways:

1. It can cause nutritional deficiencies that lead to depleted thiamine levels, causing Wernicke-Korsakoff syndrome and resulting in the irreversible memory and cognitive issues that Korsakoff syndrome causes.
2. It can cause dementia-like symptoms by damaging the brain and reducing brain volume. This is not technically true dementia and may be treatable in some cases if the person with it stops using alcohol.
3. Heavy alcohol use increases the risk of Alzheimer’s disease by 300%. Alzheimer’s disease is the most common cause of dementia and results in permanent memory loss. 

Alcoholic Dementia Symptoms

Because “alcoholic dementia” is not a real medical term and has various associated conditions, no symptoms are associated explicitly with the term. Symptoms of dementia may be associated with alcoholic dementia and include:

• Memory loss that worsens over time
• Difficulty concentrating
• Difficulty with everyday tasks
• Struggling to follow a conversation or find the right word
• Confusion about time and place
• Mood or personality changes
• Inability to remember other people

There are also symptoms specific to Wernicke-Korsakoff syndrome. During Wernicke encephalopathy, the most common symptoms are mental changes, eye movement abnormalities and discoordination while walking. 

When Korsakoff syndrome develops, symptoms include memory loss, inability to make new memories and hallucinations. Someone with Korsakoff syndrome may develop confabulations, which are memories made up to fill in gaps in memory. These may seem like lies to others, but they are actually just the person’s brain automatically filling in gaps with incorrect information. 

Alcoholic Dementia Diagnosis

Because “alcoholic dementia” is not technically a medical condition, it has no specific diagnosis. The different conditions that fall under this umbrella term are diagnosed in various ways.

• Wernicke-Korsakoff syndrome can be diagnosed by the symptoms it causes, a history of alcohol abuse and thiamine levels. An MRI scan may also be used to diagnose the condition in the initial stage.
• Cognitive issues caused by neurological changes from alcohol use can be diagnosed by CT scans or MRIs of the brain coupled with the person’s history of alcohol use.
• Alzheimer’s disease can be diagnosed through neurological tests and a positron emission tomography (PET) scan. Many other diagnostic tests will also likely be ordered to rule out other potential causes of the person’s symptoms.

Treatment for Alcoholic Dementia

True dementia can’t be cured, but you can slow progression and manage symptoms. If someone’s dementia is due to alcohol use, the first step is to stop drinking. Fortunately, there are many different treatment options to help with quitting. 

Inpatient Rehabilitation

Inpatient rehabilitation is an ideal treatment option for those struggling to stop using alcohol. This form of treatment involves checking in to a treatment facility for weeks or, in extreme cases, months. Inpatient rehab is designed to occur right after alcohol detox. It also teaches strategies and tools that help restructure peoples’ thinking about alcohol, equipping them to achieve lasting sobriety.

Outpatient Rehabilitation

Outpatient rehab is very similar to inpatient rehab in that it provides the same resources with the same goal. The major difference is that the person undergoing rehab does not live in the same place where the groups, therapies and other activities occur. This allows greater flexibility, enabling a more normal routine while still engaging in rehab. Because outpatient rehab is not as comprehensive as inpatient rehab, it is generally a better tool for those using rehab for the first time or who do not have serious health problems caused by alcohol, such as alcoholic dementia.

Support Groups

Support groups can play a crucial role in recovery. They may be a part of rehab but are particularly helpful as an aftercare tool. They can help support someone as they pursue lasting recovery and apply the strategies they learned in rehab. Groups like Alcoholics Anonymous (AA) and SMART Recovery are good examples of support groups for those overcoming alcohol addiction.

Medication

Recovery from alcoholism will primarily focus on learning new behaviors and strategies. However, medications can also play a helpful role in alcohol addiction recovery. These include:

• Naltrexone (Vivitrol): This medication blocks receptors in the brain involved in the rewarding effects of drinking alcohol, reducing cravings and the pleasure experienced with alcohol.
• Acamprosate (Campral): It helps restore the balance of neurotransmitters in the brain affected by chronic alcohol use, reducing the desire to drink alcohol.
• Disulfiram (Antabuse): Disulfiram creates unpleasant effects like nausea, flushing and palpitations when alcohol is consumed, ultimately discouraging alcohol use.
• Topiramate (Topamax): This medication is sometimes used off-label to help reduce alcohol cravings and consumption.

Holistic Approach to Alcohol Addiction

Overcoming alcohol addiction is ultimately a complicated process involving a combination of addressing your physical health, mental health and resolve to overcome the addiction. A good treatment plan will address each facet of recovery, treating each one within the broader context of your unique needs as an individual. 

A holistic treatment approach will combine conventional therapies, such as cognitive behavioral therapy, with less conventional treatments, such as yoga or art group therapy. Finding the right combination of traditional and nontraditional treatment options will help promote a holistic recovery approach.

Long-term Complications of Alcoholic Dementia

Conditions known as alcoholic dementia create long-term complications. True dementia is permanent and progressive, continually getting worse and never improving. Minor issues from dementia include forgetting trivial pieces of information, while more serious problems could include being unable to feed or dress oneself.

Someone with dementia will gradually require more and more care. The problems that dementia causes make the person with dementia more susceptible to diseases and infection. While dementia itself is not directly fatal, it can lead to an earlier death.

Frequently Asked Questions

Can alcoholic dementia be reversed?

It depends on what’s causing it. Wernicke-Korsakoff syndrome can be treated in its early stage but eventually becomes permanent. Alcohol-related Alzheimer’s disease can’t be reversed with current treatments. However, brain damage caused by alcohol might improve if you stop drinking. That’s why the best chance to stop or reverse dementia from alcohol is to stop drinking.

Who is at risk for alcoholic dementia?

Anyone who drinks heavily or frequently is at an increased risk of the various forms of alcoholic dementia. And the risk only goes up the longer you drink. Older people and those already at risk for dementia are also more likely to develop alcoholic dementia from heavy drinking.