Alcohol Related Dementia

Heavy drinking over many years can damage the brain. When that damage causes lasting problems with memory, thinking and judgment, it’s often called alcohol-related dementia or alcohol-related brain damage. It is less talked about than Alzheimer’s disease, but it is important for families to understand, especially because, unlike most dementias, it can sometimes be stopped from getting worse and may even partly improve.

How alcohol harms the brain

• Direct toxic effects. Long-term heavy drinking can damage and shrink brain cells, especially in areas involved in planning, judgment and memory.
• Vitamin B1 (thiamine) deficiency. Heavy drinking often goes along with poor nutrition and interferes with how the body absorbs and uses thiamine, which the brain needs to function.
• Related harms. Head injuries from falls, liver disease, high blood pressure and strokes can add to the damage.

Excessive alcohol use is also one of the 14 changeable risk factors for dementia identified by the 2024 Lancet Commission on dementia.

Wernicke-Korsakoff syndrome

Severe thiamine deficiency can cause Wernicke’s encephalopathy, a medical emergency that may cause confusion, unsteady walking and abnormal eye movements. It needs immediate treatment with thiamine. If it isn’t treated in time, it can lead to Korsakoff syndrome, a lasting condition marked by serious trouble forming new memories. People with Korsakoff syndrome sometimes fill memory gaps with made-up information without realizing it.

Common signs of alcohol-related dementia

• Trouble with planning, organizing and making decisions
• Poor judgment and impulsive behavior
• Difficulty learning and remembering new information
• Changes in mood or personality, such as irritability, apathy or depression
• Unsteady walking and frequent falls
• Trouble staying focused

Compared with Alzheimer’s disease, problems with planning, judgment and behavior often stand out more than memory loss in the early stages, and the condition may appear at a younger age.

Can it get better?

This is what makes alcohol-related dementia different. If a person stops drinking, eats well and receives thiamine and other medical treatment, the decline often stops, and some people improve over months or longer. Recovery depends on how much damage has occurred, and some problems may be permanent. Stopping heavy drinking should always be done with medical guidance, because withdrawal can be dangerous.

Getting help

• Talk with a doctor about drinking, memory changes and nutrition. A medical evaluation can also rule out other causes of memory problems.
• The SAMHSA National Helpline, 1-800-662-4357, is free, confidential and available 24 hours a day, 365 days a year, for referrals to treatment and support.
• Support groups for families, such as Al-Anon, can help loved ones cope.

Caring for someone with alcohol-related dementia

Structure, routine, good nutrition and an alcohol-free environment are key. People may need help with medications, meals and safety, along with patient support for behavior and mood changes. For those who can no longer live safely on their own, a memory care home offers supervision, regular meals and a calm daily routine, while staff work with the person’s doctors.

This article is for general information and is not medical advice. If you or someone you love is struggling with alcohol, talk with a doctor or call the SAMHSA National Helpline.

Have questions about memory care for someone you love? Call Generations Senior Living at (352) 474-2696 or schedule a tour of one of our three homes near The Villages.