Table of ContentsView AllTable of ContentsOverviewCausesEffects on the BrainDiagnosisTreatmentCopingA Word From Verywell

Table of ContentsView All

View All

Table of Contents

Overview

Causes

Effects on the Brain

Diagnosis

Treatment

Coping

A Word From Verywell

Excessive drinkingover a period of years may lead to a condition commonly known as alcoholic dementia, or alcohol-related dementia (ARD). In the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR), it is referred to as alcohol-induced major neurocognitive disorder.

Alcohol-related dementia can causeproblems with memory, learning, judgment, and other cognitive skills.

What to Know About Alcohol Use Disorder

Alcohol-related dementia is similar in some ways to Alzheimer’s disease in that it affects memory and cognitive ability.

What Are the Early Signs of Dementia?

Wernicke-Korsakoff Syndrome

People with severe alcohol use disorder also tend to have nutritional deficiencies from a poor diet and irregular eating habits.

Alcohol’s Effect on Nutrition

Most research indicates that moderate drinking has very little negative impact on health and is considered beneficial for cardiac health. Moderate drinking is defined as less than two drinks for men and less than one drink for women per day. However, a 2017 study found that even moderate amounts of alcohol consumption over many years lead to shrinkage of an area of the brain involved in the formation of new memory (the hippocampus).The scientists could not definitively conclude whether this change was due to a temporary shift in cellular fluid versus actual cell death.

Many studies show thatheavy drinkershave less brain volume overall with evidence of impaired memory, attention span, judgment, and other aspects of cognitive functioning.Neural connections are weakened or lost, and the reward system pathways no longer function as they once did. The end stage of alcoholism is linked with severe brain damage as well as liver problems that can add additional symptoms of brain fog, confusion, and delirium.

While drinking may have started out feeling good, tolerance builds over time, and you eventually drink to avoid feeling bad.

While forgetfulness and short-term memory might be the first signs, a person may go on to experience difficulties with executive functioning (like organizing and planning) and, in a later stage, problems with motor abilities.

WKS happens in two stages. Wernickes encephalopathy is the acute stage resulting from thiamine deficiency. If it is not adequately treated, it may lead to Korsakoff syndrome (or Korsakoff psychosis), which involves significant impairments of memory as well as delirium and hallucinations. Sometimes, noticeable personality changes take place, with increased agitation and anger, and a person can become almost unrecognizable to friends and family.

The most distinguishing symptom isconfabulation (fabrication)where the person makes up detailed, believable stories about experiences or situations to cover gaps in memory.

Symptoms of WKS may present as someone telling the same stories or asking the same questions over and over, with no recollection that the questions have just been asked and answered. In conversation, someone may repeat the same piece of information 20 times, remaining wholly unaware that they are repeating the same thing.

Remarkably, at the same time, they can seem to be in total possession of most of their faculties, able to reason well, draw correct deductions, make witty remarks, or play games that require mental skills, such as chess or cards.This makes alcohol-related dementia easy to hide for some people, and difficult to diagnose at times.

ARD is a progressive illness, which means its symptoms often happen in stages and continue to get worse—especially if left untreated.

Age of Onset and Prognosis

The age of onset of alcohol-related dementia varies, but it’s often seen in middle-aged adults around 40 to 50 years old. However, it can occur earlier or later depending on the amount of alcohol a person consumes.

For instance, research suggests that a five-year history of drinking 35 alcoholic beverages a week for men and 28 for women presents a “sufficient” risk for the development of ARD.

The life expectancy of people with ARD varies, and more research is needed in this area. One study found that 50% of patients with an alcohol-related Wernicke-Korsakoff syndrome were expected to die within 8 years of a Wernicke’s encephalopathy episode; the main causes of death were cancer and bacterial infections.

While the statistics can be intimidating, try to remember that they don’t determine your journey with ARD. Quality of life and life expectancy vary significantly from person to person. Talk to a doctor to address your symptoms and learn how you can manage and, in some cases, even reverse signs of your illness.

The DSM outlines diagnostic criteria for alcohol-related dementia including multiple cognitive deficits such as memory impairment. A doctor may issue a patient a test to determine if they display any of the following signs:

A doctor will ask a patient questions to determine whether their cognitive impairments result in disturbances to their daily functioning.

They will also take a patient’s history, perform a physical exam, and conduct lab tests. They will determine if a patient’s health status is consistent with the effects of substance misuse.

In alcohol-related dementia, examination of the nervous system can also reveal various types of damage, including:

If you or a loved one are struggling with substance use or addiction, contact theSubstance Abuse and Mental Health Services Administration (SAMHSA) National Helplineat1-800-662-4357for information on support and treatment facilities in your area.For more mental health resources, see ourNational Helpline Database.

If you or a loved one are struggling with substance use or addiction, contact theSubstance Abuse and Mental Health Services Administration (SAMHSA) National Helplineat1-800-662-4357for information on support and treatment facilities in your area.

For more mental health resources, see ourNational Helpline Database.

Prompt treatment with thiamine (vitamin B1) for people with Wernicke encephalopathy can potentially prevent or lessen the development of Wernicke-Korsakoff syndrome. However, vitamin B1 treatment rarely improves the loss of memory that takes place once Korsakoff psychosis has developed.

Quitting drinking will prevent additional loss of brain function and damage. Also, improving the patient’s diet can help; however, diet does not substitute for alcohol abstinence in preventing alcohol-related dementia from worsening.

The effects of alcohol-related dementia may be reversible, depending on your circumstances. The best way to try to reverse symptoms is to quit drinking.

Abstinence of up to one year is linked with improved attention, working memory, and problem-solving abilities. However, learning and short-term memory impairments may be more difficult to reverse even with abstinence.

The Benefits of Quitting Alcohol

It isn’t easy to cope with alcohol-related dementia, but there are resources that can help. You may also choose to share your diagnosis with supportive family and friends—you don’t have to navigate your condition alone.

Consider attending a support group for sobriety such as Alcoholics Anonymous (AA). Going to meetings can hold you accountable for quitting drinking and improving your health.

Alcohol-related dementia with changes in mental status, memory loss, and personality may be the consequence of longstanding alcohol consumption. However, if you catch the signs early, it is possible to reverse some of the disease process with nutrition therapy and abstinence from alcohol. Once it progresses to Korsakoff syndrome, the damage to the brain and nervous system may be too severe to reverse.

Prevention is the key to reducing the risk of any major health problems and psychosocial consequences of heavy drinking. If you have difficulty controlling your alcohol use and want help, there are many treatment options and resources to help you through your journey toward sobriety and wellness.

Recognizing Alcoholism as a Disease

9 SourcesVerywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Ridley NJ, Draper B, Withall A.Alcohol-related dementia: An update of the evidence.Alzheimers Res Ther. 2013;5(1):3. doi:10.1186/alzrt157Alzheimer’s Association.Korsakoff syndrome.National Institute on Alcohol Abuse and Alcoholism.Alcohol’s effects on health.Topiwala A, Allan CL, Valkanova V, et al.Moderate alcohol consumption as risk factor for adverse brain outcomes and cognitive decline: Longitudinal cohort study.BMJ. 2017:j2353. doi:10.1136/bmj.j2353Spindler C, Trautmann S, Alexander N, et al.Meta-analysis of grey matter changes and their behavioral characterization in patients with alcohol use disorder.Sci Rep. 2021;11(1):5238. doi:10.1038/s41598-021-84804-7Sanvisens A, Zuluaga P, Fuster D, et al.Long-term mortality of patients with an alcohol-related Wernicke-Korsakoff syndrome.Alcohol and Alcoholism. 2017;52(4):466-471. doi:10.1093/alcalc/agx013Sachdeva A, Chandra M, Choudhary M, Dayal P, Anand KS.Alcohol-related dementia and neurocognitive impairment: A review study.Int J High Risk Behav Addict. 2016;5(3):e27976. doi:10.5812/ijhrba.27976Stanford Medicine.Alcoholics Anonymous most effective path to alcohol abstinence.Jeynes KD, Gibson EL.The importance of nutrition in aiding recovery from substance use disorders: A review.Drug Alcohol Depend. 2017;179:229-239. doi:10.1016/j.drugalcdep.2017.07.006

9 Sources

Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Ridley NJ, Draper B, Withall A.Alcohol-related dementia: An update of the evidence.Alzheimers Res Ther. 2013;5(1):3. doi:10.1186/alzrt157Alzheimer’s Association.Korsakoff syndrome.National Institute on Alcohol Abuse and Alcoholism.Alcohol’s effects on health.Topiwala A, Allan CL, Valkanova V, et al.Moderate alcohol consumption as risk factor for adverse brain outcomes and cognitive decline: Longitudinal cohort study.BMJ. 2017:j2353. doi:10.1136/bmj.j2353Spindler C, Trautmann S, Alexander N, et al.Meta-analysis of grey matter changes and their behavioral characterization in patients with alcohol use disorder.Sci Rep. 2021;11(1):5238. doi:10.1038/s41598-021-84804-7Sanvisens A, Zuluaga P, Fuster D, et al.Long-term mortality of patients with an alcohol-related Wernicke-Korsakoff syndrome.Alcohol and Alcoholism. 2017;52(4):466-471. doi:10.1093/alcalc/agx013Sachdeva A, Chandra M, Choudhary M, Dayal P, Anand KS.Alcohol-related dementia and neurocognitive impairment: A review study.Int J High Risk Behav Addict. 2016;5(3):e27976. doi:10.5812/ijhrba.27976Stanford Medicine.Alcoholics Anonymous most effective path to alcohol abstinence.Jeynes KD, Gibson EL.The importance of nutrition in aiding recovery from substance use disorders: A review.Drug Alcohol Depend. 2017;179:229-239. doi:10.1016/j.drugalcdep.2017.07.006

Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

Ridley NJ, Draper B, Withall A.Alcohol-related dementia: An update of the evidence.Alzheimers Res Ther. 2013;5(1):3. doi:10.1186/alzrt157Alzheimer’s Association.Korsakoff syndrome.National Institute on Alcohol Abuse and Alcoholism.Alcohol’s effects on health.Topiwala A, Allan CL, Valkanova V, et al.Moderate alcohol consumption as risk factor for adverse brain outcomes and cognitive decline: Longitudinal cohort study.BMJ. 2017:j2353. doi:10.1136/bmj.j2353Spindler C, Trautmann S, Alexander N, et al.Meta-analysis of grey matter changes and their behavioral characterization in patients with alcohol use disorder.Sci Rep. 2021;11(1):5238. doi:10.1038/s41598-021-84804-7Sanvisens A, Zuluaga P, Fuster D, et al.Long-term mortality of patients with an alcohol-related Wernicke-Korsakoff syndrome.Alcohol and Alcoholism. 2017;52(4):466-471. doi:10.1093/alcalc/agx013Sachdeva A, Chandra M, Choudhary M, Dayal P, Anand KS.Alcohol-related dementia and neurocognitive impairment: A review study.Int J High Risk Behav Addict. 2016;5(3):e27976. doi:10.5812/ijhrba.27976Stanford Medicine.Alcoholics Anonymous most effective path to alcohol abstinence.Jeynes KD, Gibson EL.The importance of nutrition in aiding recovery from substance use disorders: A review.Drug Alcohol Depend. 2017;179:229-239. doi:10.1016/j.drugalcdep.2017.07.006

Ridley NJ, Draper B, Withall A.Alcohol-related dementia: An update of the evidence.Alzheimers Res Ther. 2013;5(1):3. doi:10.1186/alzrt157

Alzheimer’s Association.Korsakoff syndrome.

National Institute on Alcohol Abuse and Alcoholism.Alcohol’s effects on health.

Topiwala A, Allan CL, Valkanova V, et al.Moderate alcohol consumption as risk factor for adverse brain outcomes and cognitive decline: Longitudinal cohort study.BMJ. 2017:j2353. doi:10.1136/bmj.j2353

Spindler C, Trautmann S, Alexander N, et al.Meta-analysis of grey matter changes and their behavioral characterization in patients with alcohol use disorder.Sci Rep. 2021;11(1):5238. doi:10.1038/s41598-021-84804-7

Sanvisens A, Zuluaga P, Fuster D, et al.Long-term mortality of patients with an alcohol-related Wernicke-Korsakoff syndrome.Alcohol and Alcoholism. 2017;52(4):466-471. doi:10.1093/alcalc/agx013

Sachdeva A, Chandra M, Choudhary M, Dayal P, Anand KS.Alcohol-related dementia and neurocognitive impairment: A review study.Int J High Risk Behav Addict. 2016;5(3):e27976. doi:10.5812/ijhrba.27976

Stanford Medicine.Alcoholics Anonymous most effective path to alcohol abstinence.

Jeynes KD, Gibson EL.The importance of nutrition in aiding recovery from substance use disorders: A review.Drug Alcohol Depend. 2017;179:229-239. doi:10.1016/j.drugalcdep.2017.07.006

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