The Relationship Between Alzheimer's and Alcohol Use Disorder

It is well known that heavy and binge drinking can cause liver cirrhosis. But did you know that there is also a link between alcohol use and Alzheimer's?¹

Since Alzheimer's is a progressive disease and gets worse as time goes on, caregivers are a pivotal point throughout the entire span of the disease. Alcohol use disorder adds some other challenges to this already difficult situation.

Sometimes, early signs of Alzheimer's are difficult to detect, leading some to blame new behaviors on alcohol.² Typical symptoms of dementia can also be signs of heavy drinking. Some may think of trying to get someone with Alzheimer's to drink less instead of going to the doctor.

Alcohol use, Alzheimer’s, and the brain

Over the long term, excessive drinking can cause changes in brain structure. For example, less white matter in the brain of individuals who were long-term heavy or binge drinkers. White matter helps your brain regions communicate with one another.¹

Alcohol use disorder and Alzheimer's

Up to 78 percent of people with alcoholism have some brain damage.¹ Heavy drinking of 8 or more beverages per week makes Alzheimer's progress faster, according to a 2017 study.³ An earlier study found that people who engaged in binge drinking once a month were more likely to have the worst cognitive declines. The same study found that binge drinking twice a month more than doubled their decline.⁴

Possible issues

Alcohol use disorder can cause unique problems when combined with Alzheimer's. These conflicts can include:

• People with dementia might lose track of how much they drink or whether they drank earlier.
• Drinking can worsen symptoms. For example, if someone with dementia is having trouble with balance, drinking might cause safety issues.
• People who drink heavily often neglect to stay hydrated or eat enough. But failing to do these things can worsen Alzheimer's symptoms.
• Finding long-term care could be difficult. It might be hard to find a place in many facilities because they do not accept people who drink heavily.

What can caregivers do?

Every relationship is different, and each person with dementia is different. There is no one way to deal with someone who has Alzheimer's and continues to drink. Each family and caretaker must decide which methods work for them. Your approach might also change as the disease progresses.

Tips for addressing this issue

• Always talk to the doctor and pharmacist before filling prescriptions. Be honest about the amount your loved one drinks. Discuss potential interactions between medicine and alcohol.
• Talk about driving. This is an important time to be realistic about their capacity to drive safely if your loved one still uses a vehicle and drives.
• Monitor the payment of bills. Dementia alone can make it difficult for a person to remember if they paid their bills. Alzheimer's and drinking can make it worse. If possible, have a responsible family member or friend take over finances.
• Heavy drinkers frequently have thiamine or vitamin B1 deficiency. Therefore, provide foods high in B1. This includes legumes, whole-grain bread and cereals, beef, pork, sweet potatoes, sunflower seeds, and orange juice.
• Trade alcoholic beverages for their non-alcoholic versions, if possible. There are many non-alcoholic beers and wines. Hard liquor is more challenging to replace, but you can try to reduce the alcohol in a drink.
• Request that friends and family not bring alcohol. If your loved one has alcohol delivered, ask to have the address placed on a no-deliver list.
• Remove all alcohol from the premises.
• Limit funds, if possible. Try to keep your loved one from having money to buy alcohol.

Self-care for caregivers

Caring for someone with Alzheimer's is stressful. Caring for someone with a mix of Alzheimer's disease and alcohol use disorder is even more stressful. As you deal continue to manage the situation, it is vital that you make time for yourself.

Join Al-Anon or other support groups. Ask family members to fill in or request respite help from your local aging department.

Tell us about your experience in the comments below, or share your encounter and tips with the community in this forum.