Alcohol-Related Dementia

What is alcohol-related dementia?

Alcohol-related dementia is a type of dementia that happens when drinking too much alcohol damages your brain. People sometimes call it “alcohol-induced dementia” or “alcoholic dementia,” but these are more outdated names.

Healthcare providers can suggest treatments to manage the symptoms you experience. You might partially regain some of your ability to use your brain if you stop drinking.

Having an occasional drink or two won’t cause dementia. The damage that causes alcohol-related dementia happens after years of unsafe drinking.

Talk to a healthcare provider about how much alcohol you drink. Don’t be afraid or ashamed to ask for help if it’s hard for you to stop drinking. Substance use disorder is a health condition, not a sign you’re a bad person. Treatment is available.

What is alcohol-related brain damage?

Alcohol-related brain damage (ARBD) is any brain damage that comes from overusing alcohol. Alcohol-related dementia is a serious form of ARBD.

Alcohol may be safe in moderation. But the more (and more often) you drink, the higher your risk of ARBD.

What are the symptoms of alcohol-related dementia?

Alcohol-related dementia shares symptoms with other dementias. At first, you might notice signs like memory loss, everyday tasks feeling harder than usual or trouble concentrating.

Alcohol-related dementia can affect your:

• Memory. You might not remember facts, names or faces as well as you used to. This can affect your ability to recall recent events (short-term memory) or things that happened a long time ago (long-term memory).
• Reasoning. You might have a hard time processing information or deciding what to do next. It can be hard to handle complex tasks like following a recipe.
• Language. You might say or use the wrong word or communicate less than you used to.
• Behavior and personality. You may experience mood swings, including being more aggressive than usual. You might feel agitation, paranoia or have hallucinations.
• Spatial understanding. You may have a hard time understanding how close objects around you are from your body. This can make it hard to walk or make you feel less coordinated than usual. You may bump into furniture or struggle to do delicate hand motions like tying your shoes.

Symptoms usually develop slowly over time, but some people notice changes suddenly. You’ll probably notice issues with your memory before other signs. Which symptoms you experience will depend on which areas of your brain alcohol damages.

Stages of alcohol-related dementia

Dementia causes a cognitive decline — it reduces how well your brain works. Providers sometimes group alcohol-related dementia into four stages based on its severity:

• Mild cognitive impairment. You’ll experience mild symptoms — a mild cognitive decline. It’s common to notice memory or reasoning issues in this stage. You’ll probably still be able to drive, get around familiar places and take care of yourself without issues.
• Early-stage alcohol-related dementia. The cognitive decline will cause more symptoms. You’ll experience noticeable memory loss. You might struggle to remember recent events, names or important information. The symptoms will impact your daily life, and you may require support from loved ones to do all of your usual activities.
• Mid-stage alcohol-related dementia. Cognitive decline will cause more noticeable symptoms. It may be harder to use language or move well. You might struggle to recognize places and people, even familiar loved ones and neighbors you see often.
• Late-stage alcohol-related dementia. A severe cognitive decline causes the most intense symptoms. You may not be able to talk, walk or take care of yourself. You’ll probably need constant care.

Alcohol-related dementia doesn’t cause a progressive cognitive decline like Alzheimer’s disease. This means the damage in your brain won’t automatically get worse over time if you stop drinking. But continuing to drink alcohol can cause additional brain damage and make you advance through the stages.

What causes alcohol-related dementia?

Drinking too much alcohol too often causes alcohol-related dementia.

The kind of drinking that causes alcohol-related dementia is different from an occasional cocktail, beer or glass of wine. The American Medical Association recommends that males have no more than two standard-sized drinks per day, and no more than 14 in a week. Females should have no more than one standard-sized drink a day, and seven or fewer drinks each week.

A standard-sized drink is:

• Twelve ounces of beer with 5% alcohol by volume (ABV)
• Five ounces of wine with 12% ABV
• One-and-a-half ounces of liquor of around 40% ABV

Overusing alcohol can damage nerves and blood vessels in your brain. Over time, that damage can add up and destroy special nerve cells called neurons. Your brain needs neurons to control your thoughts and body. You can start to lose the functions that area of your brain controls if alcohol destroys those neurons.

Risk factors

Alcohol-related dementia usually affects people between the ages of 40 and 50 who have been drinking heavily for years. But you can develop alcohol-related dementia at any age if you’re drinking more alcohol than is safe. It’s most common among people who have alcohol use disorder.

The best way to prevent alcohol-related dementia is to avoid drinking too much alcohol. Talk to a healthcare provider or a loved one if you’re worried you’re drinking too much. You’re not weak for admitting you need help. The sooner you reduce how much alcohol you use, the better.

What are the complications of alcohol-related dementia?

The biggest complication of alcohol-related dementia is the damage in your brain. That can cause permanent changes to your personality and your ability to think and use your body. You may experience complications, some of which can be fatal.

Complications can include:

• An overall decline in your physical health
• Infections (like pneumonia or skin infections)
• Other alcohol-related health conditions like Wernicke-Korsakoff syndrome
• Seizures
• Trouble breathing
• Trouble swallowing

Over time, you may lose your ability to control your body and take care of yourself. This can increase your risk of:

• Bedsores
• Dehydration or malnutrition
• Falls, bone fractures and other traumatic injuries
• Losing control of your pee (urinary incontinence) and poop (bowel incontinence)
• Tooth decay, cavities and other dental issues

You may also have a higher risk of traumatic brain injuries if you have alcohol-related dementia. Unsafe drinking increases your risk of falls, car accidents and other head injuries. These traumas may damage your brain and destroy neurons. This can make you progress through stages of alcohol-related dementia faster.

How is alcohol-related dementia diagnosed?

A healthcare provider can diagnose alcohol-related dementia in a few ways. The first step is doing a complete physical exam and neurological exam. Your provider will rule out other conditions that cause similar memory issues and other symptoms.

Your provider will ask you questions to understand your health and daily routine. They may also talk to a loved one to learn if they’ve noticed any changes you might not be able to see in yourself. Your provider may ask about your:

• Ability to do your usual activities
• Alcohol consumption
• Current medications
• Medical history
• Mood, behavior and personality and any changes you’ve noticed
• Nutrition
• Overall health

Be honest with your provider about how often you drink alcohol. They won’t judge you or make you feel badly. They want to help you understand what’s causing the symptoms you’re experiencing.

Your provider may use a few tests to diagnose alcohol-related dementia, including:

• Blood tests
• Brain MRI
• Cognitive tests
• CT scan
• PET scan
• Urine tests

They may use other tests to look for signs of alcohol-related conditions, including:

• Alcohol-related cardiomyopathy
• Alcohol-related hepatitis
• Cirrhosis

What are alcohol-related dementia treatments?

Your provider will suggest treatments to help you manage the symptoms you’re experiencing. But there’s no way to reverse the brain damage from alcohol-related dementia.

The most important treatment is to stop drinking alcohol. Continuing to drink will increase the damage in your brain and can make you develop more severe symptoms.

Your provider will help you stop using alcohol safely. Quitting suddenly (cold turkey) can cause withdrawal and complications like delirium tremens (DT). DT is a severe form of sudden alcohol withdrawal that’s a medical emergency.

You may need to stay in the hospital or a residential rehab center to make sure you’re safe while you adjust to living without alcohol.

Other treatments you may need include:

• Cognitive behavioral therapy (CBT or talk therapy). Talking to a mental health professional can help you process stress, anxiety and your feelings. It can also help you find coping strategies to avoid alcohol.
• Medications. There aren’t any specific drugs that treat alcohol-related dementia. But your provider may suggest some medications that treat other kinds of dementia. They might prescribe medicines to treat alcohol use disorder like naltrexone and acamprosate.
• Nutrition support. You’ll need supplemental nutrition if you have malnutrition or a vitamin deficiency.
• Support groups. Support groups are a way to connect with others who understand your situation. Your provider can suggest groups for you and your loved ones.

What is the prognosis for alcohol-related dementia?

Alcohol-related dementia affects everyone differently. There isn’t currently a cure for any type of dementia. So, you should expect the changes in your ability to think and use your body to be permanent. But you’re still you, even if you have to adjust to new changes.

What is the life expectancy for someone with alcohol-related dementia?

Alcohol-related dementia can affect how long you’ll live (your life expectancy). But it’s hard for experts to estimate a set number or guidelines that apply to everyone.

What you can expect depends on a few factors, including:

• If you stop drinking alcohol
• The severity of the brain damage
• Which areas of your brain are affected
• Your age
• Your overall health

You may have other alcohol-related health conditions that can affect your life expectancy, too. It’s hard to prove which condition affects your life expectancy the most. What’s most important is making sure you’re safe and that you have ways to manage the symptoms.

Your provider will help you set realistic expectations based on your health and unique situation.

When should I see my healthcare provider?

See a healthcare provider if you’re experiencing issues with memory or thinking. They can determine if the issues are due to alcohol-related dementia or another condition. Don’t hide symptoms or how you feel from your provider. Remember, they’re not trying to get you in trouble or make you feel shame. But they need to know how you feel and what you’re experiencing to help you get the right diagnosis and treatments.

You’ll need regular check-ups with your healthcare provider They’ll monitor your brain for any changes and adjust your treatments as needed.

Which questions should I ask my healthcare provider?

Ask your provider any questions you may have. You might want to ask them:

• Can you suggest resources to help me quit using alcohol?
• Are there any medications that can help? If so, how do I take them?
• Can you recommend a therapist and/or support groups?
• Which other symptoms or signs of complications should I watch out for?