Alcohol & Dementia: Can Alcohol Cause Memory Loss?

What is Dementia?

Dementia is an umbrella term used to describe various syndromes of impaired brain functioning, which may include symptoms of memory loss, and a decline in thinking and reasoning abilities.³ The neurodegenerative disease processes that underlie certain types of dementia are progressive and irreversible.^3,4 There are several different forms of dementia, including:^3,4,5

• Alzheimer’s disease — the most common neurodegenerative type of dementia among older people. It is thought to develop in association with certain types of brain changes, including pathological protein buildup known as amyloid plaques and tau tangles.
• Frontotemporal dementia — more rare than Alzheimer’s and most commonly affects people under age 60. It also is thought to develop in association with abnormal amounts or forms of proteins in the brain. This type is also neurodegenerative.
• Lewy body dementia — this neurodegenerative type results from abnormal deposits of a protein known as Lewy bodies.
• Vascular dementia — develops as a result of impaired blood flow to the brain or damage to blood vessels in the brain, such as from strokes or mini-strokes.
• Mixed dementia — involves a combination of dementia types.

Dementia is a major concern in the United States. Statistics show that:

• Between 60-80% of dementia cases are attributed to Alzheimer’s disease.⁵
• People age 75 and up account for 72% of Alzheimer’s cases, with 6.2 million Americans age 65 and up having Alzheimer’s disease.⁷
• There are 5.6 million Americans 65 or older who have some type of dementia.²
• Around 200,000 Americans under 65 have younger-onset Alzheimer’s.²

Signs & Symptoms of Dementia

The symptoms aren’t exactly the same for everyone, and not all types of dementia have the same symptoms.⁴ However, some of the more common signs and symptoms of dementia include:^3,4,5,8,9

• Asking the same questions.
• Becoming disoriented in familiar areas.
• Changes in personality.
• Confusion.
• Difficulty focusing, reasoning, or solving problems.
• Difficulty learning new things.
• Forgetting recent things, such as events or conversations, or the names of people they know well.
• Impaired judgment.
• Memory loss.
• New difficulty managing money or paying bills.
• Problems with balance or coordination.
• Referring to familiar objects with unusual words.
• Trouble controlling their emotions.
• Trouble speaking or reading and writing.
• Unusual visual changes not attributed to aging.

Risks & Causes of Dementia

Neurodegenerative and vascular types of dementia are caused by progressive damage to the nerve cells in the brain, resulting in such brain cells not working effectively, losing their connection to other brain cells, and ultimately dying off.⁴ Such changes can affect the parts of the brain that control thought, reasoning, judgment, memory, emotions, and movement.⁴ There are several factors that can increase the risk of developing dementia. These include:^3,4,7,8

• Age. People who are older are more likely to develop dementia, especially after age 65.
• Family history. If you have a parent or sibling with dementia, you may be more likely to develop it due to increased genetic risk.
• Gender. Females may be more likely to eventually develop dementia, as on average, they have longer lifespans than men.
• Lower cognitive reserve. The concept of cognitive reserve describes our resiliency to certain brain disease processes based on having kept our brains active over the course of a lifetime. People who don’t continue learning throughout life, who utilize a narrower range of mental skills at work, and who are more isolated may be at greater risk for dementia.
• Race and ethnicity. Older African Americans have more than double the risk of developing dementia than Caucasians, while Hispanics have 1.5 times the risk compared to Caucasians.
• Physical health. People with hypertension and high cholesterol have a greater risk of developing dementia when these conditions are not well-managed. People who are overweight, not physically fit, or have type 2 diabetes are also more prone to dementia. Other chronic health issues can also raise the risk for dementia, including multiple sclerosis, HIV, kidney disease, developmental disabilities, and rheumatoid arthritis.
• Mental health. People with depression are more likely to get dementia.
• Head injuries. Traumatic brain injuries can raise the risk of developing dementia, particularly if they have occurred multiple times, involved a loss of consciousness, or were severe. Heavy alcohol use can lead to accidents, injuries, and falls, and frequent head injuries may damage the brain and significantly increase the risk of dementia.
• Lifestyle issues. Cigarette smoking, heavy alcohol use, and binge drinking have been linked to an increased risk of developing dementia. People with alcoholism are more likely to develop dementia, and at earlier ages.
• Environment. Exposure to micro-particulate substances in certain types of air pollution or burning wood could make dementia more likely.

Alcohol and Brain Injury

Alcohol intoxication tends to impair coordination, so people who are intoxicated are more likely to have accidents or falls. Head injuries, especially if they are severe, involve a loss of consciousness, or happen multiple times, are linked to an increased risk of dementia, even many years after the brain injury occurs.^4,9 These types of injuries may be known as traumatic brain injuries (TBIs), and can occur as a risk of car accidents, falls, or fights. TBIs can cause damage to areas of the brain, and begin a series of changes that allow proteins that cause dementia to accumulate near the damaged area.⁹

Alcohol-Related Dementia and Wernicke-Korsakoff Syndrome

While alcohol is just one of the risk factors that can contribute to dementia, it can also lead to the development of Wernicke-Korsakoff Syndrome (WKS), a condition that shares certain symptoms with dementia.^5,10 WKS is initially caused by a deficiency in vitamin B1 (thiamine) and alcohol-related changes in the brain and often causes memory loss, cognitive issues, and problems with coordination.¹¹ People who drink heavily over long periods of time are prone to nutritional deficiencies, which can contribute to brain injury.⁷

People who binge drink or drink heavily are more likely to develop dementia and be diagnosed at earlier ages compared to nondrinkers.^5,7,8 This risk increases as people drink more heavily and over longer periods of time.⁷ However, long-term heavy drinking also places people at increased risk of developing WKS.¹⁰ If WKS is treated early enough, it can be prevented from progressing to more severe disease.¹⁰ Since there is significant overlap of the cognitive symptoms of WKS and dementia, there is an ongoing discussion about whether there is a separate type of dementia known as alcohol-induced dementia.¹⁰

Alcohol Consumption with Dementia

If you or a loved one has been diagnosed with dementia, it is important to speak honestly with your doctor about alcohol use, and they can discuss whether it is safe to consume alcohol. Only your physician can provide accurate and specific advice on this. However, since the consumption of alcohol can worsen and accelerate dementia symptoms, your doctor may advise you to cut back or abstain from alcohol entirely, especially for people who drink heavily or have been long-term drinkers.⁵ Although most forms of dementia are irreversible and chronic, symptoms of alcohol-related dementia can be halted or reversed if drinking is stopped and you follow a healthy diet with vitamin supplementation.⁸

Treatment & Outlook

To properly diagnose dementia, doctors will first rule out any other conditions that can cause the symptoms through a physical and psychiatric exam and blood work.³ They will then ask about the person’s medical history, family history, and inquire about symptoms, medications, and recent changes.^3,8 The diagnosis is then made based on testing of neurological and cognitive functioning, scans of the brain, and genetic testing.^3,8 Treatment for dementia depends on the type, but may involve medication, developing methods to strengthen the memory, and having supportive people in place to help.^4,8

If a person has dementia and an AUD, it can be especially difficult for them to understand that they need to stop drinking as part of treatment.⁸ Attending an alcohol rehab can help to reverse alcohol-related dementia and early symptoms of WKS, or improve the outlook for people with dementia.⁸ Treatment commonly involves inpatient detox to manage withdrawal symptoms, followed by a combination of medication, behavioral therapy and high doses of thiamine, as well as ensuring a balanced diet and adequate hydration.^7,8