Scientists from Mount Sinai and elsewhere found that patients who start abusing alcohol later in life—after age 40—may be doing so secondary to an underlying neurologic condition, such as frontotemporal dementia
The research is published in the Journal of Alzheimer’s Disease and was conducted by Georges Nassan et al.
Overall alcohol abuse—classified as when alcohol consumption negatively impacts work or social life or leads to legal ramifications—is present in 1.7 percent of older adults in the United States.
Previous research has identified lifelong alcohol abuse as a risk factor for dementia. However, it has been unknown whether older adults who begin abusing alcohol late in life have an underlying neurodegenerative disease.
In the study, the team aimed to identify and compare the frequencies of lifetime alcohol abuse, late-onset alcohol abuse, and alcohol abuse as a first symptom of dementia.
They tested 1,518 patients who had a clinical diagnosis of frontotemporal dementia (bvFTD), Alzheimer’s-type dementia, or semantic variant primary progressive aphasia.
Lifelong alcohol abuse was defined as alcohol abuse that began before the patient was 40 years old, and late-onset alcohol abuse as abuse that began at age 40 or above.
Alcohol abuse as a first symptom of dementia as abuse that started within the first three years, either before or after symptom onset.
The team found is that alcohol abuse may be the first sign of an underlying neurological condition when it presents late in life.
They found that late-onset alcohol abuse was significantly more frequent in patients with frontotemporal dementia than those with Alzheimer’s-type dementia.
They also found that alcohol abuse as a first symptom occurred in 1.4 percent of all patients, five times more frequently in patients with frontotemporal dementia than those with Alzheimer’s-type dementia.
The results indicate not only that late-onset alcohol abuse is much more frequent in frontotemporal dementia than Alzheimer’s-type dementia, but also the likelihood that the biological mechanisms underlying late-onset and lifelong alcohol abuse are different.
The team says because patients who begin using alcohol late in life are usually first seen by psychiatrists, primary care providers, and rehabilitation specialists, these professionals should be aware of the possibility that a neurodegenerative disease might be underlying the onset of alcohol abuse late in life in people who historically didn’t abuse alcohol.
Therefore, a specific evaluation including checking for other frontal lobe symptoms should be performed, and patients at risk should be referred to a neurologist.
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