Alcohol-related ‘dementia’

A person with alcohol-related ‘dementia’ may also have problems with their memory. They might not be able to understand new information –  for example, they may quickly forget the details of a conversation. They may also not be able to recall knowledge and events, such as where they lived previously or places where they have been on holiday.

A person with alcohol-related ‘dementia’ may be unsteady on their feet and more likely to fall over – even when they are sober. This is because alcohol damages the part of the brain that controls balance, co-ordination and posture.

Alcohol-related ‘dementia’ can also cause problems with a person’s mood, such as apathy, depression or irritability. These can make it even harder for the person to stop drinking – and make it difficult for people close to them to help.

It can be difficult to get an assessment, as some GPs will insist that the person has stopped drinking for several weeks before they can assess the person’s memory. Some experts think that a person can be assessed for alcohol-related ‘dementia’ while they are still drinking too much, as long as they aren’t intoxicated at the time of the assessment.

The diagnosis is less certain than if they had been sober for a long time. 

In order to make a diagnosis of alcohol-related ‘dementia’, a doctor may ask the person to do a paper-based test to check for problems with memory and thinking. 

The doctor will also do a full physical examination and take a detailed history of the person’s symptoms and how they are affecting their life. They should also take an account from someone who knows the person well, as this can help if the person has gaps in their memory. The doctor may also ask about problems with mood, such as anxiety or depression.

It is likely that a person will need a brain scan to rule out other causes of their symptoms. These include a stroke, a bleed caused by physical trauma, or a tumour.

A person can be diagnosed with alcohol-related ‘dementia’ if they have problems with memory, thinking or reasoning that severely affect their daily life, and are most likely to have been caused  by drinking too much alcohol. 

For a clear diagnosis, the person needs to have these symptoms even when they have stopped drinking and are not suffering from the effects of alcohol withdrawal. The doctor will also need to make sure that these symptoms don’t indicate another type of dementia, such as  Alzheimer’s disease or vascular dementia. 

The first part of treatment usually lasts up to several weeks. It aims to stop the person drinking alcohol and make their health more stable. Most people with alcohol-related ‘dementia’ will need to stay in hospital for this.

Alcohol withdrawal usually causes a person to have delirium, which can make them easily distracted and confused, disorientated, and prone to mood swings. They may also experience intense sweating, anxiety and a high heart rate. They may become agitated or hallucinate.

They may be treated with drugs that mimic the effect of alcohol on the brain to reduce  withdrawal symptoms. These drugs can be safely reduced slowly. The person will also be given fluids and salts, and high doses of thiamine (vitamin B1) by injection.

As well as medication, the person will need a lot of non-drug support. This often includes counselling or ‘talking therapies’ that help them to stay alcohol-free. They may also be encouraged to attend self-help groups once they are out of hospital. Find links to support and resources 

Some of the common symptoms of alcohol-related ‘dementia’ may make it harder for a person to take part in an alcohol treatment programme. These symptoms can include denial, lack of insight and being impulsive. The person may struggle to stay focused during therapy sessions.

Many people with alcohol-related ‘dementia’ have to wait in hospital for a long time before they can get specialist care. Depending on how serious their condition is, they could be supported in residential care, sheltered accommodation or in their own home – with support in the community.

A professional who has experience of supporting people with alcohol-related ‘dementia’ should be involved in the person’s care. The type of support they get will depend on the person’s individual situation and what they need. People with alcohol-related ‘dementia’ tend to be younger and physically more active than most people who have other types of dementia. They may benefit from services designed for people with young-onset dementia.

Staying alcohol-free can be particularly challenging if the person is homeless or isolated from their family due to drinking too much, or if they have poor physical or mental health. Dealing with all these issues is important for helping the person to stay alcohol-free, and to reduce the symptoms of alcohol-related ‘dementia’. 

Supporting a person with alcohol-related ‘dementia’ can be challenging for their carer, friends and family.  They will need different kinds of support, which may not always be easy to access.

Most alcohol support services are designed to help people stop drinking and stay sober and there may sometimes
be less immediate support available to deal with the dementia-related parts of rehabilitation.

However, many support services have a ‘complex needs’ team which are better equipped to support the different needs of someone with alcohol-related ‘dementia’.