alcohol abuse dementia, frontotemporal dementia

Later-Life Alcohol Abuse: A Possible Sign of Dementia

By Nicholas Chan | April 1st, 2022

A new study finds that later-life alcohol abuse could be an early red flag for dementia.

Excessive drinking that begins later in life can occur for a number of reasons, such as loneliness, retirement and the loss of a loved one, experts say. But recent research suggests that alcohol abuse can also be one of the earliest symptoms of neurodegenerative diseases, including the behavioral variant of frontotemporal dementia (bvFTD)

A new study, published in the Journal of Alzheimer’s Disease, reported that about one in every 50 people with dementia had issues with alcohol abuse at the age of 40 or older, and it was much more common among those with bvFTD than Alzheimer’s.

Further, alcohol abuse coincided with the onset of people’s neurodegenerative conditions for roughly one in every 60 patients with dementia, the researchers found. Alcohol abuse was significantly more common as an early symptom among people with bvFTD than among people with Alzheimer’s. 

Georges Naasan, a neurologist at Mount Sinai and senior author of the study, said that while a person’s late-onset alcohol abuse can be related to a host of factors like depression and social isolation, the team’s findings should prompt clinicians to also consider dementia, especially bvFTD, as another potential variable. 

“One additional thing to add to the list that currently isn’t systematically thought of is: Could this person have any beginnings of a possible neurologic disease?” Naasan told Being Patient. 

Considering the possibility of dementia for a patient who abuse alcohol later in life could mean finding the right diagnosis and treatment earlier. 

The red flags bvFTD and alcohol abuse

Elisa de Paula França Resende, the study’s lead author and a neurologist at the Hospital das Clínicas da Universidade Federal de Minas Gerais in Brazil, said that if a person who has never abused alcohol before and who typically drinks one or two beers a weekend, begins consuming alcohol daily in late life, this could be cause for concern. That’s a good reason to consult with a health care professional.

Further, symptoms like apathy, hyperorality, loss of empathy, obsessive compulsive behavior, disinhibition and impaired judgement are all prominent features of bvFTD. Naasan added that any such new behaviors or uncharacteristic changes from an individual’s personality should prompt a doctor’s appointment.

More about the study

For the study, the team gathered data from 1,518 patients of University of California San Francisco’s Memory and Aging Center. Among them, 1,254 patients were diagnosed with Alzheimer’s. 173 patients were diagnosed with bvFTD, and 91 were diagnosed with another subtype of FTD called the semantic variant of primary progressive aphasia (svPPA).

The team observed that 2.2 percent of study participants abused alcohol at the age of 40 or older, a number that is higher than the previously reported rate of alcohol abuse in the population of older adults in the U.S., the researchers noted. For 1.4 percent of participants, alcohol abuse appeared within the first three years of the onset of dementia symptoms, the study reported; this was more than five times more likely in people with bvFTD than in people with Alzheimer’s.

The researchers noted that in bvFTD, damaged regions of the brain are involved in behavior, impulse control and reward processing, and these injured brain regions could all play a role in alcohol abuse, they hypothesized. 

The design of the study, in which the team retrospectively reviewed patients’ medical charts, comes with limitations. For instance, the researchers noted that they did not have access to information like the quantity of alcohol consumed or the psychological and environmental context of a patient’s alcohol abuse. And their results should be interpreted with caution, the team wrote. 

To confirm the study’s findings, Naasan said future research that follows participants over time is needed. Resende also hopes that the study will prompt researchers to develop alcohol abuse interventions specifically for people with dementia. 

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