Find out about Alcohol-related 'dementia' including symptoms, diagnosis, treatment, support and rehabilitation.
Alcohol-related brain damage
What is Alcohol-related 'dementia'?
Alcohol-related 'dementia' is a type of alcohol-related brain damage (ARBD).
If a person has alcohol-related ‘dementia’ they will struggle with day-to-day tasks. This is because of the damage to their brain, caused by regularly drinking too much alcohol over many years.
The person may have memory loss and difficulty thinking things through. They may have problems with more complex tasks, such as managing their finances. The symptoms may cause problems with daily life. For example, the person may no longer be able to cook a meal.
What are the symptoms of alcohol-related 'dementia'?
Symptoms include difficulties with:
- staying focused on a task without becoming distracted
- solving problems, planning and organising
- setting goals, making judgements and making decisions
- being motivated to do tasks or activities (even essential ones like eating or drinking) controlling their emotions – they may become irritable or have outbursts
- understanding how other people are thinking or feeling (their behaviour may seem insensitive or uncaring).
The symptoms of alcohol-related ‘dementia’ can change a lot from person to person. If a person with the condition has a brain scan, it will often show that some areas of the brain have shrunk much more than others. Alcohol particularly affects the frontal lobes of the brain.
Alcohol-related ‘dementia’ and memory problems
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.
Alcohol-related ‘dementia’ and balance
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’ and mood
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.
Need more information on mood and behaviour?
Read our advice on supporting a person with dementia who has depression, anxiety or apathy.
Talking about alcohol consumption can help
It can be very difficult to diagnose alcohol-related ‘dementia’. If a doctor is unaware of the person drinking too much alcohol over many years, they may not consider alcohol-related ‘dementia’ as a possible diagnosis. The person may not get the right treatment and support, which is why it is important to tell doctors about drinking too much alcohol.
Getting an assessment for alcohol-related ‘dementia’
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. If the person is refused an assessment by the GP, they can contact NHS England to make a complaint.
Completing the assessment for alcohol-related ‘dementia’
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.
Getting a diagnosis of alcohol-related ‘dementia’
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.
Need more information on assessment and tests?
Read our advice on assessment and diagnosis.
Can you get better from alcohol-related 'dementia'?
Unlike Alzheimer’s disease or vascular dementia, alcohol-related ‘dementia’ is not certain to get worse over time. With the right treatment and support, there is often a good chance that it will stop getting worse or improve.
For example, if the person stops drinking alcohol, takes high doses of thiamine and starts eating a balanced diet. However, if the person keeps drinking alcohol and doesn’t eat well, alcohol-related ‘dementia’ is very likely to get worse.
It is not easy to help a person with alcohol addiction to stop drinking. However, it can be even more challenging when the person has alcohol-related ‘dementia’. Problems with thinking and reasoning (caused by dementia) can prevent a person from understanding that they need to stop drinking.
They may also find it very difficult to stay motivated if they do stop drinking, because losing motivation is a symptom of dementia.
What are the treatments for alcohol-related '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.
How long does treatment take for alcohol-related 'dementia'?
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.
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.
After the first part of treatment, a person with alcohol-related ‘dementia’ will need support from different kinds of services.
Firstly, the person is likely to need support to help them stop drinking alcohol. They may be given special prescription drugs to reduce their craving for alcohol. They will also need to take high-dose thiamine (vitamin B1) tablets and eat a healthy, balanced diet, and have counselling or 'talking therapies'.
Getting the right care for alcohol-related ‘dementia’
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’.
Support for carers, friends and family
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’.
Get support with ARBD
View our list of resources and useful organisations who can support with ARBD.
What is rehabilitation?
As well as staying alcohol-free, a person with alcohol-related ‘dementia’ will need help to get better. This is known as rehabilitation and is support that is matched to the person’s needs. It works towards goals that the person agrees with a health professional. This could include practising ways to improve their memory, and learning to use memory aids or other supportive technology.
How to access rehabilitation
Rehabilitation may be provided by a dementia service, community mental health team or rehabilitation service for people with a brain injury (for example, following an accident or stroke).The availability of these local services may be different across the country.
How long does rehabilitation take?
A person should usually see the most improvement in their abilities during the first three months after they stop drinking alcohol. However, for some people this improvement could continue for as much as two or three years.