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Is Alcohol Dementia A Real Thing? Facts Revealed

Medically reviewed by Dr. Po-Chang HsuOctober 4, 2024
Written by
On October 4, 2024

Table of Contents

Key Points

  • Alcohol dementia is due to regular heavy drinking that has caused brain damage.
  • Stopping drinking and seeking medical treatment can sometimes improve cognitive function, but the extent of recovery varies and may not fully reverse all brain damage caused by alcohol.
  • Some people may have permanent cognitive impairments that can not be reversed, even with long-term abstinence.

Alcohol dementia is the result of regular, excessive alcohol consumption that has caused brain damage. Symptoms include memory problems and cognitive impairments. If treated early on and abstaining completely from alcohol, memory and cognitive abilities may return. Having a family history of dementia and heavy drinking can increase your risk of developing alcohol dementia.

What is Alcohol Dementia

Regularly drinking alcohol and drinking beyond the recommended limit of alcohol can cause brain damage. Brain damage can result in memory problems and a deficiency in thinking clearly. If a person with these symptoms continues to drink, it is likely to get worse and can develop into alcohol-induced dementia. Alcohol-induced dementia shares some similarities with other forms of dementia, including memory and cognitive impairments, but it has distinct causes and progression related to alcohol use. 

Those who drink heavily and have an alcohol use disorder are also at risk of developing Wernick-Korsakoff syndrome. This neurological condition is due to a lack of thiamine (Vitamin B1).[1] Alcohol abuse can cause a thiamine deficiency, damaging the thalamus, hypothalamus, hippocampus, and cerebellum, leading to the development of Wernicke-Korsakoff Syndrome. This syndrome causes vision, movement, language, sleep, memory, and motivation problems. Without treatment, it can be severely disabling, result in permanent memory loss, and be life-threatening.

Signs and Symptoms of Alcohol-Induced Dementia

Alcohol-induced dementia or alcohol-induced major neurocognitive disorder involves both:[2]

Memory impairment: the inability to recall or learn new information

Cognitive disturbance: 

  • aphasia: difficulty understanding and expressing language
  • apraxia: difficulty completing tasks or movements
  • agnosia: inability to recognize and identify objects, persons, or sounds using one or more of their senses despite otherwise normally functioning senses
  • Executive dysfunctioning: Inability to manage one’s thoughts, emotions, and actions. 

 

Alcohol-induced dementia goes beyond having memory problems and can make it difficult to complete daily tasks. Alcohol-induced dementia can also impact a person’s balance, even when they are sober, as the alcohol has caused damage to the area of their brain that controls balance, coordination, and posture. It can also cause changes to the person’s mood, including apathy, depression, or irritability. These mood changes can make it even more difficult to stop drinking and result in the person being less likely to accept help. 

Signs and Symptoms of Wernicke-Korsakoff Syndrome

Wernicke-Korsakoff Syndrome is a chronic memory disorder due to severe thiamine deficiency and is commonly caused by alcohol misuse. This syndrome progresses in two stages, starting with Wernicke’s disease and progressing to Korsakoff’s psychosis. 

Wernicke’s disease symptoms include: [3]   

  • Confusion 
  • Lack of energy
  • Hypothermia
  • Low blood pressure
  • Lack of muscle coordination:  poor posture and balance, tremors 
  • Vision problems: abnormal eye movements, double vision, crossed eyes, and eyelid drooping
  • Coma

 

With rapid thiamine treatment, muscle and vision problems are reversible. Other symptoms may take longer to respond to treatment or never return. Without prompt treatment, 

Wernicke’s disease can progress to Korsakoff’s psychosis, which is not reversible.

Korsakoff’s psychosis symptoms include: [4]  

  • Severe, irreversible memory impairments: problems forming new memories and recalling memories
  • Making up inaccurate information about events or remembering events incorrectly
  • Hallucinations 
  • Repetitive speech and actions
  • Decision-making difficulties: planning, organizing, and completing tasks
  • Lack of motivation
  • Emotional apathy

How Does Alcohol Damage The Brain?

The most common ways alcohol damages the brain include:[5] 

Nerve Cells: drinking too much alcohol is toxic to nerve cells. Long-term use of alcohol can cause brain cells to die and brain tissue to shrink. As cells die off, fewer messages are available to carry to the brain. 

Blood Vessels: Drinking too much alcohol damages blood vessels in the brain and can cause high blood pressure. This increases a person’s risk of having a stroke. 

Low Thiamine Levels: The brain needs thiamine to function properly. People who misuse alcohol over a long period often have poor nutrition, receiving their calories from alcohol rather than food. This can lead to malnutrition and a lack of vitamins and minerals, including thiamine. 

Higher risk for head injuries: Drinking too much alcohol regularly increases one’s risk for falls, accidents, fights, and victims of violence, all of which can result in blows or hits to the head and brain damage. 

Preventing Alcohol-Induced Dementia

The best way to prevent Alcohol-induced dementia is to abstain from alcohol. Low to moderate alcohol consumption is considered safe for most people, but excessive and chronic alcohol consumption increases the risk of alcohol-related brain damage and other health issues. The general recommendation is no more than one serving of alcohol per day for women and two servings of alcohol per day for men. If stopping alcohol consumption seems impossible, you should consider speaking with professionals at an alcohol rehab for assistance.

Treating Alcohol-Induced Dementia

If alcohol-induced dementia is detected early on, the effects may be reversed by completely abstaining from alcohol. Heavy drinking and binge drinking often come with vitamin and mineral deficiencies, so a healthy diet is also important to help restore proper nutrition. Refraining from drinking alcohol usually results in an improvement in cognitive functioning. However, it can take several months and even up to a year of abstinence to determine what cognitive function can be restored and which ones may be permanent.[6] Women usually recover faster than men. 

Having the support of your family and friends is essential for achieving and maintaining abstinence. Lifestyle changes such as a balanced diet and regular exercise can help support your health and cognitive improvements. Memory training has also been shown to help improve cognitive impairment. 

Unfortunately, not everyone will recover from alcohol dementia or alcohol-induced neurocognitive impairment, even with total abstinence. For some people, alcohol has caused too much damage to their brain to be able to recover. 

People with cognitive impairments struggle with motivation, self-efficacy, participating in group therapy, and complying with their treatment program. This makes it even more difficult to maintain sobriety and improve cognitive abilities. 

One specific program, cognitive remediation therapy, has been shown to improve divided attention, alert capabilities, working memory, and episodic memory, improve self-esteem, and reduce cravings.[7]

Treatment of Wernicke-Korsakoff Syndrome

If detected and treated when symptoms first appear, Wernicke’s disease can be reversed. This means seeking treatment within 48-72 hours of the onset of symptoms.[8] Wernicke’s disease should be treated as a medical emergency by administering intravenous thiamine, with or without glucose, depending on the patient’s condition.[9]   Failure to administer sufficient amounts of thiamine promptly results in a 20% mortality rate among those with Wernicke’s encephalitis.[10] Other treatments may be provided to treat other symptoms, including detox support for alcohol use.  

Without treatment, Wernicke’s disease can progress into Korsakoff’s psychosis. Treatment for Korsakoff’s psychosis involves administering intravenous and oral thiamine and improving nutrition and hydration.  However, severe memory loss and other damages may be permanent at this stage.[11]  Other treatments may be considered for psychosis symptoms, and memory rehabilitation therapy may be helpful to reduce the severity of symptoms. Approximately 20% of individuals with Wernicke-Korsakoff Syndrome require residential care.   

Support For Alcohol Dementia

If you believe you or a loved one may be experiencing dementia symptoms that are linked to alcohol consumption, you should talk to your healthcare provider immediately. Diagnosing alcohol-related dementia early on increases the likelihood of stopping further cognitive damage and increasing your cognitive recovery. 

If you have been drinking alcohol for a while, you may benefit from a detox program or other inpatient or outpatient programs to monitor withdrawal symptoms. Some treatments can help lower withdrawal symptoms experienced and help you start your sobriety with a positive experience.

Medical Content Writer

Amanda Stevens is a highly respected figure in the field of medical content writing, with a specific focus on eating disorders and addiction treatment. Amanda earned a Bachelor of Science degree in Social Work from Purdue University, graduating Magna Cum Laude, which serves as a strong educational foundation for her contributions.

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Frequently Asked Questions About Alcohol Dementia

There is no safe level of alcohol consumption. However, should you choose to consume alcohol, it is recommended not to exceed one drink per day for women and two drinks per day for men. Anything beyond this can be considered drinking too much.  

One drink is:[12]  

  • Beer: 12 oz (at 5% alcohol)
  • Wine: 5 oz (at 12% alcohol)
  • Liquor/Spirits (Rum, Tequila, Whiskey, etc): 1.5 oz (at 40% alcohol)

About one in ten people with dementia have some form of alcohol-related brain damage (ARBD). [13] Among those with early-onset dementia (younger than 65 years old), it is estimated that alcohol is involved in one in eight cases. It is also suspected that alcohol-induced dementia is underdiagnosed, and those numbers are likely higher. People are usually diagnosed with ARBD between the ages of 40 and 50. It affects men more than women, but when women do develop ARBD, it is usually at a younger age than men and with fewer years of alcohol misuse. This is attributed to the fact that women are at a greater risk of the damaging impact of alcohol.

Research is unclear if there is a genetic component to alcohol-induced dementia. There has been research that supports those who have a genetic risk factor for Alzheimer’s disease and who have moderate alcohol consumption are at higher risk for developing Alzheimer’s disease.[14] There is enough research to support that having a family history of Alzheimer’s or dementia increases your genetic risk for having dementia, and drinking increases this risk.

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[1,3,4,9,11] U.S. Department of Health and Human Services. (2022, July). Wernicke-Korsakoff syndrome. National Institute on Alcohol Abuse and Alcoholism. Retrieved from https://www.niaaa.nih.gov/publications/brochures-and-fact-sheets/wernicke-korsakoff-syndrome on 2024, Sept 25.   

[2,6,7,8,10] Sachdeva, A., Chandra, M., Choudhary, M., Dayal, P., & Anand, K. S. (2016). Alcohol-Related Dementia and Neurocognitive Impairment: A Review Study. International Journal of High Risk Behaviors & Addiction, 5(3). Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5086415/ on 2024, Sept 25. 

[5,13] Alzheimer’s Society. (2021, November 30). Alcohol-related brain damage (ARBD): What is it and who gets it?. Retrieved from https://www.alzheimers.org.uk/about-dementia/types-dementia/alcohol-related-brain-damage-arbd on 2024, Sept 25.  

[12] U.S. Department of Health and Human Services. (2022, May 6). The basics: Defining how much alcohol is too much. National Institute on Alcohol Abuse and Alcoholism. Retrieved from https://www.niaaa.nih.gov/health-professionals-communities/core-resource-on-alcohol/basics-defining-how-much-alcohol-too-much on 2024, Sept 25.  

[13] Matloff, W. J., Zhao, L., Ning, K., Conti, D. V., & Toga, A. W. (2020). Interaction effect of alcohol consumption and Alzheimer’s disease polygenic risk score on the brain cortical thickness of cognitively normal subjects. Alcohol (Fayetteville, N.Y.), 85, 1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7220836/ on 2024, Sept 25.

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