There are many links between alcohol addiction and a whole host of physical and mental health conditions. According to leading charity Alcohol Change UK, in fact, abusing alcohol is the biggest risk factor for death, ill-health and disability among 15-49-year-olds in the UK, and the fifth biggest risk factor across all ages.
Most of the time, it is the acute or chronic alcohol consumption that is a causal factor in the other health condition. There are exceptions, however. There is often a complex relationship between alcohol and mental health conditions, for example, and some mental health issues can trigger or exacerbate alcohol misuse and addiction. A new study also now suggests that in some cases, late-onset alcohol abuse could be a symptom of dementia.
What is dementia?
The umbrella term ‘dementia’ generally refers to a syndrome or group of related symptoms associated with an ongoing decline in brain functioning. People often get confused about the difference between Alzheimer’s disease and dementia or use them interchangeably. Alzheimer’s is actually one of many different forms of dementia, but it is also one of the most common, along with vascular dementia.
Memory loss is one of the major symptoms of dementia, but the condition can also affect the way you think, speak, feel and behave. Common symptoms include:
- Memory loss
- Mental sharpness and speed of thinking
- Ability to understand
- Poor judgment
- Difficulty using language
- Mood swings
- Problems with movement
- Difficulties with everyday activities
As well as there are many different types of dementia, there are many causes, and not all are fully understood. Frontotemporal dementia is a less common type caused by clumps of abnormal protein forming inside brain cells. Dementia usually affects people over 65, but frontotemporal dementia tends to start at a younger age, with most cases diagnosed in people aged 45-65.3
What is late-onset alcohol abuse?
Alcohol abuse, as a general term, refers to a range of problematic drinking behaviours. These can include binge drinking or heavy drinking, regular hazardous drinking (consuming more than the recommended safer drinking levels), alcohol dependency and alcohol addiction. These behaviours can have a wide range of negative impacts and may require alcohol addiction treatment. If you become dependent on alcohol, for example, you may need to undergo a supervised alcohol detox as you may experience unpleasant and potentially dangerous withdrawal symptoms when you stop or significantly reduce your alcohol intake.
Alcohol abuse and alcohol use disorders can occur at any time. Young people can certainly use alcohol in a harmful fashion, particularly when it comes to binge drinking – although alcohol dependency is rarer in younger age groups. Drinking at a young age can increase the risks of alcohol problems later in life, though. One US study showed that adults ages 26 and older who began drinking before age 15 were 5.6 times more likely to report having alcohol use disorder over the previous year compared to those who waited until age 21 or later (the US legal drinking age) to begin drinking.4
Late-onset alcohol abuse refers to older adults developing alcohol abuse issues after the age of 40. This means they start increasing their alcohol use or abusing alcohol for the first time after that age and is a different situation to people over 40 who have maintained a long history of alcohol misuse and may have attended alcohol rehab previously. Lifelong alcohol abuse is a serious issue but it can be successfully treated with a holistic addiction treatment programme and comprehensive relapse prevention and aftercare plan.
The connection between late-onset alcohol abuse and dementia
It has long been known that alcohol abuse can increase the risk of developing dementia, but a team of researchers from the Icahn School of Medicine at Mount Sinai and the University of California, San Francisco, has now examined if the reverse is also the case – whether older adults who begin abusing alcohol later in life may have an underlying neurological condition such as frontotemporal dementia.5
Senior author, Doctor Georges Nassan, Associate Professor of Neurology, and Medical Director for the Division of Behavioural Neurology and Neuropsychiatry, explained: “Our study aimed to identify and compare the frequencies of lifetime alcohol abuse, late-onset alcohol abuse, and alcohol abuse as a first symptom of dementia in a group of patients living with several forms of dementia, including Alzheimer’s disease and frontotemporal dementia.”
A foreword to the study also said that people who began abusing alcohol late in life due to an underlying neurological condition could be misdiagnosed with alcohol abuse as the primary condition, which could lead to the wrong approach when it came to treatments.
The researchers found that late-onset alcohol abuse could be the first sign of a neurological condition. Up to 7% of patients with frontotemporal dementia were found to have developed late-onset alcohol abuse, and 5% (or one in 20) were believed to have done so as a first symptom of this type of dementia.
When does late-onset alcohol abuse usually happen?
The researchers screened more than 1,500 participants who had been diagnosed with behavioural variant frontotemporal dementia (bvFTD), Alzheimer’s disease or semantic variant primary progressive aphasia. The study, which was published in the Journal of Alzheimer’s Disease, found that late-onset alcohol abuse usually started to occur within the first three years of dementia symptoms. It affected 2.2% of the overall sample, which was significantly higher than the 1.7% figure for older adults overall. The researchers found that late-onset alcohol abuse was also significantly higher in people with frontotemporal dementia compared to those with Alzheimer’s.
How many dementia patients have alcohol abuse as a first symptom?
Alcohol abuse as a first symptom was observed in 1.4% of all patients but was five times more frequent in patients with frontotemporal dementia than those with Alzheimer’s. Dr Nassan said social factors such as loneliness, retirement and loss of loved ones could contribute to late-onset alcohol abuse, but that it was important for clinicians not to attribute alcohol abuse to these factors systematically. Early diagnosis of underlying neurological conditions could help provide the best care and outcomes, he added.
