Overview of Alcoholic Dementia

Excessive drinking over the years can lead to a form of alcoholic dementia (formally described in DSM 5 as a major neurocognitive disorder caused by alcohol), which can cause problems with memory, learning, and other cognitive skills.


Alcohol has a direct effect on brain cells, leading to poor judgment, difficult decision-making and lack of insight. The nutritional problems that often accompany chronic alcohol abuse may be another contributing factor, as certain parts of the brain may be damaged by vitamin deficiencies.

Alcoholic dementia is similar to Alzheimer’s disease in some respects because it affects memory and cognitive abilities.

Wernicke-Korsakov syndrome

One of the symptoms of alcoholic dementia is called Wernicke-Korsakoff syndrome (WKS), these are actually two diseases that may occur independently or at the same time: Wernicke’s encephalopathy and Korsakoff syndrome, also known as Korsakoff psychosis.

Wernicke’s encephalopathy is characterized by a syndrome that includes ophthalmoplegia (abnormal eye movements), ataxia (unsteady gait), and confusion.

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Alcohol does not cause Wernicke-Korsakoff syndrome like the damage caused by lack of thiamine (vitamin B1) to brain cells. People with severe alcohol use disorder often suffer from nutritional deficiencies due to poor diet.

Thiamine deficiency is common in chronic alcoholics, and this is a problem because nerve cells need thiamine to function properly. Long-term lack of vitamin B1 can permanently damage them.

Thiamine works in the brain by helping brain cells produce energy from sugar. If thiamine is lacking, brain cells cannot produce enough energy to function normally.

Effects on the brain

If Wernicke’s disease is not adequately treated, it may lead to Korsakoff syndrome or Korsakoff psychosis, which involves significant impairment of memory and other cognitive functions. The most obvious symptom is fabrication, in which people make up detailed and credible stories about experiences or situations to fill gaps in memory.

People with this type of dementia may have little ability to learn new things, while many of their other mental abilities are still in a highly functioning state.Sometimes, obvious personality changes occur.

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Signs and symptoms

The broader category of alcohol-related dementia (ARD) includes Wernicke-Korsakoff syndrome and a type of dementia characterized by impaired planning, thinking, and judgment.

Symptoms of WKS may manifest as someone telling the same story or asking the same questions over and over again without remembering that these questions have just been asked and answered. In a conversation, someone may repeat the same information 20 times without realizing that they are repeating the same thing in an absolutely rigid way of expression.

It is worth noting that, at the same time, they seem to have full control of their talents, can reason well, can make correct inferences, can make witty remarks, or can play games that require intelligence, such as chess or cards.


In alcohol-related dementia, examination of the nervous system can reveal various types of damage, including:

  • Abnormal eye movements
  • Reduced or abnormal reflexes
  • Fast pulse (heart rate)
  • Low blood pressure
  • Hypothermia
  • Muscle weakness and atrophy
  • Walking (gait) and coordination problems
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Early treatment is the key to successful treatment of alcoholic dementia. If caught early, people with more general types of alcohol-related dementia can show great improvement by quitting alcohol and improving their diet.

Timely treatment with thiamine (vitamin B1) for patients with Wernicke encephalopathy can prevent or reduce the development of Wernicke-Korsakoff syndrome.

However, vitamin B1 treatment rarely improves memory loss that occurs after the development of Korsakoff’s psychosis.

Quitting alcohol will prevent additional loss and damage to brain function. In addition, improving the patient’s diet is also helpful, but it is not a substitute for abstinence to prevent further alcoholic dementia.