Understanding Alcohol Use And Dementia: From Diagnosis To Patient Education
An estimated 50 million people currently have dementia, and projected prevalence rates for the years 2030 and 2050 are 82 million and 152 million, respectively, according to the World Health Organization.1 This trend underscores the need to identify potentially modifiable risk factors to inform dementia prevention and treatment efforts. To that end, accumulating research is exploring the link between alcohol consumption and the risk of developing dementia.
While results vary across studies, findings consistently point to an elevated dementia risk with both high levels of alcohol intake and abstinence. A 2021 meta-analysis of 6 cohort studies demonstrated that the consumption of more than 14.0 alcoholic drinks per week was linked to a higher risk of progression to dementia .2
In a 2018 cohort study of 9,087 participants aged 35-55 years, analyses of trajectories from midlife to early old age revealed a higher risk for dementia with long-term abstinence from alcohol , reduced consumption , and long-term consumption of more than 14.0 drinks per week compared to long-term intake of 1.0-14.0 drinks per week.3
In research published in September 2019 in JAMA Network Open, Koch et al investigated the risk for dementia and cognitive decline in a cohort of 3,021 individuals with or without mild cognitive impairment who self-reported details regarding alcohol use.4
What does the evidence suggest thus far regarding the association between alcohol consumption and the risk for dementia?
I Study Summaries: Research On Drinking And Dementia
Large Studies
Moderate drinking protects older persons from the development of cognitive impairment. Thats the conclusion of researchers who studied 15,807 Italians 65 years of age and older. Among the drinkers, only 19% showed signs of mental impairment. That compared to 29% of the abstainers.1
Other investigators studied 12,480 older women over time. Drinkers were about 20% less likely than abstainers to have poor memory as they aged. The same was true for thinking abilities. The positive effects of different alcoholic beverages were all the same.2
Two large studies in Australia tested people age 20 to 64. They found that moderate drinkers did better than abstainers on all measures of cognitive ability.3
Long Studies
A long-term study of over 6,000 Britons began in 1967. Drinkers did much better on tests of cognitive functioning than teetotalers. For example, abstainers were twice as likely as occasional drinkers to receive the lowest test scores. The beneficial mental effects of alcohol occur when a person drinks up to about 30 drinks per week. It increased with consumption. Researchers did not test higher levels of drinking.4
A study followed 1,018 men and women age 65-79 for an average of 23 years. The subject was drinking and dementia. rinking no alcohol, or too much, increases risk of cognitive impairment.5
Important Fact
Significant
Both non-drinkers and heavy drinkers had the lowest CASI scores.7
Specifically Alzheimers
Progression of Dementia
Other
Alcoholic Dementia Life Expectancy
Alcohol-related dementia is a broad term and can describe multiple conditions related to alcohol use that affects the brain. In most cases, determining the life expectancy of someone with alcohol-related dementia is also complicated by a history of heavy alcohol use, causing other alcohol-related problems that also shorten life expectancy.
While there are no specific life expectancy projections for alcohol-related dementia in general, a study shows that the life expectancy for someone with Wernicke-Korsakoff Syndrome is eight years for 50% of people who have this form of alcohol-related brain damage.
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Are Dementia And Alcohol
Although most people associate dementia with Alzheimer’s disease, this is only one type of condition. Dementia is more of an umbrella term used to describe several conditions related to memory loss, changes in social function, and cognitive impairments associated with natural aging. And even though dementia can be idiopathic, several subtypes can be directly linked to alcohol abuse. This direct relationship exists because alcohol and drugs can kill brain cells much faster than aging alone.
One study discovered that those who drank one bottle of wine or five or more bottles of beer in a single sitting while in midlife were three times more likely than those who didn’t binge drink to have dementia by the time they were 65.
What Is The Cause
It is currently unclear as to whether alcohol has a direct toxic effect on the brain cells, or whether the damage is due to lack of thiamine, vitamin B1.Nutritional problems, which often accompany consistent or episodic heavy use of alcohol, are thought to be contributing factors. Key parts of the brain may suffer damage through vitamin deficiencies, particularly marked levels of thiamine deficiency and the direct effect that alcohol has on the absorption and use of thiamine.
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Alcohol And Alzheimers Medication
People diagnosed with Alzheimers disease should not take medications that do not mix well with alcohol. However, not all medications used to manage Alzheimers symptoms or to treat the disease itself interact poorly with alcohol. That means its the responsibility of every person with Alzheimers to get accurate information to make informed decisions about drinking alcohol.
Belsomra is a medication that causes drowsiness and is often given to people with Alzheimers to help them sleep at night. Mixing the drug with a depressant like alcohol is not recommended. The warning is directed to both people who have consumed a small amount of alcohol several hours before taking it, and for anyone who is or has ever been a heavy drinker. Drinking alcohol while taking suvorexant can increase your chance of experiencing the drugs serious side effects. Those side effects include liver problems or lung and breathing difficulties.
Suvorexant is one of the most common Alzheimers medications that you should not mix with alcohol. However, there may be more drugs that interact problematically with alcohol. If you arent sure whether alcohol is compatible with a certain medication, its best to refrain from drinking until you have more information from your doctor, pharmacist, or neurologist.
How To Get Help
If you or a loved one drink heavily and its affecting your memory and overall health, help is available. Here are some places to start:
- Talk to your primary care doctor. If you drink heavily, you may need medical support for when you decide to stop drinking to prevent potentially severe withdrawal symptoms. Your doctor may suggest admitting you to a hospital or alcohol treatment facility to help.
- Call the Substance Abuse and Mental Health Services Administration free national helpline at 1-800-662-HELP . The helpline is available 24 hours a day.
- Find a local Alcoholics Anonymous meeting near you. These meetings are free and have helped thousands of people stay sober.
- Talk to friends and family members, and tell them if you think you need help. Their support can help get you through.
You should never be ashamed or afraid to ask for help. These steps can save your life.
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What Is The Alcohol Dementia Life Expectancy
The life expectancy for alcoholic dementia differs. . Some patients heal entirely, while others suffer from severe complications. This highly depends on several factors, including treatments and sobriety.
If the patient has Wernicke-Korsakoff Syndrome left untreated, about 10% to 20% of those affected will die in a matter of months.
For those who recover from alcoholic dementia, though, there is a widely accepted life expectancy of five to ten years in the general population without proper treatment.
Still, alcohol-induced dementia has a high mortality rate, with over 70% dying within three years.
If you’re drinking alcohol regularly for years, and you start to notice symptoms of dementia, or memory loss, and other forms of alcohol use. Even reducing the alcohol to moderate amounts for several weeks may not help, and the risk is that you might shorten your life expectancy.
Find a self help group immediately, and commit yourself to treatment options by limiting or eliminating your alcohol use completely.
How To Treat And Prevent Alcoholic Dementia
Alcohol dementia treatment can be quite stressful for patients to undertake, but it is necessary to prevent more dangerous health problems and even death. The alcoholism treatment consists of IV therapies and infusions which attempt to reestablish the proper nutritional balance of the body. Patients need to stay in clinics or hospitals for certain periods where they will be closely monitored and treated. Alcohol must be avoided at all costs during the treatment period, a thing which most alcohol abusers find very hard to do. This happens because alcohol addicts have become so used to this toxic substance that the body craves it regularly. Alcoholism support groups are very helpful in these cases.
Dementia from alcohol abuse can also be treated with Thiamine therapy which brings the much-needed nutrients back into a sufferers body. This treatment improves the neurological functioning of the patient and prevents dementia from advancing to more dangerous stages. Patients must also receive proper counsel from professional therapists to discover the root causes of their alcohol addiction and to eliminate them. If proper treatment is administered on time, alcoholic abusers might have a chance of living an alcohol-free and happy life. The rehabilitation facility for alcoholics is the best option to contact to learn more about the recovery process.
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What Is The Current Advice
According to the UK chief medical officers, we should stick to drinking no more than 14 units of alcohol a week. This keeps health risks to a low and safe level.
- Large glass of wine – 3 units
- Pint of higher-strength lager or beer – 3 units
- Standard glass of wine – 2 units
- Pint of lower-strength lager or beer – 2 units
- Bottle of lager or beer – 1.7 units
- Single shot of spirits – 1 unit
Alcohol And Dementia: A Complicated Relationship
James M. Ellison, MD, MPH
Swank Center for Memory Care and Geriatric Consultation, ChristianaCare
- Expert Advice
The role of alcohol use as a risk factor for dementia is complicated. At different times, alcohol has been seen as protective, harmful, or incidental to the risk of dementia. Each of these views is partially correct, and the entire story is not yet fully known. This article discusses some of what we do know.
Terry* was a heavy drinker for most of his life. He started with beer in high school and upped his intake over time. By his mid-60s, he was drinking a pint of vodka or more on most days. Faced with the symptoms of progressive liver disease at age 68, he resolved to stop, and he used AA successfully for support. However, his family brought him for cognitive assessment because they wondered if he was developing Alzheimersor was it the long-term effect of alcoholor both?
*Terry is a fictitious composite of multiple patients, to illustrate the important issues without risking the privacy of any individuals protected health information.
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Get The Choline Advantage
Cauliflower delivers one of the rarer nutrients found in foods choline, a nutrient our body needs for our brain and nervous system to function properly.
Choline delivers another bonus – it helps prevent cholesterol from accumulating in the liver and thus reduces the risk of liver, heart disease, and dementia too.
Other good sources of choline are egg yolks and red meat.
How Can Dementia Affect Drinking
Someone with dementia may become dehydrated if theyre unable to communicate or recognise that theyre thirsty, or if they forget to drink. This can lead to headaches, increased confusion, urinary tract infections and constipation. These can make the symptoms of dementia worse.
As people get older the sensation of thirst changes. This can mean they dont feel thirsty even though theyre not drinking enough. Someone with dementia may experience similar changes. They may be less able or likely to get themselves a drink.
Placing a drink in front of someone doesnt always mean they will drink it. Also, an empty cup doesnt always mean that the person has finished the drink. It may have been spilled, drunk by someone else, or poured away.
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Can Alcohol Cause Dementia
People who do not binge drink or become dependent on alcohol do not need to worry about an alcohol-dementia link, says Nikola Djordjevic, MD. “Alcohol consumption in moderate amounts has not been found to cause dementia or any other cognitive impairments. However, excessive use and abuse in old age have been associated with changes in brain structure that increase the risk of Alzheimerâs and variants of dementia,” he explains.
A 2018 study found that heavy drinking increased the risk of dementia by about three times. Alcoholism may increase the risk of certain medical conditions that damage the cardiovascular system, including high blood pressure. Research increasingly links both heart disease and heart disease risk factors to an elevated risk of developing dementia.
Alcoholism may also cause a rare type of dementia called Korsakoff syndrome, according to The Alzheimer’s Association. This dementia appears when a person is deficient in thiamine/vitamin B1, a deficiency that is more prevalent among chronic alcoholics.
The Start And Progression Of Alcoholic Dementia
Dementia caused by alcoholism can appear to people of all ages, and it usually starts as a result of abusing alcohol regularly for many years. Alcohol addicts develop the Wernickes encephalopathy first, and then this causes the Korsakoff syndrome. Ultimately, the serious memory problems caused by Korsakoff syndrome will lead to alcoholic dementia. The process takes time to develop, but it can be an incurable disease. The Wernickes encephalopathy appears because heavy drinkers lose thiamine from the body as a result of frequent and long binge drinking episodes. Most alcohol addicts do not replenish this vital substance , and as a result, alcoholic dementia can appear.
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The Dangers Of Alcohol
As pleasant as it is to hear that sharing a drink with a friend can decrease your chances of developing Alzheimers disease, we need to acknowledge the significant dangers of regularly over-consuming alcohol. Over-consumption is defined as consuming 4 drinks for men and 3 drinks for women in a single day.
A recent study examined more than thirty-million Europeans to identify the largest factors determining whether an individual develops Alzheimers or dementia. The study found that alcohol was the largest non-genetic risk factor for dementia and Alzheimers disease.
The researchers were shocked at how significantly alcohol contributed. We hypothesized that alcohol would play some role, but I dont think anyone expected the size of the effect to be so large, said lead author Dr. Jürgen Rehm.
The study found that individuals who regularly over-consumed were three times more likely to develop a dementia as those who did not. Over-consumption of alcohol was especially common in study participants diagnosed with early-onset dementia or Alzheimers disease. Early-onset is defined as being diagnosed before the age of 65.
While frequently drinking to excess has been known to have a wide range of negative, this new research shows that the damage caused by alcohol is much more common and much more severe than previously imagined.
The Benefits Of Alcohol
A study published in the journal of Neuropsychiatric Disease and Treatment states that consuming one or two alcoholic drinks per day can lower your risk of Alzheimers disease. This research joins a growing body of work suggesting that moderate drinking may have positive mental effects.
The study looked at data collected from more than 365,000 participants around the world. They found that moderate drinkers, defined as no more than two drinks a day for men and one drink a day for women, were 23 percent less likely to show signs of serious memory problems or to develop Alzheimers disease when compared to non-drinkers.
Researchers also found that drinking wine had more mental benefits than consuming other types of alcohol. Researchers arent completely sure how to explain these benefits. Some point to the anti-inflammatory features of alcohol while others suggest that these positive effects are actually due to the social interactions which occur while the alcohol is being consumed. Having an active social life has shown to help ward off Alzheimers disease.
Regardless of why the benefit exists, the authors conclude that there is substantial evidence that light to moderate drinking, particularly of wine, reduces the risk of dementia and cognitive impairment.
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What Is Moderate Alcohol Consumption
These reviews typically defined moderate alcohol consumption as 1-14 units of alcohol per week for women and 1-21 units a week for men. NHS guidelines published in 2016 state that both men and women should limit their intake to 14 units a week. A unit is dependent on the amount of pure alcohol in a given volume and can be calculated for specific drinks here. According to the NHS, a basic guideline for units of alcohol is as follows:
- A typical glass of wine: 2 units
- A pint of lower alcohol beer or cider: 2 units
- A pint of higher alcohol beer or cider: 3 units
- A single shot of spirits such as whisky, gin or vodka : 1 unit
Should Moderate Drinkers Worry
Most research suggests that drinking one or two units of alcohol a day – a small glass of red wine, particularly – could be of benefit to brain health.
But the advice is not straightforward because studies have also found that even in moderation, drinking alcohol could increase the risk of dementia.
However, there is a big difference between low-to-moderate drinking and people who drink in a way that is harmful – those who are binge-drinkers or alcohol-dependent.
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Studying Alcohol Intake And Dementia Risk
Sabia and colleagues examined 9,087 study participants who were aged between 35 and 55 at the beginning of the study.
The team assessed their alcohol consumption and potential dependence regularly using standard questionnaires and by looking at alcohol-related hospital admissions.
The researchers also examined hospital records for cases of dementia, as well as for any diagnoses of cardiometabolic conditions, such as heart disease or diabetes.
For the purposes of the study, anything over 14 standard U.K. alcohol units per week counted as heavy drinking. In the U.K., a standard glass of wine counts as 1 unit of alcohol, and 14 weekly units is the maximum threshold for what is considered harmful drinking.In the U.S., the Dietary Guidelines for Americans recommend that men should not drink more than two drinks per day and women should not exceed one drink per day.
The average follow-up period for the study was 23 years. During this time, 397 people developed dementia. Sabia and team accounted for various sociodemographic factors that may have influenced the results.
The findings revealed that both abstaining from alcohol in midlife and drinking heavily raised the risk of dementia when compared with light-to-moderate drinking.
More specifically, alcohol-related hospital admissions raised the risk of dementia by fourfold.
Long-term abstinence, on the other hand, also correlated with a higher risk of dementia, due to a higher incidence of cardiometabolic conditions.