Alcohol-Related Brain Damage
University of South Wales
What is Alcohol-Related Brain Damage?
Alcohol-Related Brain Damage (or ARBD for short) is a term used to describe a spectrum of conditions that are caused by chronic and excessive alcohol use and associated nutritional deficiencies. These conditions are characterised by cognitive impairments, meaning that there are problems with thinking, processing and memory. Consumption of alcohol at damaging rates can lead to longer-term difficulties as a result of alterations to the size and structure of the brain. Damaging rates of alcohol consumption are typically defined as more than 50 units per week for men, or more than 35 units a week for women, although the effects of alcohol will largely vary from person to person.
Importantly, ARBD is not a degenerative condition, meaning that those with the condition can halt the progression of symptoms and in some cases, full recovery is possible if the appropriate support and treatment is sought and provided. The earlier the condition is recognized and diagnosed, the better chances there are for improvements to be seen. This means that timely investigation and intervention is key to successful treatment. Unfortunately, ARBD is often under or misdiagnosed, especially as some of the symptoms appear similar to the signs of intoxication and/or certain forms of dementia. As the understanding and awareness of ARBD is poor, a series of research studies were conducted by the University of South Wales in collaboration with the Pobl group to increase understanding of the condition.
A person is considered ‘at risk’ of developing ARBD if they consume 35 units a week or more over a period of 5 years. Current guidelines in the UK recommend consuming no more than 14 units a week for males and females. This is roughly 6 pints of beer or 6 medium glasses of wine spread evenly across the week with a couple of alcohol-free days in between the days that you do drink alcohol.
People who are affected by ARBD often experience impairments in cognitive functioning that include:
- Memory (particularly in forming and retaining new memories)
- Attention and concentration
- Reasoning/judgment
- Information processing, planning and decision making
- Visuospatial abilities (identifying and interpreting visual information e.g. map reading, judging distances)
- Confusion
In some cases, additional indicators of ARBD can include changes in personality and behavior (e.g. aggression, apathy), confabulation, and ataxia. Confabulation refers to the process whereby individuals fill in gaps in their memory by producing fabricated or distorted “memories” although the individual does not realize that these memories are false and they are not intentionally being deceptive. Ataxia is a term used to describe a cluster of disorders that affect speech, balance, and coordination, leading to difficulties with walking, swallowing, writing, eating, and vision.
About the project
Appropriate treatment of ARBD is currently lacking due to the limited information about the condition with a high possibility of people being misdiagnosed or not being identified at all. Although the effects of alcohol on the brain are usually short-lived, long-term alcohol consumption at hazardous rates can lead to structural and functional changes to the brain which can impact memory, thinking, planning, and reasoning among other things, although these effects are often unfamiliar to many people. Because of this, there may be a lack of awareness and misunderstanding of the condition and confusion as to who is best suited to cater to the needs of these individuals. By combining information about the condition with new research findings in this area, the resources on this website aim to increase awareness and understanding of ARBD.
By combining information about the condition with new research findings, this project aims to increase awareness and understanding of ARBD and offers a new understanding in relation to these three main areas:
- Prevalence and characteristics of individuals with ARBD
- Accurate assessment and diagnosis of the condition
- Effective treatment of ARBD
How many people have ARBD?
It is hard to know exactly how many people have the condition, especially as people may go unnoticed, especially if they only have mild symptoms.
How can I identify someone?
There are some key signs and symptoms that might help you recognise if someone might have ARBD. Spotting the condition early will help get the right treatment.
What can I do to help?
If you have a friend, family member or work with someone who might have ARBD or may be at risk of ARBD, here are some ways that you might be able to help.
Alcohol Use in Wales
Alcohol is the second most widely used drug, only second after caffeine and it is used throughout societies. There is a considerable proportion of people who frequently use alcohol in the UK with 47% of the population reported to use alcohol on a weekly basis in Wales.
Although there are safe levels of alcohol consumption, 18% of the population in Wales self-report drinking alcohol at hazardous levels, which is defined as consuming more than 14 units per week. Of those drinking at hazardous or harmful levels, these drinkers accounted for 68% of all alcohol consumed in Wales between 2018-2019. The 2% of the population who consumed alcohol at the most harmful levels during this period accounted for 23% of the overall consumption of alcohol.
Alcohol is also a major cause of illness and death in Wales. Statistics for Wales show that around 1 out of every 20 death are attributable to alcohol.
Assessment and Diagnosis
Idenfifying those who may have ARBD or who are at risk of developing ARBD is important to ensuring that they are assessed promptly and can receive treatment and management of their condition as soon as possible. There are a number of tools thtat can be used to assess and diagnose ARBD.
Treatment
Research suggests that if individuals with ARBD receive appropriate treatment, the condition can be successfully treated and the outlook for these individuals can be promising. There are a number of stages in the treatment of ARBD from actue care through to long-term rehabilitation.
Ongoing Support
Those with ARBD will likely receive support from a number of specialists and services. This care package should follow a care pathway with planning for longer-term care including maintaining a suitable diet, abstinence from alcohol and relapse prevention.
Training Materials
A series of training materials have been developed by researchers at the University of South Wales in collaboration with the Pobl Group to provide an understanding of ARBD, which include a range of handbooks that are suitable for a range of individuals and specialists. For a brief summary of the findings of the project, see the Infographic and the Information Leaflet. For more detailed information, see the handbooks below. A list of further resources and sources of information are also listed in the Further Resources section.