It is sometimes hard to know if your loved one’s mental decline is as a result of normal aging, Alzheimer’s disease or Korsakoff syndrome.
“You may be aware of a relative or friend who presents symptoms of dementia, which is a general term for a decline in mental ability severe enough to interfere with daily life,” said Ms Laetitia Goosen, the deputy manager of Rand Aid Association’s Wedge Gardens Treatment Centre.
Dementia is a brain disease that impairs memory, personality and intellectual functioning. Alzheimer’s disease is the most common cause of dementia. However, people are often diagnosed with Alzheimer’s when in fact their dementia is alcohol related.
The big difference is that a story of alcohol abuse is indicative of Korsakoff syndrome. Korsakoff is a brain disorder associated with heavy alcohol consumption over a long period of time. It is a permanent memory disorder caused by a deficiency of thiamine (Vitamin B-1) which results from alcohol abuse. Alcohol has a direct effect on brain cells in the frontal lobe of the brain.
“Although Korsakoff syndrome is not, strictly speaking a dementia, people with the condition experience a loss of short-term memory and may also have difficulty with new information or tasks, attention, may undergo a change in personality, show a lack of insight, reasoning, problem solving and have problems with executive functions like dressing and cooking,” said Ms Goosen.
Korsakoff syndrome is diagnosed in about one in eight people with alcoholism (a dependency on, or addiction to, alcohol).
Alzheimer’s on the other hand, is an incurable, degenerative brain disease that erodes the memory and eventually robs the sufferer of the ability to perform even the most basic tasks.
As with Korsakoff syndrome, it attacks the brain’s nervous cells, resulting in loss of memory, thinking, language skills and behavioural changes.
“There are very few qualitative differences between alcohol dementia and Alzheimer’s disease and it is therefore difficult to distinguish between the two. Some of he warning signs may include memory loss, difficulty performing familiar tasks, poor or impaired judgement and problems with language. However, the biggest indicator is family members and friends reporting changes in personality. Anyone who drinks excessive amounts of alcohol over a long period of time is at risk of succumbing to alcohol-related dementia,” said Ms Goosen.
Alzheimer’s disease accounts for between 50 to 60 percent of all cases of dementia. Statistics on alcohol-related dementia are more difficult to quantify as there is controversy about alcohol as the primary cause and also what role alcohol has in secondary damage.
“We know that alcoholics are at greater risk of dementia and that in up to 20 percent of cases of dementia, alcohol plays a negative role,” said Ms Goosen.
To assess Korsakoff syndrome, the person must have a history of alcohol abuse over several years. Evaluation may include cognitive assessments while MRI scans may also be used to identify lesions in the brain that may develop as a result of the disease.
“The only way to slow down the development of this degenerative disease is total abstinence from alcohol. If the person has been drinking excessively, detoxification in a treatment facility may be required. When abstaining from alcohol, the person will need high doses of thiamine, a healthy diet, therapeutic intervention and support,” said Ms Goosen.
The similarity of symptoms are a decline in memory, learning and communication skills impairment, mood shifts, personality changes, decreasing attention span and judgement, increasing confusion and disorientation. There may also be difficulty in acquiring new information or learning new skills or a change in personality. At one extreme, the person may show apathy, lack of insight into the condition, confabulation, attention lapses and impairment of reasoning and problem solving skills.
“The appearance of the majority of these symptoms may be an indication of the development of either Korsakoff or Alzheimer’s disease. Alcohol misuse is a prime indicator of Korsakoff syndrome and it is advisable to seek professional help should these symptoms appear,” said Ms Goosen.
