31st January 2024

Background

There are several subtypes of dementia, characterised by different patterns of cognitive impairment, loss of learned skill and independent functioning. There is some evidence that heavy and sustained alcohol use can result in early-onset dementia presentations and is a potentially modifiable risk factor for dementia.

There are several proposed hypotheses as to the link between heavy alcohol use and dementia, which include the following:

1. Ethanol is metabolised to acetaldehyde – this substance is known to be neurotoxic.
2. As previously mentioned, thiamine deficiency secondary to heavy alcohol use can result in Wernicke’s encephalopathy and/or Korsakoff’s syndrome – for some chronic cognitive impairment persists despite treatment.
3. Heavy alcohol use can increase the risk of developing cardiovascular risk factors such as hypertension, which are themselves associated with an increased risk of developing vascular dementia.
4. Alcohol intoxication can cause falls with head injury or seizures, both of which have been raised as potential predisposing factors in alcohol-related dementia development.