Alcohol abuse can completely destroy lives. Not only does it lead to severe health and social problems but it can even take away the individual’s ability to function mentally. One of the most disturbing outcomes of chronic alcohol abuse is alcoholic dementia. It is similar to Alzheimer’s disease as it impacts memory and cognitive ability. Once the individual has progressed to this state there may be little that can be done to reverse it. This type of dementia can develop in people of any age.
Alcoholic dementia is comprised of two separate conditions known as Wernicke’s encephalopathy and Korsakoff psychosis. This type of dementia can also be referred to as Wernicke-Korsakoff Syndrome or wet brain. Although there are two conditions in Wernicke-Korsakoff Syndrome it is more correct to say that they are different stages of the same disorder. The individual usually develops Wernicke’s encephalopathy first of all and the damage caused by this leads to Korsakoff syndrome.
Wernicke-Korsakoff Syndrome causes atrophy to the brain. The damage is particular focused around the mammillary bodies. This atrophy occurs due to a thiamine deficiency (vitamin B1). Chronic alcoholics tend to have a poor diet and so they do not receive all the nutrients they need for proper functioning. Alcoholic drinks can contain a lot of calories but they have poor nutritional value. It is the poor diet of the heavy drinker that is the main cause of alcoholic dementia and not the alcohol directly. Nerve cells require thiamine to do their job and a chronic lack of this vitamin leads to problems.
The symptoms of alcoholic dementia will depend on the stage of the syndrome. The individual who develops Wernicke’s encephalopathy can experience:
* Mental confusion
* Agitation and paranoia
* Lack of muscle coordination (ataxia)
* Eye problems including involuntary eye movements, unequal pupils, and impaired eye movement.
If the individual is habitually intoxicated it can be difficult to diagnose Wernicke’s encephalopathy. This is because they may be confused and uncoordinated due to alcohol. It is only when these symptoms remain while sober that they become more obvious. Later Wernicke’s encephalopathy can progress to Korsakoff psychosis and the symptoms can include:
* The inability to create new memories
* False memories
* The loss of memories
If Wernicke-Korsakoff Syndrome is not treated it will progress to coma and death.
The goal of treatment will be to fix the thiamine deficiency. This will stop the progression of dementia, but if there is extensive damage to the brain already there may be little hope of a full recovery. It is usually necessary for the individual to stay in hospital until the nutritional deficiency is corrected using IV infusions or injections. Thiamine therapy tends to be more effective at treating the Wernicke’s encephalopathy symptoms rather than the loss of memory.
Once Alcoholic dementia is treated it is vital that the individual remains abstinent from alcohol. If the damage to their brain has been mild they should be able to build a good life in recovery. Those who have suffered permanent brain damage will need to adapt to this, but their life should improve greatly once they quit alcohol. If the individual has progressed to severe Wernicke-Korsakoff Syndrome it can be difficult for them to remain abstinent from alcohol. They will lack the insight to understand the need for abstinence. As their mental faculties continue to deteriorate they will likely end up beyond help. It is therefore vital that the individual quits alcohol as early as possible before the condition worsens.
Those people who have chronically abused alcohol over many years can find abstinence a challenge. Not only will they need to deal with physical withdrawal symptoms but they will also need to learn how to live life free of addiction. It can be a tough adjustment but relapse will often mean death. This is why such people can benefit greatly from rehab and other forms of support. This is especially necessary during the early months of recovery when the risk of relapse is particularly high.
Chronic alcohol abuse combined with poor nutrition is the cause of alcoholic dementia. The key to prevention then is to avoid drinking too much and to eat a balanced diet. Thiamine is found in many foods including grains, bananas, lentils, and potatoes. Heavy drinkers may benefit from taking B1 supplements, but the best solution is to drink within safe limits. Those individuals who struggle to drink sensibly should choose complete abstinence from alcohol. The safe limit for alcohol use is 1 drink per day for women and those over 65 and 2 drinks per day for men. Anyone who stays within the safe limits should never develop alcoholic dementia.
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