Alcohol-related brain damage cannot be reliably diagnosed unless the person has stopped drinking alcohol for several weeks, to enable the symptoms of alcohol intoxication and withdrawal to resolve.
A person's assessment for suspected ARBD follows broadly the same steps as for dementia. The doctor will carry out a full physical examination and take a detailed history from the person and someone who knows them well if possible. This history will include how their symptoms started and how they are currently affecting the person's life. It will also cover the person's history of alcohol use (how much, how often, and for how long). Tests of the person's mental abilities (eg memory, thinking) will also be carried out, as will tests for depression.
A brain scan may also be required. This may rule out other possible causes of symptoms (eg stroke, bleed, tumour). Alternatively, it may show changes such as shrinkage of the cerebellum at the back of the brain, which supports a diagnosis of ARBD rather than dementia.
ARBD should be diagnosed if the person has impaired memory, thinking or reasoning which is bad enough to affect daily life, together with a recent history of several years of alcohol misuse. The person will also be monitored to see whether their condition stabilises or worsens once they are alcohol-free. If their condition continues to worsen, they may be diagnosed with a form of dementia, such as Alzheimer's disease. If they stabilise or improve with abstinence, ARBD is a more likely diagnosis.
Someone will not usually be given a diagnosis of just ARBD but rather a specific form of it. According to the symptoms, the doctor may diagnose Wernicke-Korsakoff syndrome, Korsakoff's alcoholic psychosis, alcoholic dementia, alcohol amnestic syndrome, chronic alcoholic brain syndrome or another condition.