what is the link between alcohol and dementia

What is the link between alcohol and dementia?

5 min read |
Gemma Clay Sweet Pea Care Webinars

Author 01.12.2023

Gemma Clay
Dr. Danielle Kelvas, MD

Expert review 02.07.2024

Dr. Danielle Kelvas, MD

Dementia is one of the UK’s leading causes of death but what is the link between alcohol and dementia?

There is a definite link between alcohol misuse and one form of dementia, called Korsakoff syndrome.

But is there a link between general alcohol consumption and dementia?

Let's explore that question in more detail.

Here’s what we will cover in this article:

  • There is growing evidence that alcohol is connected to some forms of dementia but more studies are needed to determine the exact risk.
  • Korsakoff syndrome is ‌alcohol-related brain damage that presents as dementia.
  • Recommended maximum units of alcohol per week is now 14 for men and seven for women.
  • Binge drinking is now defined as over 6 units in one session for women, 8 for men.
is there a link between alcohol and dementia

What is the link between alcohol and dementia?

Research into alcohol and the risk of dementia is a growing field of study, which is producing interesting results.

A 2018 study published in BMJ examined the association between alcohol consumption and risk of dementia. 

The results suggested that both abstinence and drinking over 14 units a week in midlife (35-65) can increase the risk of developing dementia.

What do the findings mean?

So that means that drinking no alcohol at all, or drinking lots of alcohol per week, can both be linked to dementia. 

However as the Alzheimer’s Society rightly points out, this was an observational study and so we need longer trials to explore whether this is actually the case. 

If you are worried about your own alcohol consumption, or that of a loved one, speak to your Doctor or GP for advice.

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Alcohol-related dementia - Korsakoff's syndrome

Korsakoff syndrome is the most severe form of alcohol-related dementia.

Alcohol misuse is the most common cause, but malnutrition (including from anorexia), AIDS, cancers and chronic infections can also cause it.

Korsakoff syndrome is caused by a lack of a vitamin called Thiamine, also known as vitamin B-1 (1).

Thiamine is essential in converting glucose into usable energy for brain cells.

When thiamine is missing or reduced, it cannot convert this sugar into the energy the brain needs.

This affects how well brain cells work. They can effectively become starved of energy.

How many units of alcohol are in my drink?

Vitamin B-1 deficiency

A deficiency of vitamin B-1 also disrupts the efficiency of chemicals that help signals move between brain cells.

The lack of these chemicals might also prevent the storage of memories, or gaining access to old memories.

While Korsakoff syndrome is less common than other forms of dementia, there is a suggestion that it may be under-diagnosed. 

There are no clinical tests for this syndrome, so a doctor’s best judgement is used to diagnose the condition.

People often underestimate how much they actually drink, and ‌this may also have a bearing on the number of diagnoses.

dementia and alcohol

Symptoms of Korsakoff's syndrome

Memory is the first and most affected brain function in Korsakoff’s syndrome.

Sufferers may find themselves unable to remember very recent events. Individuals also begin to experience gaps in long-term memory (1). 

This may not affect other reasoning skills initially, and individuals may remain relatively lucid and coherent. However, forgetting a conversation or event minutes after it occurred is not uncommon.

Experiencing hallucinations

A person with Korsakoff’s syndrome may experience hallucinations, (seeing or hearing things that aren’t there). 

They may also make up information without realising they have done so. This is thanks to a confused cognitive function that ‘fills in the gaps’ of knowledge. 

It is important to note that this ‘confabulation’ is not lying or falsification. The person believes the information they have created to be real and truthful.

does alcohol cause dementia

Wernicke encephalopathy

Some people who develop Korsakoff’s syndrome experience Wernicke encephalopathy prior to the dementia symptoms starting. 

This is a striking and life-threatening reaction to the lack of B-1 in the brain (2).

This reaction can include coordination loss, balance issues, extreme confusion, and uncontrollable eye movements. 

If left untreated, 20% of people suffering from Wernicke encephalopathy will die.

85% of people who suffer from it will ‌develop Korsakoff’s syndrome.

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Treatments for encephalopathy

This encephalopathy is treatable with an injection of vitamin B-1, however, the effects can be felt for months afterwards. 

As the effects of the Wernicke encephalopathy fade, usually the symptoms of Korsakoff’s syndrome then become apparent.

Korsakoff’s syndrome effects can, to some degree, be slowed or stopped with medical support.

If the person suffering from alcohol dementia can reduce or stop their alcohol consumption, they can moderate their symptoms.

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Alcohol related brain damage

ARBD symptoms can be similar to those of alcohol dementia. The cells of the brain do not work as well as they should, thanks to the effects of too much alcohol. 

People may experience confusion, memory loss and problems with balance.

The difference between ARBD and dementia related to alcohol is that alcohol related brain damage can be partially reversed. 

When someone with ARBD stops drinking alcohol and gets support with therapies and medication, some lost brain functions can return.

what is the link between alcohol and dementia

Advice on alcohol consumption

Recently, the NHS has changed its advice on alcohol consumption. The recommended maximum number of units per week has now dropped to 14 for both men and women (3). 

Drinking up to 14 units per week is considered a ‘low risk’ level of alcohol consumption. There is now no amount of alcohol consumption that is considered ‘safe’.

There has long been concern over the links between drinking alcohol and developing diseases. Most commonly known is liver damage or cirrhosis. 

Diseases caused by alcohol

Many people assume an increased risk of alcohol-related illnesses comes from drinking to great excess. 

This is not the case at all. Drinking over 14 units a week is now known to increase the risk of developing‌ the following diseases.

how many units can you drink

Other risks to the brain from alcohol consumption

Cognitive decline is another issue that alcohol consumption can contribute to. Brain cells find alcohol toxic and do not respond well to repeated exposure. 

Repeated alcohol abuse, followed by withdrawal, is very taxing to the body, ‌and particularly the brain.

This unnecessary wear and tear is damaging to the cells of the brain, and leads to cognitive decline. 

Cerebrovascular disease

Alcohol misuse can also lead to cerebrovascular disease.

This is a variety of disorders relating to how blood flows to the brain. It includes clots, stroke, artery restriction, haemorrhage and blockages.

Whilst under the influence of alcohol, the risk of losing balance increases. 

Many people who drink heavily find they are at risk from falling, or being involved in alcohol fuelled violence.

Head injuries, sustained while misusing alcohol, have the potential to lead to brain damage.

How to plan your alcohol consumption

It is very easy to misjudge the amount of alcohol we are drinking. We relax as we consume it, and become less likely to count our drinks, check their size or the ABV of each type of drink. 

A unit is a way of counting how much pure alcohol is in each drink. It equals around 8-10mg of pure alcohol, which is roughly what an adult can process in one hour.

Binge drinking is now quantified by the NHS as 6 units of alcohol in one session for women, and 8 for men. 

A bottle of beer has a different unit count than a pint, which differs from a spirit and mixer. It is tricky to work it out as you go!

Work it out before you start to drink

Work out the maximum units you would like to consume, and plan which drinks fit in your unit ‘budget’.

If you decide you want to drink 3 units, you could stop drinking alcohol after three single gin and tonics.

Or perhaps a pint and a half of low strength beer. Two small glasses of wine (125ml) would also make up 3 units.

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Early signs of dementia free guide

How can I reduce my risk of alcohol-related dementia?

If you want to reduce your risk of alcohol related dementia then it is recommended to drink less alcohol. 

There is a good deal of evidence to suggest that alcohol consumption has ‌many risks, including in developing dementia. 

What is the link between alcohol and dementia?

Alcohol can still play a part in a healthy lifestyle when infrequently and carefully consumed.

Eating a healthy balanced diet, taking plenty of exercise, and having several alcohol free days per week will all help. 

Ensuring you drink less than 14 units of alcohol per week is the best plan of action. 

Binge drinking is now qualified as 8 units in a single session for men, 6 for women, so make sure you stay within those limits to reduce the risk of drinking alcohol. 

That looks like 4 pints of 3.6% beer (8 units) and just under 3 glasses of 175ml wine (6 units).

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Find the care you need

There is a wide variety of care available to assist families during life’s later years.

If your loved one is living with dementia you can also find additional care guides on our dedicated dementia care section.

If you need more information you might like to read our guides on personal care or what is domiciliary care.

Citations for this article:

1. Covell, T., Siddiqui, W. Korsakoff Syndrome. [Updated 2023 Jan 30]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing. 

2. Vasan, S., Kumar, A. Wernicke Encephalopathy. [Updated 2023 Aug 14]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing.

3. Rosenberg G, Bauld L, Hooper L, Buykx P, Holmes J, Vohra J. (2018). New national alcohol guidelines in the UK: public awareness, understanding and behavioural intentions. J Public Health, 1;40(3):549-556.

Sweet Pea has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations. You can find out more about how we ensure our content is accurate and contemporary by visiting our editorial policy.

Dr. Danielle Kelvas, MD

Expert review 02.07.2024

Dr. Danielle Kelvas, MD

Dr. Danielle Kelvas is a primary care physician who has spent her career advocating for global health initiatives. As an avid writer, Dr. Kelvas is passionate about patient education and combating disinformation online.

Gemma Clay Sweet Pea Care Webinars

Author 01.12.2023

Gemma Clay

Gemma is the Founder and CEO of Sweet Pea Care and has been advising families and care companies for the last decade through Arc Seven Communications.