Smoking and Dementia
Smoking and long-term heavy drinking can pose risks for healthy people, but both can overtly compromise the health and safety of people living with dementia. Should you let someone with dementia smoke or drink?
Risk Factors: Smoking and Dementia
Smoking and dementia are significantly related. Smoking is a risk factor for developing dementia, and second-hand smoke exposure is included in that risk.
Smoking increases vascular issues such as cerebrovascular disease, stroke, and coronary heart disease, which is associated with cognitive decline and an increased risk for dementia. Smoking also increases plasma homocysteine levels which is an additional risk factor for stroke, cognitive impairment, Alzheimer’s, and other dementias. Atherosclerosis, the narrowing of blood vessels in the heart and brain raises the risk level for dementia due to a deprivation of oxygen and nutrients in the brain. Oxidative stress, which is an inflammatory response that can be caused by smoking, is also associated with neural death.
Quitting tobacco will reduce the risk factors for additional diseases, including dementia, but it does not reduce the damage already done.
Safety Tips: Smoking and Dementia
Ensuring your loved one’s safety in their home is crucial but can be challenging. Using a safety checklist can help. Ensure that the process includes the removal of anything that presents a fire hazard, including items related to smoking.
If your loved one with dementia smokes, you must remove all tobacco products, including cigarettes, pipes, matches, lighters, and ashtrays. This not only reduces the fire hazard but can help the person forget their desire to smoke.
Medical Intervention for Smoking and Dementia
Seek help from your loved one’s physician. Medications may be prescribed to decrease tobacco cravings and reduce withdrawal symptoms such as anxiety, depression, irritability, as well as changes in appetite or sleep patterns.
Heavy Drinking and Dementia
Risk Factors: Heavy Drinking and Dementia
Alcohol abuse, the excessive consumption of alcohol consumed over long periods can lead to brain damage, which is a known risk factor for developing dementia.
Moderate drinking, per the CDC, consisting of 2 drinks or less in a day for men, or 1 drink or less in a day for women, is not attributed to the development of brain damage and dementia.
Heavy consumption of alcohol over a long period of time, per the Alzheimer’s Society, can lead to a reduced volume of white matter in the brain. This affects the way the brain transmits signals between brain regions and affects how the brain functions.
Heavy long-term alcohol consumption can cause a lack of thiamine (vitamin B1) which leads to brain damage that affects short-term and some long-term memory. This results in a disease termed Wernicke-Korsakoff’s Syndrome or alcohol-related dementia (ARBD).
The Alzheimer’s Association describes Korsakoff syndrome as life-threatening, as it disrupts the brain and leads to confusion, staggering, stumbling, lack of coordination, and abnormal involuntary eye movements. Most of these symptoms resemble those of non-alcohol-related dementias, including confabulation, “Making up information they can’t remember. They are not ‘lying,’ but may believe their invented explanations. The person may also see or hear things that are not there (hallucinations).”
Per the Alzheimer’s Society, the symptoms of alcohol-related dementia (Korsakoff syndrome) can include:
- staying focused on a task without becoming distracted
- solving problems, planning, and organizing
- setting goals, making judgments, and making decisions
- being motivated to do tasks or activities (even essential ones like eating or drinking) controlling their emotions – they may become irritable or have outbursts
- understanding how other people are thinking or feeling (their behavior may seem insensitive or uncaring)
Abstinence from alcohol, as well as a balanced diet and thiamine treatment, can increase the chances of symptom improvement. The syndrome will continue to worsen if the person keeps drinking and does not eat a healthy diet.
The treatment for alcohol-related dementia may include prescription drugs to reduce a person’s craving for alcohol, as well as thiamine replacement, a balanced diet, and counseling or “talk therapies.”
Safety: Alcohol and Brain Injury
Safety is also a concern for people with dementia who consume alcohol. Dementia patients often lack coordination and spatial judgment. Per the American Addiction Centers, people who are intoxicated are more likely to have accidents or falls. The resulting head injuries are linked to an increased risk of dementia. These types of injuries are known as traumatic brain injuries (TBIs) and can cause damage to areas of the brain that lead up to a series of changes that allow proteins that cause dementia to accumulate near the damaged areas. In this situation, a person might be diagnosed with mixed dementia, consisting of the originally diagnosed dementia and TBI-induced dementia.
Safety: Medication and Diagnosis Issues
Some dementia medications do not mix well with alcohol, which can lead to increased side effects, dangerous interactions, and can present as worsened dementia symptoms, as well as a threat to health. Physicians who are not aware of a dementia patient’s alcohol use may also misdiagnose symptoms. For example, they may treat the symptoms as dementia, but may not know that a detox is needed.
5 Tips for Management Alcohol Abuse and Dementia
Daily Caring offers 5 tips to reduce challenging symptoms and behaviors and cope with dementia and alcohol abuse:
1. Remove all alcohol from the environment
- Clear out all alcohol from the residence, including products that contain alcohol
- Ask family and friends to not bring any alcohol into the home
- Notify liquor or grocery stores to not deliver alcohol
- Restrict access to money that can be used to buy alcohol
Note: To prevent withdrawal and other side effects, always talk with your loved one’s physician before removing alcohol from the home.
2. Substitute non-alcoholic wine or beer
You may be able to substitute your loved one’s drink with one that is alcohol-free or low alcohol. Discuss this with your physician, as this practice may prolong the recovery process.
3. Do a safety checkup
Remove dangerous items, like smoking materials, but also ensure you perform a home safety check-up. Remember that safety in the home involves three key areas: Inside the Home, Danger Zones, and Outside the Home.
4. Protect your safety
Be prepared for changes in behavior. Alcoholism and dementia are serious conditions. The changes might be verbal or physically aggressive behaviors, spawned by anger, physical discomfort, confusion, or anxiety produced from withdrawal.
Ensure you are safe. Talk with other caretakers, perhaps through a support group, to gather helpful advice.
5. Determine what is causing the alcohol abuse (get help with this)
Your loved one with dementia may not be new to drinking, and with dementia, they may not be able to articulate why they drink. Attempt to determine if they are depressed, anxious, lonely, or grieving. But this is a good time to bring in the professionals:
- Always ask your physician for advice
- Contact therapists that work with dementia (Example: Find an Alzheimer’s Therapist locator)
- Contact addiction organizations to determine if they have programs for people with dementia (Example: SAMHSA’s National Helpline and locator)
- Contact dementia organizations to find resources for addiction (Example: Alzheimer’s Association Programs and Support)
We Are Here for You
Your journey as a caregiver can be very difficult, and for your own welfare, you do not have to ‘go it alone.’ You may need help so that you are prepared for the immense changes and challenges that come with dementia.
We want to help you with your questions and ease your mind about memory care.
If are in the Round Rock, Texas area, and would like to schedule a family visit or a tour, you may do so online, or by calling us at 512-399-5080.