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Seniors: Understanding alcohol-related dementia

Alcohol has increasingly become a part of our social life to such an extent that it is impossible to think of a social gathering without alcohol. A report released by World Health Organization in 2017 found that Canadians aged 15 and older drank 10 litres of pure alcohol per capita in 2016—3.6 more than the world average.
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Alcohol has increasingly become a part of our social life to such an extent that it is impossible to think of a social gathering without alcohol. A report released by World Health Organization in 2017 found that Canadians aged 15 and older drank 10 litres of pure alcohol per capita in 2016—3.6 more than the world average.

Who is drinking more alcohol- young adults or older adults? Men or women? According to a recent study, middle-aged men and women are drinking more alcohol, and the biggest increase is among middle-aged women.

Alcohol-related dementia (ARD) had received little recognition in the past as a clinical entity. Recently researchers have showed great interest in ARD, due to the increasing incidence of alcohol-related disorders world-wide, ageing of the population, and increasing focus on risk reduction.

Alcohol has emerged as the most modifiable risk factor for dementia, surpassing even high blood pressure and diabetes. Excessive alcohol consumption (binge drinking) has been found to more than triple the risk of young-onset dementia (dementia occurring before 65 years of age) in both men and women.

Excessive alcohol intake is associated with increased risk of Alzheimer’s Disease, stroke and vascular dementia. The fact is you need not be an alcoholic or get drunk often to develop dementia. Regularly drinking a little more than permitted levels increases your risk.

A point to remember is that as we age, alcohol stays in the body for a longer time, which means that even if you have been drinking the same amount all these years, it can still become more toxic for you with age.

It has been found that regular excessive consumption of alcohol can lead to Alcohol-Related Brain damage (ARBD), a condition that is undiagnosed or unrecorded due to stigma.

ARBD refers to long-term decline in memory and cognition resulting from excessive alcohol intake. If the cognitive symptoms continue to worsen despite being alcohol-free, it is called Alcohol-Related Dementia.

ARBD affects about 1 in 200 of the general adult population, but affects 1 in 3 alcoholics. People with ARBD tend to be middle-aged, they can also be younger or older. ARBD affects more men than women, but women tend to be affected at a younger age than men, despite fewer years of alcohol misuse.

Alcohol can affect the brain by directly damaging the nerve cells. It can also cause chemical changes in the brain, lead to shrinking of the brain, cause thiamine deficiency, increase blood pressure and cholesterol, and increase the risk of falls and head injury.

Alcohol-Related Brain damage can either manifest as alcoholic dementia or the less common Korsakoff’s syndrome.

In alcoholic dementia, there is extensive damage involving multiple areas of the brain- predominantly, frontal lobe responsible for executive functions (planning, organizing, decision-making, initiative, personality and social skills), and cerebellum controlling balance and coordination.

Symptoms usually appear gradually, manifesting as poor attention and judgment, inappropriate and impulsive behaviour, difficulty controlling emotions, and problems with balance and coordination. Day-to day memory may not be affected initially.

Korsakoff’s syndrome is primarily due to Thiamine deficiency, from poor intake of food or poor absorption of nutrients resulting from alcohol-induced irritation of the stomach. It is usually preceded by untreated or poorly treated alcohol withdrawal, and causes severe loss of short-term memory, loss of memory of events that occurred after the disease-onset, changes in personality & behaviour and inability to carry out daily activities.

How can we prevent Alcohol-Related Brain damage? By avoiding alcohol, or sticking to the permitted levels. The Canadian drinking guidelines recommend no more than two drinks a day, 10 per week for women, and no more than three drinks a day, 15 per week for men. It all begins with understanding ABC and leading a healthy life style.

Padmaja Genesh, who holds a bachelor degree in medicine and surgery as well as a bachelor degree in Gerontology, has spent several years teaching and working with health care agencies. A past resident of Red Deer, and a past board member of Red Deer Golden Circle, she is now a Learning Specialist at the Alzheimer Society of Calgary. Please send your comments to padmajaganeshy@yahoo.ca