Alcohol-related brain damage

Learn more about Alcohol-related brain damage (ARBD) and read practical tips for carers supporting someone with the condition.

What is Alcohol-related brain damage (ARBD)?

Alcohol-related brain damage is a brain disorder caused by regularly drinking too much alcohol over several years. The term ARBD covers several different conditions including Wernicke-Korsakoff syndrome and alcoholic dementia. None of these is actually a dementia, but they may share similar symptoms. However, in contrast to common causes of dementia such as Alzheimer's disease, most people with ARBD who receive good support and remain alcohol-free make a full or partial recovery. In addition, there is a good possibility that their condition will not worsen.

Patterns of drinking in Great Britain have changed over the past 10 years. Middle-aged people are now the age group which consumes the most alcohol and they are drinking more than in the past, especially middle-aged women. In contrast, younger people (aged 16-24) are now drinking less, particularly when it comes to binge drinking. Against this background, ARBD is an under-recognised and growing problem.

Alcohol as a risk factor for dementia

Drinking more than the recommended limit for alcohol increases a person's risk of developing common types of dementia such as Alzheimer's disease and vascular dementia.

Learn more

Causes of Alcohol-related brain damage

Some people regularly drink much higher levels than the recommended limits of alcohol. For men, such excessive drinking could mean more than 50 units per week, and for women, more than 35 units/week. Drinking at these high levels not only poses a particularly high risk to someone’s health but it also increases the risk of the person becoming addicted. (Alcohol addiction is where someone has become dependent on alcohol. They have an excessive desire to drink and their drinking is causing problems in their daily life.) Alcohol intake at such high levels over several years directly damages the brain, causing alcohol-related brain damage (ARBD) in some people.

Alcohol-related brain damage leads to slightly different symptoms in different people and causes a range of conditions. The most common form of ARBD is alcoholic dementia which may also be called alcohol-related dementia. ARBD also includes Korsakoff's syndrome, which is also called Korsakoff's psychosis.

What does ARBD do to the body?

ARBD is defined as long-term decline in memory or thinking caused by excessive alcohol use and a lack of vitamin B1 (thiamine). Thiamine is needed to provide energy to the body. It is especially important for brain and nerve cells because they use so much energy.

Alcohol misuse causes ARBD in a range of ways. Regular heavy drinking over time damages nerve cells because alcohol is a toxin. It also causes chemical changes in the brain and the shrinkage of brain tissue.

The second way that alcohol misuse leads to ARBD is by causing thiamine deficiency. This is partly because heavy drinkers tend to not look after themselves and have poor diet. Alcohol also irritates the stomach lining, leading to vomiting and poor absorption of nutrients. Thiamine deficiency also happens because alcohol interferes with the way the body stores and handles the vitamin.

Alcohol can also cause ARBD through repeated head injuries. People who misuse alcohol are more prone to falls and getting into fights.

Finally, heavy drinking damages blood vessels and is linked to high blood pressure, raised cholesterol levels and an increased risk of heart attacks and strokes. All of these conditions can damage the brain.

It is important to note that not all of these factors are equally important in all forms of ARBD or in everyone with the condition.

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