Brain disorders caused by alcohol misuse
WHO recently reported that India’s alcohol consumption has doubled in a decade. Rises in heavy drinking among all classes and backgrounds indicate a potential surge in reporting of alcohol-related brain damage (ARBD). If someone you know is a heavy drinker, displays signs of mental confusion, difficulty walking, and has vision problems, they might be already be affected. In this post, we talk about brain disorders caused by alcohol misuse, and the signs to look out for.
30% of the Indian population are alcohol consumers, with at least 11% being moderate-heavy drinkers, as per the 2014 WHO Global Status Report on Alcohol and Health. 17% of these account for 20-30% of alcohol-related issues needing hospitalization. In 2018, WHO reported that 3 million deaths every year are due to alcohol consumption and diseases caused by alcoholism. Among the diseases caused by alcoholism, alcoholic dementia and Wernicke-Korsakoff’s Syndrome are some of the most common yet most under diagnosed conditions.
Alcohol’s Real Impact on the Human Body
Alcohol is often considered a stimulant. In reality, this substance and its many variants play the role of depressant on the human body. Many individuals find themselves addicted to alcohol and suffer severe consequences in every aspect of their lives – whether physical, mental, professional, and social.
Research shows that alcohol intake can contribute to cognitive decline, and if left unchecked, can cause irreversible brain damage. For example, day-drinking, binge drinking, and regularly drinking alcohol in excess increases your risk for developing Alzheimer’s and vascular dementia in later life.
For some, even slight intake of alcohol causes severe adverse impacts on their health and can set them on the path towards permanent alcohol-related brain damage. Heavy drinkers face an even higher risk of developing such conditions.
How much alcohol is too much alcohol?
In India, AIIMS physicians define a standard drink or 1 alcohol unit (which is equal to 10ml of absolute alcohol) as follows:
- 300-400 ml of standard beer, or 100-150ml of strong beer
- 100-250 ml of wine, or 60-90ml of fortified wine
- 30ml of spirits (whiskey, rum, gin, vodka, brandy etc)
- 40ml of arrack (country liquor)
However, India is yet to define a national alcohol policy, but the widely accepted definition of a “heavy drinker” as per the guidelines set by the U.S. Department of Health and Health Studies is ‘someone who drinks too much at one time or over the duration of a week’. This is further classified by gender as follows:
- Men: 4 or more drinks in one sitting OR 14 drinks or more during a week.
- Women: 3 or more drinks in one sitting OR 7 drinks or more during a week.
Given the recent rises in access to disposable income and “eating-out” culture, as well as changes in attitudes regarding consumption of alcohol, it is not surprising that WHO found that India’s alcohol consumption has doubled in a decade.
While men are more likely to be diagnosed with alcoholism or brain damage caused by alcoholism, more women are now reporting similar difficulties. Women are also at higher risk for alcohol-related brain damage with regards to age and duration of drinking habit.
What is Alcohol-related Brain Damage?
Alcohol-related brain damage (ARBD) refers to brain disorders caused by excessive intake of alcohol.
You are at high-risk for ARBD if you fit the following factors:
- Moderate or heavy drinker
- Aged 40s to 50s
- Having nutritional deficiencies due to lack of care about diet
- History of hypertension, high cholesterol, heart attacks, stroke (all caused by damaged blood vessels, often caused by heavy drinking)
- More men are affected than women.
- However, women are susceptible to develop ARBD at younger ages and with fewer years of excessive alcohol consumption.
ARBD is triggered by damage to the nerve cells from overconsumption of alcohol. Falls while intoxicated can cause head injuries are also classified as ARBD.
The two most common forms of ARBD are alcoholic dementia and Wernicke-Korsakoff’s Syndrome.
What is Alcoholic Dementia?
Alcoholic dementia, also known as alcohol-related dementia, is the most common form of ARBD. It is like Alzheimer’s in that memory and cognitive abilities are affected. It is also irreversible.
- Problems in decision-making, risk assessment, planning, organizational skills, judgment
- Impulsivity, emotional outbursts, irritability
- Trouble paying attention, feeling “slow”
- Reduced sensitivity and empathy for other people’s feelings
- Socially inappropriate behaviours
What is Wernicke-Korsakoff’s Syndrome?
Wernicke-Korsakoff’s syndrome is a degenerative brain disorder resulting from severe thiamine (Vitamin B1) deficiency due to alcohol abuse. It is a disease consisting of two separate syndromes: Wernicke’s encephalopathy and Korsakoff’s psychosis. 80-90% of individuals with Wernicke’s encephalopathy develop Korsakoff’s psychosis.
The symptoms of Wernicke’s encephalopathy are:
- Mental confusion: the person is exhibiting disorientation and/or memory is impaired.
- The person is very underweight and not eating a healthy or nutritious diet
- Paralysis of the eye muscles or jerky eye movements.
- Poor balance: motor coordination is affected.
When Wernicke’s encephalopathy remains untreated, it leads to Korsakoff’s psychosis, characterized by:
- Memory loss – the person is unable to form new memories or learn new information (anterograde amnesia).
- Difficulty with walking – loss of muscle coordination (ataxia).
- Eye movement problems – double vision, drooping upper eyelids.
- Hallucinations are commonly reported as part of mental confusion.
- Confabulation: the person exhibits exaggerated storytelling (“unbelievable stories”).
Unlike other diseases related to alcoholism, the person affected by Wernicke-Korsakoff’s Syndrome usually lacks insight into their condition and may display personality changes. This is due to the brain structure being affected by alcohol misuse.
How to diagnose, how to treat
There are no specific lab tests or procedures to diagnose alcoholic dementia or Wernicke-Korsakoff’s syndrome. These conditions are often mistaken for other issues such as intoxication, withdrawal, infection, head injury. The current methods of diagnosis involve a neuropsychiatric examination and a full medical checkup while checking for memory loss and other cognitive changes. It is important to ask about prior alcohol use.
Abstinence from alcohol is vital to ensuring that the alcohol-related brain damage and disorders do not continue to progress. Treatment from a clinical perspective focus on thiamine re-supplementation but this is useful only if the condition is correctly detected early enough.
Psychological therapeutic approaches are employed to help the individual come to terms with their condition and re-learn the necessary skills to thrive again. While some may require lifelong assistance depending on the severity of the brain damage, many are able to find meaning in a new start.
How Samvedna can help your loved one with ARBD
Our team comprises of highly qualified experts in neuropsychology, mental health, and dementia care. Trained in detecting and understanding mental health problems, our professionals will able to help create and implement client-appropriate and individualized non-pharmacological interventions for clients with ARBD.
If you suspect that a loved one might be having trouble due to alcohol misuse, contact us at 98184 00561 or write to us on firstname.lastname@example.org.
We at Samvedna Senior Care aim to help seniors live happy, active and independent lives, in the comfort of their home and community through interactive caregiving.
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