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Alcohol related brain damage often goes undiagnosed, says report

BMJ 2014; 348 doi: https://doi.org/10.1136/bmj.g3409 (Published 20 May 2014) Cite this as: BMJ 2014;348:g3409
  1. Jacqui Wise
  1. 1London

Between 80% and 90% of cases of alcohol related brain damage go undiagnosed, says a new report that calls for more services to support these patients.1

The report by the Royal College of Psychiatrists, the Royal College of Physicians, the Royal College of General Practitioners, and the Association of British Neurologists said that three quarters of people with alcohol related brain damage improve with the right multidisciplinary care.

Alcohol related brain damage is an umbrella term for the psychoneurological and cognitive conditions associated with long term alcohol misuse and related vitamin deficiencies. It usually affects people in their 40s and 50s, with women presenting a decade younger than males.

Drinking an average of 35 units or more a week (women) or 50 units or more a week (men) for five years will affect memory and reasoning ability. The report said that most people are likely to recover over the first two to three months of abstinence, although a small minority may be left with longer lasting cognitive damage.

The report said that the condition was often not diagnosed because of a lack of awareness among health professionals and the stigma associated with long term alcohol misuse. It added that because no national guidelines, standards of care, or established pathways of care exist in the United Kingdom patients either receive no care or are directed to inappropriate care, such as nursing homes designed for older people with dementia.

Patients who have intellectual or cognitive problems as a result of alcohol misuse should be screened in hospital emergency departments and in alcohol treatment services in the community, the report said. Cognitive testing should be carried out again after three months of abstinence.

The report also called on clinical commissioning groups to commission multidisciplinary specialist care for the assessment and rehabilitation of patients with severe alcohol related brain damage.

The report also covered fetal alcohol spectrum disorder and called for the dangers of alcohol consumption during pregnancy to be routinely explained to all pregnant women or those planning pregnancy.

Kenneth Wilson, editor of the report and professor of old age psychiatry at the University of Liverpool, said, “Alcohol related brain damage is a costly problem, both for individuals and their families, and for health and social services.” He added, “But specialist services for these patients can make a dramatic improvement to their quality of life. We also know from work we have done in this area that it can also dramatically reduce hospital admissions by some 85%.”

Notes

Cite this as: BMJ 2014;348:g3409

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