Picture this in your mind. A man shuffles down the long hallway of a nursing home. He is wearing only one shoe, his shirt front is damp from drooled saliva. His clothes are wrinkled and stained. He won't let anyone change them.
As he stumbles along, bumping into walls, he waves his arms and mutters incoherently. His hands tremble, his body twitches. He stops walking and looks around, obviously lost and confused.
He stares at a painting on the wall, then pulls at his hair in agitation, and turns back toward the people-filled lobby. He can't recall his own name, where his room is, or how to eat with a spoon.
Its Not Alzheimer's ...
Did you know there are many types of dementia? More than 2 or 3? Did you know some diseases, such as Parkinson's are counted among the dementias for their effect on cognition?
Okay. Raise your hand if you have heard of Alzheimer's disease.
Because Alzheimer's disease is the most common form of dementia, it gets the most press. It is really sad that we had to lose a celebrity figure to Lewy-Body dementia before it received some much needed attention.
But what about the others? Raise your hand if you had heard the term Lewy-Body dementia before this year. Or Korsakoff syndrome. Or the letters ARD.
This one you should definitely know about. Because you probably know a few people that might be at risk. Your college kids. Your best friend who is going through a divorce. Your over-stressed boss...
The most common culprit in Korsakoff syndrome and ARD is...
Alcohol abuse.
Drink Yourself Into Oblivion
Is it really a dementia if it is caused by a lifestyle choice? Physiologically, no. Korsakoff syndrome (in alcoholics) isn't caused by genetics. In fact, it is actually caused by a severe deficiency in thiamine.
Not all people who drink heavily will become deficient in thiamine though. Just like not all heavy drinkers will experience organ failure. So there may be some genetic factors at play, or it could be the difference in diet.
Because this isn't a "true dementia", its easy to see why it isn't as widely discussed as Alzheimer's. Its also easy to see why families might want to keep it hush-hush. But because it does have a known cause, and it can be prevented in most cases, it should actually be more publicized.
Because I've provided care for a few of these lost people. And it is not a beautiful sight.
Alcohol Is Not That Cool
Now lets see your hand again. Who has seen an ad, article, label, graphic, commercial, video, Tweet, billboard or other in-your-face warning that tells of the danger of tobacco use, processed foods, carbonated beverages, chemicals, pesticide or hormone-laden foods, sugar, fat, cholesterol, sodium, white bread, narcotics, caffeine, hamburgers, high heel shoes, and whatever else is bad to put in, on or near your body?
Alcohol kind off gets of light, doesn't it? I mean, you can't even see television for a half hour without at least two commercials advertising how great alcohol is.
We campaign against drunk driving, but where are the other warnings? You have to look pretty hard to find them. In fact, most information on recovering from alcohol abuse makes it seem like you should only give it up if it makes you an abusive person or a bad decision maker.
The other articles tell you to give up alcohol if you are pregnant, if you want to lose some weight, or you want to save a little extra money.
Other information points out that a glass or two of certain alcoholic beverages can be beneficial. And that is okay too. But I see a lot of people that are really excited about that, and think that means they can drink all they want (because they've always drank that much) and it won't hurt them.
Drinking is fun, and funny, society says. And you have people who wouldn't dare touch a McDonald's french fry, a cigarette or a Coca Cola, but think nothing of partying through a fifth of vodka.
Alcohol Related Dementia and Korsakoff Syndrome--What Happens?
Besides wreaking havoc on your liver, heavy drinking can affect your brain. This is especially true of heavy drinkers who eat poorly, causing malnutrition. But anyone who drinks frequently and regularly is at risk for alcoholic dementia.
Very serious drinking can eventually lead to intellectual loss. That means that memory, decision making, and language skills can deteriorate. Eventually, so can motor skills, balance, and coordination.
The person with ARD may also be unable to perform even simple tasks, may develop depression, confusion, and apathy. They may have terrible mood swings. Pretty much the same signs you would witness in someone with any form of dementia.
This is what makes diagnosis difficult. Although alcohol related dementia can appear in a person's 30's, the average time span is between the 50's and the 70's, as a result of years of alcohol abuse. Because this a common age period for people to present with signs of dementia and Alzheimer's, alcoholism may be overlooked.
Korsakoff syndrome (also known as "wet brain", starts out as Wernicke's encephalopathy. It is caused directly from malnutrition, and if not treated, can become a permanent form of dementia.
But It Gets Worse
Getting help to overcome alcohol addiction early can help delay or prevent these diseases. However, alcohol use actually increases for some as they age, especially among men. The danger to the individual increases too.
When they elderly drink, they are more prone to falls and the side effects of mixing alcohol and prescription medications. Drinking can aggravate pre-exisiting medical conditions as well.
As dementia worsens, it inhibits sound judgement, meaning they could drink more than ever, creating a downward spiral.
Even worse? Not having access to alcohol could lead them to drink toxic substances, such as rubbing alcohol, cough syrup, and mouthwash. The affects of this habit can include blindness, rapid organ failure, brain damage, throat and mouth burns, ulcers, infections, seizures, and eventually, death.
That Brings Me Back to My Story
The man at the beginning of this article was 49 years old when his wife left him. She thought his mood swings and irrational behavior were due to his drinking. He seemed to always be intoxicated.
To cope with this, he drank more. Soon after, he was fired from his job for showing up drunk and not being able to perform. He drank more. After a few months, he was evicted from his house after failing to pay rent several times. His utilities had already been turned off.
On the street, he tried staying with friends, but they couldn't deal with his moods. He lived in motels until he ate through his savings, then he wandered the streets. Everyday he would knock on doors and beg people to give him mouthwash. Many people did, thinking that he just wanted to be clean. They gave him money and clothes too.
After awhile, drinking the toxins caused him to begin hallucinating. The police picked him up, several times. He had a few seizures.
Eventually, he ended up in the hospital, and then at the nursing facility.
To anyone who visited, he would have seemed like just another resident with Alzheimer's. Or one of the many seniors there who had been born with developmental disabilities.
He was neither.
He behaved differently. He was aggressive. He spit on people all the time. He fought with other residents. He wandered around the halls, looking for something. If he wasn't watched closely, he would try to break into the med cart for rubbing alcohol. He would go into other people's rooms and try to drink denture cleaner out of the cups.
He hated to eat, he hated to have his clothes changed. The doctors kept him on a variety of medications to control his behaviors.
He was a lost person.
Speak Out About Alcohol Related Dementias
Alcoholism is a difficult topic to discuss with anyone, but you might feel particularly awkward bringing it up to your aging parent. However if they are showing signs of memory loss, poor judgment, depression, apathy, irritability and lowered appetite, and you know they are drinking, you should investigate deeper into the matter.
The National Institute of Alcohol Abuse and Alcoholism recommends no more than seven alcoholic drinks per week for persons over age 65, and no more than three drinks in one day.
Help make these forms of dementia well known too. They can be prevented. They can be slowed down.
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