How alcoholism can be mistaken for Alzheimer's
A doctor has warned she has seen a rise in family members fearing their loved one has Alzheimer's, when symptoms are in fact due to alcoholism.
While the physical effects of continued drinking may be obvious or more discussed, the psychological effects can be harder to spot, though they can be just as harmful. In some cases, brain damage can be irreversible.
Someone who may seem a bit forgetful or disorganised – also signs of Alzheimer's – could be presenting with cognitive symptoms related to long term or acute alcohol issues. Alcohol changes perceptions and feelings about life, meaning it can affect decision making, executive function, impulse control and stress tolerance.
"At Delamere [an addiction rehab centre], we see a significant number of guests who arrive for treatment of alcohol dependence whose family worry that they are developing Alzheimer's or some other dementia," says Psychiatrist Dr Catherine Carney. But she adds, “a significant proportion of these cases have no worrying cognitive issues once alcohol is taken out of the picture.”
The doctor explains, however, that sadly there is another "significant proportion" of people in their 50s and 60s presenting with permanent and irreversible signs of cognitive impairment, including something called Korsakoff psychosis (more on this later).
This Alcohol Awareness Week – with the theme 'understanding alcohol harm' – here we dig a little deeper into the cognitive signs of alcoholism, how to prevent long term damage and where to get help.
How common is it for alcoholism to be mistaken for Alzheimer's?
"Cases are increasingly common at Delamere. Alcohol addiction makes up almost half of all of our guests seeking treatment currently, and roughly a quarter of these have relatives who expressed concerns about their cognitive functioning and the possibility of Alzheimer's prior to admission."
So once an individual has been referred for treatment for alcoholism first and foremost, it becomes apparent any psychological symptoms are (typically) related to this too. "What we see is that family members also voice concerns about cognitive issues when the guest is first brought into the clinic. In almost all cases, particularly for younger guests, the family member is later informed that issues like memory loss and confusion are a byproduct of alcoholism, which can be recovered.
"However, we do see with older guests that they are more at risk of irreversible damage to nerves and supporting cells in the brain as a result of their alcoholism."
Dr Carney says they have experienced this issue among a range of age demographics, but it is more typically brought up with the over 60s.
Cognitive signs of alcoholism
While they could relate to other health conditions too, it's important to be aware these could also be cognitive (and social) signs of alcoholism...
Increased anxiousness and depression
Hallucinations and/or delirium tremens
Increased levels of risk taking
Delusional and compromised thinking
Struggling to take in new information
Unable to recall events in the short and long term
Preventing long term damage
"In most cases," says Dr Carney, "these symptoms can be reversed and the person's health will improve, if they receive the proper treatment. At Delamere [for example], we place a higher importance on a full medical detox to start off the recovery process, followed by identifying and working on the psychological impacts."
However, the psychiatrist adds, "In some cases, these symptoms can be permanent, particularly with age and depending on how long the person has abused alcohol for."
Korsakoff (the example given above of long term damage), Dr Carney explains, "Is, like Alzheimer's disease, a chronic memory disorder. It is more commonly linked to alcohol abuse, while Alzheimer's is often mistaken as an outcome for alcohol abuse."
That said, separately, previous research found that those who drank more than 14 alcoholic drinks per week did increase their dementia risk.
How to get help for alcoholism
Addiction deserves the same care and treatment as any other health problem. While hard, with the right help and support, it's possible to overcome.
Here are Dr Carney's top tips for getting help with alcoholism, or helping a family member or loved one.
Remove alcohol from the home
Develop interests that do not involve alcohol but do require abstinence to engage in them
Keep a written record of your alcohol intake – this can help you self-reflect real-time or share the burden of this issue with someone else
Share your experience with friends and family – loneliness and isolation can exacerbate the issue further
Review your 'Alert Zones' and avoid them – these are settings (people/place/situations) that trigger alcohol use
Contact your GP and/or your community drug and alcohol teams who are a good source of support
Other than the NHS, there are a number of charities and support groups for alcohol misuse across the UK, including:
Drinkline national alcohol helpline on 0300 123 1110
Alcoholics Anonymous helpline on 0800 9177 650
Al-Anon Family Groups helpline on 0800 0086 811
Men and women are advised not to drink more than 14 units a week on a regular basis.
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