Can alcoholism cause early dementia?

The old meme is that drinking “kills off brain cells”, which sounded like urban legend.

But now I’m not so sure. A person I know is starting to act sort of bizarre: forgetting important conversations, overreacting angrily to mundane minutiae, weeping inappropriately.

He has been a long-term drinker, on and off, but most recently on. He tries to keep it secret, but comes home from work on time but slurring. Goes out in the mornings on the weekend “to the hardware store” and comes back a couple of hours later slurring and staggering. And now the bizarre behavior listed above is starting to kick in.

It’s hard to post about this because verbalizing it now makes it real. Can anyone educate me about alcoholism and early dementia?

Yes it can in a few ways. Long-term alcohol abuse often damages liver function and can cause alcoholic hepatitis. If the liver becomes too badly scarred or inflamed, it can result in encephalopathy which is very similar to dementia and results from the inability of the liver to properly break down ammonia in the blood among other things so the body poisons itself. The bad news is that encephalopathy is an incredibly serious condition and a warning sign of liver failure which can turn fatal rapidly. The good news is that the liver may heal if they person abstains from drinking and dementia caused by encephalopathy is almost fully reversible.

Alcoholism can also cause a number of other conditions that impact mental function. Some of these aren’t caused by alcohol itself but instead the malnutrition that alcoholism often causes. Alcoholics often have rather severe vitamin deficiencies (B vitamins in particular) that impact mental performance. Some of these symptoms can be reversed through abstinence, vitamin supplements, and good nutrition but others are permanent. See Korsakoff’s Syndrome for a serious form of this type of dementia.

Alcoholism can also have other affects that impact mental performance. Many alcoholics go to bed impaired or completely drunk often or every night. That results in passing out unconscious but interferes with normal sleep patterns. Over time, this can have a great effect on mental and emotional health. Alcoholics that manage to quit drinking usually have sleep disturbances or very vivid dreams (or nightmares) for a month or more as the normal sleep processes go into rebound.

Being drunk all the time does a pretty good job of descreasing mental performance all by itself.


Yep - Korsakoff’s causes very strange behaviour - in a conversation with a person with this syndrome, it will appear that they are lying about just about everything discussed - this is technically true as the information provided is false; however, it’s unintentional - the brain will grasp for any scrap of data to fill in gaps in the person’s actual memory resulting in some quite fantastical stories.

Korsakoff’s is most commonly diagnosed in chronic alcoholics, I think; however, chronic anorexics also get it - it’s basically caused from severe malnutrition - in the alcoholic because food is replaced with alcohol and in the anorexic because food is replaced with nothing.