14
views
0
recommends
+1 Recommend
0 collections
    0
    shares
      • Record: found
      • Abstract: found
      • Article: found
      Is Open Access

      Alcohol-Related Dementia and Neurocognitive Impairment: A Review Study

      review-article

      Read this article at

      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Context

          Alcohol consumption has escalated rapidly in many countries over the past decade. Evidence suggests a correlation between alcohol use and cognitive decline. We have systematically reviewed the concept and controversies, epidemiology, nosology, neuropathology and neurobiology, neuropsychology and management updates of alcohol-related dementia (ARD) in this paper.

          Evidence Acquisition

          We retrieved papers for this review by searching the PubMed database for terms “alcohol and dementia”, “alcohol and cognitive impairment”, and “alcohol and wernicke-korsakoff” mentioned in the title of the published papers. A total of 131 studies showed up. Appropriate studies were shortlisted and included (n = 72). Cross-references if relevant were considered from the selected studies. Eligible articles were fully read by the authors and the results were compiled.

          Results

          The prolonged and excessive use of alcohol may lead to structural and functional brain damage, leading to ARD. The cognitive deficits are most frequently observed in domains of visuospatial functions, memory and executive tasks, with a potential of partial recovery if abstinence is maintained. However, there are doubts regarding the etiopathogenesis, nosological status, prevalence and diagnostic criteria for ARD, due to difficulty in assessment and various confounding factors.

          Conclusions

          With growing cohort of young and middle-aged people, there is a probable risk of upsurge of ARD. Presently, there are dilemmas over the diagnosis of independent ARD. Thus, there is a need to develop evidence-based guidelines for diagnosis and management of ARD through further systematic studies.

          Related collections

          Most cited references70

          • Record: found
          • Abstract: found
          • Article: not found

          Widespread and sustained cognitive deficits in alcoholism: a meta-analysis.

          The cognitive repercussions of alcohol dependence are well documented. However, the literature remains somewhat ambiguous with respect to which distinct cognitive functions are more susceptible to impairment in alcoholism and to how duration of abstinence affects cognitive recovery. Some theories claim alcohol negatively affects specific cognitive functions, while others assert that deficits are more diffuse in nature. This is the first meta-analysis to examine cognition in alcohol abuse/dependence and the duration of abstinence necessary to achieve cognitive recovery. A literature search yielded 62 studies that assessed cognitive dysfunction among alcoholics. Effect size estimates were calculated using the Comprehensive Meta-Analysis V2, for the following 12 cognitive domains: intelligence quotient, verbal fluency/language, speed of processing, working memory, attention, problem solving/executive functions, inhibition/impulsivity, verbal learning, verbal memory, visual learning, visual memory and visuospatial abilities. Within these 12 domains, three effect size estimates were calculated based on abstinence duration. The three groups were partitioned into short- ( 1 year) term abstinence. Findings revealed moderate impairment across 11 cognitive domains during short-term abstinence, with moderate impairment across 10 domains during intermediate term abstinence. Small effect size estimates were found for long-term abstinence. These results suggest significant impairment across multiple cognitive functions remains stable during the first year of abstinence from alcohol. Generally, dysfunction abates by 1 year of sobriety. These findings support the diffuse brain hypothesis and suggest that cognitive dysfunction may linger for up to an average of 1 year post-detoxification from alcohol. © 2012 The Authors, Addiction Biology © 2012 Society for the Study of Addiction.
            Bookmark
            • Record: found
            • Abstract: found
            • Article: not found

            Alcohol, dementia and cognitive decline in the elderly: a systematic review.

            dementia and cognitive decline have been linked to cardiovascular risk. Alcohol has known negative effects in large quantities but may be protective for the cardiovascular system in smaller amounts. Effect of alcohol intake may be greater in the elderly and may impact on cognition. to evaluate the evidence for any relationship between incident cognitive decline or dementia in the elderly and alcohol consumption, a systematic review and meta-analyses were carried out. Criteria for inclusion were longitudinal studies of subjects aged >or=65, with primary outcomes of incident dementia/cognitive decline. 23 studies were identified (20 epidemiological cohort, three retrospective matched case-control nested in a cohort). Meta-analyses suggest that small amounts of alcohol may be protective against dementia (random effects model, risk ratio [RR] 0.63; 95% CI 0.53-0.75) and Alzheimer's disease (RR 0.57; 0.44-0.74) but not for vascular dementia (RR 0.82; 0.50-1.35) or cognitive decline (RR 0.89; 0.67-1.17) However, studies varied, with differing lengths of follow up, measurement of alcohol intake, inclusion of true abstainers and assessment of potential confounders. because of the heterogeneity in the data these findings should be interpreted with caution. However, there is some evidence to suggest that limited alcohol intake in earlier adult life may be protective against incident dementia later.
              Bookmark
              • Record: found
              • Abstract: found
              • Article: not found

              Clinical signs in the Wernicke-Korsakoff complex: a retrospective analysis of 131 cases diagnosed at necropsy.

              A recent necropsy study has shown that 80% of patients with the Wernicke-Korsakoff syndrome were not diagnosed as such during life. Review of the clinical signs of these cases revealed that only 16% had the classical clinical triad and 19% had no documented clinical signs. The incidence of clinical signs in this and other retrospective pathological studies is very different from that of prospective clinical studies. This discrepancy may relate to "missed" clinical signs but the magnitude of the difference suggests that at least some cases of the Wernicke-Korsakoff syndrome may be the end result of repeated subclinical episodes of vitamin B1 deficiency. In order to make the diagnosis, clinicians must maintain a high index of suspicion in the "at risk" group of patients, particularly alcoholics. Investigations of thiamine status may be helpful and if the diagnosis is suspected, parenteral thiamine should be given.
                Bookmark

                Author and article information

                Journal
                Int J High Risk Behav Addict
                Int J High Risk Behav Addict
                10.5812/ijhrba
                Kowsar
                International Journal of High Risk Behaviors & Addiction
                Kowsar
                2251-8711
                2251-872X
                07 February 2016
                September 2016
                : 5
                : 3
                : e27976
                Affiliations
                [1 ]Department of Psychiatry, ESIC Medical College and Hospital, Maharishi Dayanand University, Haryana, India
                [2 ]Department of Psychiatry and Drug De-addiction, Post Graduate Institute of Medical Education and Research (PGIMER), Dr Ram Manohar Lohia Hospital, Guru Gobind Singh Indraprastha University, New Delhi, India
                [3 ]National Drug Dependence Treatment Centre (WHO Collaborating Centre), All India Institute of Medical Sciences (AIIMS), New Delhi, India
                [4 ]Department of Neurology, Post Graduate Institute of Medical Education and Research (PGIMER), Dr Ram Manohar Lohia Hospital, Guru Gobind Singh Indraprastha University, New Delhi, India
                Author notes
                [* ]Corresponding author: Ankur Sachdeva, Department of Psychiatry, ESIC Medical College and Hospital, Maharishi Dayanand University, Haryana, India. Tel: +91-1126593236; +91-9899528355, Fax: +91-1292413032, E-mail: drankur.rml@ 123456gmail.com
                Article
                10.5812/ijhrba.27976
                5086415
                27818965
                ea73da09-6f57-4da3-953a-3ccd195ceedc
                Copyright © 2016, Zahedan University of Medical Sciences

                This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License ( http://creativecommons.org/licenses/by-nc/4.0/) which permits copy and redistribute the material just in noncommercial usages, provided the original work is properly cited.

                History
                : 07 March 2015
                : 01 June 2015
                : 05 July 2015
                Categories
                Review Article

                alcohols,dementia,cognition,wernicke encephalopathy,thiamine

                Comments

                Comment on this article