Korsakoff's syndrome info?

Ed1937

I'm not even sure if that was spelled correctly, but you know what I mean. I've known a man for 60 years. We first met when we were neighbors, and we know each other's families. I haven't seen him for a while, but one of our daughters told me that he is having memory problems, and maybe problems with speech. He has abused alcohol for as long as I have known him, and I'm wondering if he has Korsakoff's syndrome. Apparently his daughter has at least some influence in his life. I'm trying to get in touch with her to give her some information. Does anyone have links to some good information? Should I ask her to check out this forum? Thanks for your time.

harshedbuzz

Hi Mayor Ed-

How kind of you to be looking out for a friend. I don't envy the daughter in this situation, dealing with dementia in the context of alcohol abuse adds a layer of ugliness to an already ghastly situation. One of the downsides, IME, was that the medical professionals we ran into- even in a large Ivy League teaching hospital- parsed alcoholism as a moral issue rather than illness and painted family rather dismissively. 

Alcohol is toxic to the brain and can cause alcohol related dementia (ARD). Korsakoff's is part of a pair of conditions- Wernicke-Korsakoff's (WKS) that is caused by a vitamin B1 (Thiamine) deficiency. It can also be caused by certain cancers, end-stage AIDS, extreme morning sickness, eating disorders and bariatric surgery patients. Wernicke's usually precedes Korsakoff's and can look like psychosis, if not reversed with IV supplementation (oral doesn't cut it), it will progress to Korsakoff's which is as much an amnesia as dementia. The short term and working memories are MIA and the ability to lay down new information (learning) is lost.  There seems to be a genetic component to WKS- not everyone who abuses alcohol will develop it. Much of the literature on the condition comes out of the UK and Australia and many of the people who do develop it are of British background. During WW II many, but not all, British soldiers held by the Japanese developed WKS on the meager rations they were fed. 

FTR, my dad and his nephew both had WKS. My sister likely did, too, in the last 9 months before she died of complications of AIDS in 1994. 

Dad was in his 80s when diagnosed, although it could have been sooner if I had prevailed against my mom's denial. He also had Alzheimer's. His diagnosis was made on the strength of history, paper testing and imaging. He had a PET scan which showed a characteristic pattern of glucose uptake. My cousin was in his late 40s- his son recognized the issue and got him help earlier. He lived with his son who was able to take over IADLs and restrict his drinking, but last I heard he got worse (maybe drinking?- hard to say) and dies when he was about 55. 

WKS has a lot of overlap with other dementias, but there are a few distinct symptoms. PWWKS_

often have a kind of reeling gait early on even when they are sober

many have eye involvement where their eyes sort of roll in their head/they may have double vision

their ability to regulate temperature goes fairly early on (this was one of the quirks I first noticed about dad, he was constantly cranking up the heat- he woke up in his coastal MD house in July and set the heat to 85F) His own body temperature ran quite low as well- usually around 95.5. When he died from complications of aspiration pneumonia, he never mounted a fever.

confabulation. While a lot of PWD conflate, this is an early and relentless characteristic in WKS.  With dad it felt a lot like he was rewriting history. 

All 3 of the individuals I personally knew with WKS were suspicious and difficult, but I don't know if that's the WKS or just their personalities. 

Some links for your friend-

Wernicke-Korsakoff Syndrome Information Page | National Institute of Neurological Disorders and Stroke (nih.gov)

Korsakoff Syndrome: Clinical Aspects, Psychology and Treatment | Alcohol and Alcoholism | Oxford Academic (oup.com)

Korsakoff Syndrome: Clinical Aspects, Psychology and Treatment | Alcohol and Alcoholism | Oxford Academic (oup.com)

Korsakoff Syndrome: Clinical Aspects, Psychology and Treatment | Alcohol and Alcoholism | Oxford Academic (oup.com)

Korsakoff Syndrome | Symptoms & Treatments | alz.org

HTH-
HB

Ed1937

Thank you very much for your thoughts and links. I'm sure they will prove very helpful.

Ed1937

You said "One of the downsides, IME, was that the medical professionals we ran into- even in a large Ivy League teaching hospital- parsed alcoholism as a moral issue rather than illness and painted family rather dismissively." As common as alcoholism is, you would think medical professionals would start thinking differently about it. I think most families have been touched by it. I know ours has.

Rescue mom

HB covered the serious bases. I’m sorry for everyone involved.  I knew 2 people with this, and it’s really ugly even as dementias go (which this isn’t totally but). One was in her 50s, the other almost 70. Both were pretty far along before Dx; part of the problem was that they did have remarkable periods of awareness/functioning, until very near the end.