Monday, January 11, 2010

Dementia and alcohol abuse

Experts do not really know. It could be caused by lack of light, fatigue, changing routines, changing life passages, lack of support. It is a syndrome that family members spot in the evening. Common emotional and psychoscial symptoms include:

I have written previously about Sundowner's Syndrome

What is it?
  • rapid mood changes, fatigue, confusion, frustration, anger, crying, depression, stubbornness, fearfulness, hallucinations, paranoia and agitation.
In my dad's case, we hired a PSW to come in a support him, one-on-one, in the evening when he was most at risk: angry, beligerant, anxious, irritated, irritable and irritating.
In some cases, the self-medication for this syndrome has been alcohol. There is a difference between Sundowners and alcohol abuse.
For seniors, living alone with access to liquor and beer, or a liquor store, this is a result of their depression, loneliness, and inability to come to terms with their changing circumstances.

One concern about excess alcohol is that it can cause dementia. *Karen Quemby, Education Coordinator for the Alzheimer Society of Ottawa, wrote an excellent piece for our local paper. I summarize it here for you.

She explains that the alcohol-related dementia is a neurological disorder that causes confusion and affects memory. In the late 1800s, Wernicke and Korsakoff found that in acute and chronic phases of this disease, 'encephalopathy results from acute deficiency of Vitamin B1, thiamine.'

It is called Wernicke-Korsakoff Syndrome (WKS). There are two aspects to it.
  1. Wernicke's encephalophy -
  2. Korsakoff's psychosis -
Now, WKS this explains a lot in some of the people with whom I have worked. In conjunction with alcohol abuse - obviously, is a general lack of good nutrition. The brain atrophies, and the person creates a lot of coping strategies. This makes the case for those who judge addicts, since we know that many people with dementia can cover it up for a long time. They know what they don't know, and can go back in time. One client keeps speaking of 'the operation I'm going to have', which was many, many years ago. He has fooled his friends around this issue. This is why a medical test for dementia is an important issue for those caring for geriatrics, and before discharge from hospital into ALC. (Alternate Levels of Care)

Symptoms of WKS

  • confabulation - inventing information to compensate for poor memory
  • chronic memory disorder for short-term events
  • natural conversations and normal recall of long-term events, people, places, things
  • impaired ability to learn new information or complete new tasks
  • ataxia - weaknesses in limbs, lack of muscle control
  • raid eye movements
  • sense of smell
  • coma
  • damage to nervous system - decreased or abnormal reflexes
  • damage to muscle systems - slow walking, coordination issues
  • paralysis of eye muscles
  • diminished fine motor function - hand and finger muscles
  • low body temperature
  • low blood pressure
  • fast heart rate
  • the appearance of malnutrition

Criterea for alcohol abuse
  • 35 drinks/ week for men
  • 28 drinks /week for women
  • over a five year period
  • period of significant drinking with 3 years of diagnosis of dementia
If caught early it is treatable. In later stages the damage in long-lasting, leaving complications in motor skills, amnesia, and brain damage. With the acceptance of alcohol, many addicts are enabled by friends and family who may purchase and deliver alcohol, or give such as gifts to family members. While a person has a right to their dignity and humanity, there is a fine line between enabling alcohol abuse, and controlling another's life. 

*Another good reason not to overindulge

By Karen Quemby Friday, January 8, 2010  Question: Can too much alcohol cause dementia? Last month I probably left you feeling good about the benefits of red wine on the brain and I signed off by saying that if you feel like a glass of red wine to go ahead but just make sure that you don’t over indulge.

Why are people with Alzheimer's disease worse in the evening?

Question: Why are people with Alzheimer's worse in the evening? ... Karen Quemby has completed her Master's degree in Gerontology.

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