Does Alcohol Abuse Cause Dementia?

Dr. John Elgin Wilkaitis

Dr. John Elgin Wilkaitis completed medical school at The University of Mississippi Medical Center and residency in general psychiatry in 2003. He completed a fellowship in Child and Adolescent Psychiatry at Cincinnati Children’s Hospital in 2005. Following this, he served as Chief Medical Officer for 10 years of Brentwood Behavioral Healthcare a private health system including a 105-bed hospital, residential treatment, and intensive outpatient services.

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Protecting Your Brain: The Link Between Alcohol Abuse and Dementia

Is there a link between alcohol abuse and dementia? While there is often an emphasis on the effects of alcohol on the liver and cardiovascular system, the truth is that the impact of excessive alcohol on the brain can be just as grim. Alcohol abuse can threaten brain health and cognition in a variety of different ways. Yes, it can even potentially raise a person’s risk factor for dementia. While moderate alcohol consumption, in general, is not linked with elevated dementia risks, the threshold for alcohol consumption for dementia risk is lower than most people might realize. Here’s what everyone needs to know about the link between alcohol abuse and dementia.

What Is Dementia?

Dementia isn’t a single disease. Instead, it is a term that describes a set of acquired intellectual disturbances caused by brain dysfunction. People with dementia live with cognitive impairments that cause memory loss, poor judgment, and forgetfulness. Many also experience changes in visual perception, reasoning, and socializing. In most cases, dementia is triggered by degenerative disorders, vascular disorders, or traumatic head injuries. It can also be triggered by alcohol-related brain damage. In fact, long-term abuse of alcohol causes a specific form of dementia through the development of Wernicke-Korsakoff syndrome.

How Wernicke-Korsakoff Syndrome (Alcohol Dementia) Affects the Brain

Also known as alcohol dementia, Wernicke-Korsakoff syndrome is caused by the way alcohol prevents proper vitamin B1 (thiamine) absorption in the brain. The most common symptoms of alcohol dementia are:

  • Loss of memory
  • Inability to form and keep new memories
  • Making up stories (confabulation)

The onset of alcohol dementia is marked by an intense swelling of the brain called Wernicke’s encephalopathy. During an episode, a person may experience intense confusion, loss of muscle coordination (ataxia), and tremors. Vision problems are also common. For example, people experiencing Wernicke’s encephalopathy often have double vision, eyelid drooping, or abnormal eye movements that cause their eyes to continuously move back and forth. In some people undergoing Wernicke’s encephalopathy, the confusion and loss of mental activity are so severe that symptoms progress to coma and death.

When Wernicke’s encephalopathy is treated quickly, recovery is possible. When not treated quickly, this onset of symptoms can result in long-term brain damage associated with alcohol dementia. Most people who are affected by alcohol dementia require some form of ongoing support or long-term residential care. While Wernicke-Korsakoff syndrome occurs in 1% to 2% of the adult population in the United States, it’s believed that it remains undiagnosed in around 80% of affected people.

Other Ways Alcohol Abuse Causes Dementia

In addition to triggering acute dementia symptoms through Wernicke-Korsakoff syndrome, excessive alcohol consumption has also been shown to increase a person’s overall risk of developing dementia. Alcohol consumption is linked with reduced volume in the brain’s white matter. White matter is crucial for cognitive function and memory because it transmits signals between different regions of the brain. In addition, chronic overconsumption of alcohol over several years is linked with alcohol-related brain damage (ARBD). ARBD is a general term covering several conditions impacting brain health and function.

People affected by ARBD, including alcohol dementia, often struggle with the basics of everyday life. Memory loss and difficulty completing tasks are two hallmarks of ARBD. Other signs that a person is living with ARBD include:

  • Difficulty staying focused
  • Difficulty committing to tasks
  • Difficulty with setting goals
  • Difficulty with judgment or making decisions
  • Lack of motivation for essential tasks
  • Emotional dysregulation

ARBD symptoms can vary from person to person. While alcohol abuse often impacts the brain’s frontal lobes, some people experience more extreme symptoms because shrinkage has been experienced in more areas of the brain. Generally, a brain scan is the only way to confirm the extent of ARBD.

What About Alcohol Abuse’s Risks for Alzheimer’s Disease?

Alzheimer’s is a specific type of dementia that is characterized by progressive memory loss and cognitive decline. It accounts for roughly 60% to 80% of all dementia cases. If you’re concerned about alcohol abuse and dementia, you may also be curious to know if consuming large amounts of alcohol also increases the risks for Alzheimer’s. The answer is that it does.

Researchers found that even modest amounts of alcohol can accelerate brain atrophy. That means that every sip of alcohol can bring a person closer to brain decline. In addition to triggering a loss of brain cells that can make the brain more vulnerable to both Alzheimer’s and dementia as a whole, excessive alcohol consumption can also increase the number of amyloid plaques in the brain. This is significant because amyloid plaques are the toxic proteins associated with Alzheimer’s disease. Additionally, chronic alcohol exposure impacts the regulation of brain metabolism in ways that potentially accelerate the pathology of Alzheimer’s disease.

There’s also another component of alcohol consumption that may contribute to Alzheimer’s and dementia risks. Drinking alcohol causes elevations in blood sugar and insulin-resistance markers. While these markers are generally associated with risks for type 2 diabetes, they are also associated with increased risks for Alzheimer’s disease. In fact, insulin resistance is considered one of the direct causes of dementia.

How Much Alcohol Increases Risks for Dementia?

You might be wondering how much alcohol you need to consume before dementia risks increase. It may be far less than most people expect. Researchers believe that consuming more than two drinks per day increases a person’s risk for developing dementia.

What Are the Signs of Alcohol Abuse?

Alcohol use disorder (AUD) is the term applied when someone is abusing alcohol. AUD is a medical condition that involves heavy or frequent use of alcohol. If you’re living with AUD, you may be turning to alcohol even though it is causing emotional and physical harm in your life. For people caught up in AUD, there is a loss of control over drinking habits. People with AUD are often preoccupied with alcohol to the point that finding a way to take their next sip becomes the top priority in life. They may allow careers, relationships, and personal health to fall by the wayside. While AUD can be mild, moderate, or severe, the common signs of AUD include:

  • Being unable to limit alcohol consumption
  • Being unable to cut down the amount you are drinking
  • Spending a significant portion of time obtaining alcohol, drinking alcohol, or recovering physically from alcohol consumption
  • Failing to fulfill major obligations in your work life, personal life, or home life due to the effects of alcohol use
  • Continuing to consume large amounts of alcohol even though it is causing serious problems in your life
  • Retreating from activities and hobbies that you enjoy just to be able to focus on alcohol consumption
  • Consuming alcohol in unsafe scenarios and environments that can include while swimming, driving a car, working, operating machinery

In addition, one of the telltale signs that a person has AUD is alcohol withdrawal. When the body becomes physically dependent on alcohol, both reducing and stopping alcohol consumption can trigger withdrawal. While the withdrawal period can last anywhere from several days to several weeks, symptoms will generally appear within a few hours of the last sip of alcohol. Withdrawal is an unpleasant experience that causes a variety of painful and uncomfortable physical and psychological symptoms. This includes headaches, nausea, sweating, anxiety, and depression. In some cases, withdrawal symptoms can escalate to a life-threatening level if a person experiences something called delirium tremens. Typically beginning two to five days after taking a final drink, delirium tremens is a potentially fatal condition that is characterized by shaking, confusion, fever, high blood pressure, and hallucinations.

While withdrawal is a common side effect of AUD, it should be treated as a serious event. For this reason, a medically supervised detoxification program is recommended as a safe option for breaking physical alcohol dependence. In addition to creating a safer situation, a medically supervised detox can often decrease a person’s chances of relapsing by making the process more comfortable.

Getting Help for a Problematic Relationship With Alcohol

For most people, a problematic relationship with alcohol can cause a myriad of issues long before dementia signs show up. This can include turmoil in relationships, career, and education. It can also mean severe and life-changing health issues that include:

  • Liver disease
  • Fatty liver (hepatic steatosis)
  • Scarred liver (cirrhosis)
  • Digestive problems
  • Inflammation of the stomach lining (gastritis)
  • Inflammation of the pancreas (pancreatitis)
  • High blood pressure
  • Enlarged heart
  • Heart failure
  • Stroke
  • Sexual dysfunction
  • Involuntary rapid eye movement (nystagmus)
  • Vitamin B deficiencies
  • Miscarriage and fetal alcohol spectrum disorders (FASDs)
  • Osteoporosis
  • Neurological complications
  • Weakened immune system
  • Increased risk of cancer
  • Medication and alcohol interactions

One of the best ways to protect your health against dementia and other serious health complications is to limit alcohol consumption. However, scaling back to a moderate intake on your own may not be possible if you’re someone who is affected by alcohol use disorder. Seeking support and resources to treat alcohol use disorder can be an important step in preventing dementia risks. For most people, an inpatient setting that offers personalized residential care is the best way to make a major life turnaround.

One place where people from around the country are seeking professional help for alcohol abuse is Defining Wellness in Missouri. Offering intensive inpatient care in a professional and compassionate setting, we work with most major insurance providers. Clients of ours enjoy residential treatment that offers an opportunity to build a solid foundation for lasting recovery without the stress and distractions of everyday life. This setting provides a place to get some distance from environmental elements that contribute to an unhealthy relationship with alcohol. During treatment, our credentialed and experienced support staff utilizes evidence-based therapies to help diminish drinking urges, build coping skills, and uncover underlying causes of excessive alcohol use. Clients can also take advantage of custom aftercare plans developed to help each client continue sobriety following discharge.

Final Thoughts: Protecting Your Brain Against the Effects of Alcohol

There is a well-established link between alcohol consumption and dementia risks. The fact of the matter is that excessive alcohol can shrink parts of the brain that are associated with cognition and memory. While many people assume that dementia and Alzheimer’s risks only exist for people who consume excessive amounts of alcohol for years, updated research shows that the threshold for brain damage is much lower than most people would guess. Don’t wait for dementia to rob you or a loved one of vitality. Seek help for alcohol use disorder today to begin the path to emotional recovery and mental clarity.

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