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Dementia in the elderly male alcoholic— a retrospective clinicopathological study
Author(s) -
Fisman Michael,
Ramsay D.,
Weiser M.
Publication year - 1996
Publication title -
international journal of geriatric psychiatry
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.28
H-Index - 129
eISSN - 1099-1166
pISSN - 0885-6230
DOI - 10.1002/(sici)1099-1166(199603)11:3<209::aid-gps326>3.0.co;2-c
Subject(s) - dementia , retrospective cohort study , medicine , psychiatry , gerontology , psychology , disease
Although intellectual decline associated with alcohol use has been extensively documented, the neuropathological basis for this cognitive change remains controversial. We have therefore undertaken a naturalistic survey of a population of patients identified as having an excessive alcohol intake. Records of all autopsies on patients resident in a chronic hospital between 1983 and 1993 were reviewed for evidence of alcohol abuse. Multiple brain pathology was found in the demented alcoholic patients. The most unexpected finding in this series was that seven of 12 cases of dementia with history of alcohol abuse presented with significant cerebrovascular disease, meeting NINDS– AIREN criteria for vascular dementia, suggesting that cerebrovascular disease may be a significant component of dementia in older alcoholics. Our finding that in four of six cases mamillary pathology may be secondary to vascular lesions suggests that unless these lesions are sought, the presence of mamillary pathology may lead to overdiagnosis of nutritional factors as the basis for alcoholic dementia.