Alcohol Related Brain Damage – A relatively new problem?

Alcohol Related Brain Damage (ARBD) is a term used to refer to a range of conditions including Wernicke’s encephalopathy, and Korsakoff’s syndrome (Schmidt et al 2005).  What these conditions have in common is that they are all induced by chronic alcohol consumption resulting in some degree of brain damage and neuropsychological dysfunction

 There are a number of characteristics commonly associated with ARBD:

  • Confusion about time and place
  • Impaired attention and concentration
  • Difficulty learning new information
  • Problems with short-term memory
  • Confabulation (the fabrication of memories as a way of masking memory impairment)
  • Frontal lobe dysfunction (e.g. problems with planning, organising and regulating behaviour)
  • Physical problems such as ataxia (a gait disorder resulting in poor balance)
  • Depression, anxiety and irritability

Alcohol can cause damage to the brain (ARBD) through a number of mechanisms, including

  • Direct toxic effect on the brain
  • Prevents absorption of thiamine (vitamin B12) – an important brain nutrient
  • Poor nutrition & dehydration
  • Liver disease (hepatic encephalopathy)
  • Falls and accidents
  • Changes to metabolism and blood supply to the brain

ARBD severity exists on a continuum from mild to severe and will differ greatly from person to person (as does the potential for recovery)

ARBD is not the same as having an intellectual disability or having a dementia, although there are some overlaps. It has been suggested that people affected by ARBD have needs more akin to adults of similar ages with acquired brain injury than to people with other dementias (e.g. Jacques & Anderson, 2002; Mental Welfare Commission, 2010).  The main reason for this is the recognition that other dementias are progressive in nature, whereas ARBD is not (assuming alcohol consumption stops).  In fact, a significant proportion of people with ARBD will make significant improvements with the right care and conditions, with the following predicted recovery rates:

  •  25% making a complete recovery
  • 25% making a significant recovery
  • 25% making a slight recovery
  • 25% making no recovery                      (Smith & Hillman, 1999)

This suggests that over half of those with ARBD will make a significant recovery.  However, this recovery will only take place if the person with ARBD sustains abstinence from alcohol and is given access to specialist rehabilitation interventions and neuropsychological assessment.