Alcoholic-induced dementia is a slow and progressive condition. As a result, this condition is more commonly seen across senior or elderly populations and is relatively uncommon in younger people. Some aspects of alcohol-induced dementia are permanent; however, it appears that if properly diagnosed some aspects may be reversed or halted when drinking is stopped altogether.
Making a Diagnosis
Arriving at a diagnosis of alcohol-related or alcohol-induced dementia requires a detailed understanding of a patient's clinical history along with a thorough physical exam. The DSM-IV states patients must present with sufficient cognitive deficits in order to meet the criteria for dementia, along with a history of alcohol abuse. The level of alcoholism is determined by lab reports, physical examination and patient reporting.
Symptoms
The DSM-IV checklist for dementia is extensive. Alcohol-induced dementia patients experience memory problems, including memory loss, poor recall and an inability to acquire new information. Language impairment, which includes difficulty speaking or writing, confusion, and an inability to perform complex motor or manipulation tasks, is seen with this condition. Executive skills planning, which includes the ability to organize and anticipate a sequence of events, is affected by high levels of chronic alcohol abuse. Last but not least, depression is also a common component of alcohol-induced dementia.
How Alcohol Damages the Brain
The effects of alcohol damage on the brain were reviewed by Drs. Susham Gupta and James Warner in an article titled "Alcohol-Related Dementia: A 21st Century Silent Epidemic?" that appeared in "The British Journal of Psychiatry" in 2008. The article notes that findings show the brains of chronic alcohol abusers have "morphological abnormalities" in the frontal lobe region, which suggests "cerebral atrophy." Imaging technology indicated that male alcoholics showed "larger ventricles and wider cerebral sulci and fissures" than control subjects. These studies also showed reduced blood flow to the brain. The study also discovered that while women are more likely vulnerable to the effects of alcohol and exhibited symptoms earlier, they also had a faster recovery following alcohol abstinence.
Challenges to Doctors
Doctors face challenges in distinguishing alcohol-induced dementia from dementia that is caused by other factors. The above-referenced Gupta and Warner article makes mention of a proposed clinical diagnostic criteria whereby a diagnosis of "probable alcohol-related dementia" could be made at least 60 days after a last exposure to alcohol, significant alcohol use for more than five years (defined as a minimum of 35 standard drinks per week for males and 28 for women), and significant alcohol use occurring within three years of the symptom onset. At this point, however, there is no such criteria in place. In addition, patients cannot be diagnosed with alcohol-induced dementia while they are in withdrawal or experiencing serious medical complications resulting from the substance abuse, according to the AlzBrain.org group.
Korsakoff's Amnesic Syndrome
Korsakoff's amnesic syndrome, or Korsakoff's psychosis (KP), is a neuro-degenerative memory disorder that can occur when the body does not have enough vitamin B1, also known as thiamine. This deficiency is commonly linked with chronic alcohol abuse, and according to Healthtree.com, it shares many of the same symptoms as alcohol-induced dementia. With both conditions, patients experience memory impairment, but Korsakoff patients have excellent long-term memory functioning. Patients with KP should be treated with thiamine to prevent the condition from worsening, but in many cases the amnesia is usually permanent.
