Alcohol-related brain damage (ARBD) is a disorder of the brain. It is caused by regular drinking of too much alcohol over several years but does not discriminate for age, gender, wealth, ethnicity, education or career attainment. It affects men and women of all ages and from all backgrounds. It can be almost invisible to the casual observer, and people who have it often don’t realise (or accept) that they do. Apart from issues with their recall, people with ARBD are often in many ways no different from the rest of the population.

ARBD is an umbrella term which also includes specific conditions such as Wernicke-Korsakoff’s Syndrome (also known as ‘wet brain syndrome’), alcoholic dementia and alcohol-related amnesic syndrome. Unlike other common causes of dementia such as Alzheimer’s disease, people with ARBD who remain abstinent from alcohol and receive good support can make a full or partial recovery. If the person stops drinking alcohol and their nutrition is restored, the person’s condition is at the very least unlikely to deteriorate.

What is ARBD (Alcohol-related brain damage)?

ARBD is defined as long-term decline in memory or thinking caused by excessive alcohol use and a lack of vitamin B1 (thiamine). ARBD has a variety of causes:

1. Alcohol is a toxin. Regular heavy drinking over an extended period damages nerve cells and causes shrinkage (atrophy) of brain tissue.
2. A person who drinks heavily is also likely to be malnourished and lacking Vitamin B1 (thiamine). This is because:
   • Heavy drinkers often have a poor diet. If the person eats at all, the food consumed is likely to be low in variety and nutritional value (junk food, take-aways, cheap microwave meals) and lacking in basic vitamins and minerals.
   • Alcohol irritates the stomach lining. This causes poor absorption of nutrients from the diet. It can also lead to vomiting, which compounds the problem.
   • Ethanol (alcohol) also interferes with the way the body stores and handles thiamine (Patterns of 35S-thiamine hydrochloride absorption in the malnourished alcoholic patient)
   • A combination of the above is likely to lead to a thiamine deficiency (what foods contain thiamine (Vitamin B1)?) Thiamine is a vital component in the process of converting carbohydrates such as sugar and other starches into energy the body can use. This is particularly important for the brain and nervous system as they use so much energy. Thiamine also promotes the proper functioning and normal growth of the nervous system, muscles and heart. (for more about thiamine, see https://pubs.niaaa.nih.gov/publications/arh27-2/134-142.htm)
3. Alcohol can also cause ARBD through repeated head injuries. A person who drinks heavily is significantly more prone to falls, accidents – and also to getting into fights with others. This can affect anyone, regardless of age and background.
4. Also, heavy drinking can damage blood vessels (think about how someone’s nose looks when they have been drinking heavily long-term – that classic red and swollen nose with visible capillaries). It is also linked to raised cholesterol levels, high blood pressure and thereby an increased risk of heart attacks and strokes. All and any of these conditions can cause damage to the brain. (see more here: Alcohol Aware website)It is important to note that not all of these factors are equally important in all forms of ARBD or in everyone with the condition.

Some people regularly drink much higher levels than the recommended limits of alcohol. For men, such excessive drinking could mean more than 50 units per week, and for women, more than 35 units per week. Drinking at these high levels not only poses a particularly high risk to someone’s health but it also increases the risk of the person becoming addicted.
(Alcohol addiction is where someone has become dependent on alcohol. They have an excessive desire to drink and their drinking is causing problems in their daily life.)

Alcohol-related brain damage leads to slightly different symptoms in different people and causes a range of conditions. The most common form of ARBD is alcoholic dementia which may also be called alcohol-related dementia. ARBD also includes Korsakoff’s syndrome, which is also called Korsakoff’s psychosis.

To find out more about Wernicke-Korsakoff’s Syndrome, follow this link: Wernicke-Korsakoff’s Syndrome