Is "Wet Brain" a Real Diagnosis?

Wernicke-Korsakoff Syndrome May Be Mistaken for Other Neurological Conditions in Seniors
by Don Drake, Connelly Law Offices, Ltd.
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A potentially deadly condition

The term "Wet Brain" was once used in a derogatory manner many decades ago to describe those who abused alcohol and behaved in a bizarre manner, but this is a real and potentially fatal condition called Wernicke-Korsakoff Syndrome, which can be mistaken for other neurological conditions, like other forms of dementia, in the elderly who are long-term alcohol abusers.

"For many, alcohol users who suffered from this condition were often the source of entertainment as they could be seen directing traffic until the police came along to remove them, spinning wildly exaggerated tales or staggering along the streets in the middle of the day, laughing and talking with their imaginary friends," said certified elder law Attorney RJ Connelly III. "They were often the so-called 'lovable alcoholics' who would hang around the bars waiting for patrons to buy them a drink to begin their 'show'" for the delight of those paying for this macabre form of entertainment."

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A source of jokes

These "lovable alcoholics" could also be seen on television programs of the past, often portrayed in a "cuddly" way, think of Otis Campbell on the Andy Griffith Show and Foster Brooks, the "hilariously funny" drunken comedian of the 1970s and 1980s.

"There is nothing funny about alcohol abuse or the term 'Wet Brain'," points out Attorney Connelly. "Some medical and addiction professionals have expressed concern that the recent lockdowns associated with the pandemic will result in increased cases of this condition since research is showing that alcohol use increased dramatically among older individuals during this time period."

Tracy's Story

Tracey, who lived in southeastern Massachusetts, had major concerns about her father, Bill. He is a widower, who was aging in place in a small home when the pandemic was declared, in a small home he had purchased prior to the death of his wife from Alzheimer’s disease. Although Tracey and her dad had explored assisted living, she was happy they made the choice for him to remain at home - at least initially. “We decided on this with him prior to the pandemic and when it hit and decimated so many senior long-term care communities, we felt that we had made the right choice.”

Bill, in his seventies and has some problems with his feet because of diabetes, was otherwise able to get around the house without much help. He was an active participant at the local senior center where he had many friends and often presented lectures about wildlife on the south coast of New England. This was Bill’s passion since his retirement from teaching environmental science at a local community college.

Prior to his involvement in the senior center, Tracy had concerns about the amount of alcohol her father was consuming. “He never drank a lot, maybe wine at a meal, but after my mom was diagnosed with Alzheimer’s and he tried to take care of her at home, his drinking picked up,” Tracy said. “Then, when her condition progressed to a point where we needed skilled nursing care, his use of alcohol became out of control.”

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Drinking to cope with loneliness

“Following mom's death, it got even worse, and we sent him to a counselor for help,” continued Tracy. "There was some progress in counseling but the best thing that ever happened to him was getting involved in the senior center. There he had company and a sense of belonging that he lost when mom died.”

But with the pandemic came the lockdown. Medical offices closed, outdoor activities stopped, and worst of all for Bill, the senior centers ceased operations. And the senior center was more than just a place with friends for Bill. While there, he would receive a healthy meal, something he seldom took time to prepare at home and a set of professional and caring eyes tracked his health and any concerning behaviors. Bill ended up being closed in his house, by himself, with all the reminders of his life with his late spouse surrounding him.

In the beginning, he called his daughter twice a day, once at work and once at night before going to bed. But those calls stopped coming after a few weeks and his alcohol intake increased to abusive levels. "Once the senior center closed, he was really isolated and lonely, and drinking became his only activity,” stated Tracy. "I was furious that the senior centers ceased operations, but the liquor stores were allowed to remain open. If I live to be a hundred, I'll never understand that thinking on the part of the government."

"I couldn't be there every day, I had a job, kids being homeschooled and other responsibilities, so I initially hired a home healthcare agency to check in on him," she said. This did provide some relief for Tracy, but that feeling was short-lived. “He started to refuse their services and eventually refused to answer the door, so they stopped coming. It was one of the home care providers who told us about all the empty bottles of wine and liquor that they found around the house and even in his bedroom. This was a huge red flag,” she said.

But Tracy had other concerns. “Dad’s cognition was failing as well. In one of his few calls to me, he didn’t remember things about mom, or our family and even struggled with my name. He started talking about hearing animals in the house and about neighbors firing shotguns at the house. He would then launch into these long elaborate stories about things that on the face of them could not be true, but he told them over and over. At first, I thought he may have been drunk, but he wasn’t slurring his words. I began to think he was heading down the same road as my mother.”

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Confabulation is a feature of WKS

The family tried to seek admission into a long-term care facility for him, but the pandemic had shut them down, too. Because Bill had trouble getting around, Tracy wondered how and where he was getting the alcohol. Then she found out from neighbors that the alcohol was being delivered by liquor stores that provided that service. "I was shocked when I found that out," Tracy said. "We couldn't get a meal delivered from the pizza parlor but he could buy a fifth of bourbon and have it delivered to his door."

Tracy finally confronted her father about his drinking, and as one could imagine, it didn't go well. "He seemed like a different person -- like he just gave up on life. Dad always had a spark about him that kept him going, but it was gone. He told me crazy stories about why he was drinking, stating that it prevented COVID and made his immune system stronger. I was able to get a doctor's appointment for him within a week and the news was not good. At first, they wanted to rule out Alzheimer's disease but then they began looking at alcoholic dementia. This was something I never heard of."

Unfortunately, Tracy's story is not out of the norm in the fallout of the COVID epidemic. According to Dr. Barry Freeman of the OptumCare Network in Arizona, “one out of five seniors are exhibiting signs of alcohol misuse.” And some treatment professionals feel that this number may be higher, much higher. Dr. Freeman pointed out that, “alcohol sales [rose] nearly 50% during the pandemic.” Such numbers indicate that the lockdown may have some profoundly serious unintended consequences that could be with our society for years, if not decades, to come.

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A support system for lonely seniors closed

"The social distancing and stay-at-home orders of the pandemic certainly presented a challenge for the senior population who were already vulnerable to the mental health effects of being isolated," said Attorney Connelly. "It was a double edge sword for our seniors, who were not only disproportionately endangered by the coronavirus, but also by the effects of attempts to keep them safe by locking them down and cutting them off from the support systems that were in place prior to the pandemic."

So, what are the dangers of alcohol abuse in the brain? And can it cause dementia? The quick answer is yes, the longer answer is it's a vastly different type of dementia and one that is preventable.

Alcohol, the Brain, and the Body

Alcohol has a major effect on the brain cells in people of all ages but is especially devastating on the aging brain. Because long-term alcohol drinkers often don’t take care of themselves nutritionally and physically, damage can occur to the brain because of poor nutrition resulting in vitamin deficiencies. Long-term alcohol use plus a lack of nutrition can lead to alcoholic dementia, which can mimic Alzheimer’s disease, especially in the way it affects memory and cognition. This type of dementia is called Wernicke-Korsakoff’s syndrome (WKS), once referred to as “Wet Brain".