This Article  • Full text  • PDF  • Video  • CME Course for This Article  • Submit Response to Patient's Crossroads  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on Web of Science (4)  • Contact me when this article is cited  Related Content  • Readers Responses  • Related letters  • Related article  • Similar articles in JAMA  Topic Collections  • Aging/ Geriatrics  • Neurology  • Alzheimer Disease  • Behavioral Neurology  • Cognitive Disorders  • Dementias  • Neurogenetics  • Neurotoxicology  • Substance Abuse/ Alcoholism  • Alert me on articles by topic  Social Bookmarking   What's this?

John C. M. Brust, MD, Discussant

JAMA. 2008;299(9):1046-1054.

Adverse effects of alcohol on the peripheral and central nervous system can be direct (ie, neurotoxicity) or indirect (eg, nutritional deficiency). Using the case of Mr E, an older, moderate to heavy drinker experiencing memory difficulty, the diagnostic considerations, which include mild cognitive impairment, early Alzheimer dementia, Wernicke-Korsakoff syndrome, and "alcoholic dementia," are discussed. These disorders are not mutually exclusive, and in a patient with either mild cognitive impairment or dementia, the contributory role of alcohol can be difficult to determine. In fact, epidemiological studies suggest that mild to moderate intake of alcohol actually reduces the risk of developing mild cognitive impairment or dementia, including Alzheimer dementia. Appropriate management includes measures to reduce alcohol dependence (eg, behavioral or pharmacological therapy) and to delay progression of the cognitive impairment (eg, engaging in healthy behaviors such as cognitive leisure activities).

Author Affiliation: Dr Brust is Professor of Clinical Neurology at Columbia University College of Physicians and Surgeons, New York, New York.

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

RELATED LETTERS

Alcohol Use, Thiamine Deficiency, and Cognitive Impairment
Francesco Panza, Cristiano Capurso, and Vincenzo Solfrizzi
JAMA. 2008;299(24):2853-2854.
EXTRACT | FULL TEXT  

Alcohol Use, Thiamine Deficiency, and Cognitive Impairment
Frances R. Frankenburg
JAMA. 2008;299(24):2854.
EXTRACT | FULL TEXT  

RELATED ARTICLE

Peripheral Neuropathy
Janet M. Torpy, Jennifer L. Kincaid, and Richard M. Glass
JAMA. 2008;299(9):1096.
EXTRACT | FULL TEXT  

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Alcohol Use, Thiamine Deficiency, and Cognitive Impairment
Panza et al.
JAMA 2008;299:2853-2854.
FULL TEXT  

Alcohol Use, Thiamine Deficiency, and Cognitive Impairment
Frankenburg
JAMA 2008;299:2854-2854.
FULL TEXT  

RAPID RESPONSES TO THIS ARTICLE

A Biopsychosocial Perspective is Essential
Art Walaszek
JAMA Online, 29 Feb 2008.
TEXT 

Is It Really Memory Loss?
Patricia R. Roger
JAMA Online, 29 Feb 2008.
TEXT 

Alcoholic neuropathy and dementia - it may not be what it seems to be!
Zaeem Siddiqi
JAMA Online, 29 Feb 2008.
TEXT