International Statistical Classification of Diseases and Related

International Statistical Classification of Diseases and Related Health Problems (ICD-10) criteria for ‘alcohol-induced amnesic syndrome’ [45] are more descriptive and detail impairment of recent memory and disturbance of time sense in the absence of impaired immediate recall or generalized cognitive impairment. Another term that is becoming widely Tipifarnib myeloid used is ‘alcohol-related brain damage’ (ARBD) (also called alcohol- related brain impairment), which in some countries has superseded the use of DSM-IV nosology [7]. Some authors do not encompass specific neurological disorders that present with a distinct clinical and neuropathological presentation (for example, Marchiafava-Bignami disease) within this terminology [20], whereas others group these under the ARBD banner [7].

For many clinicians, this term is preferential to ARD because it better accounts for the heterogeneity of presentations, avoids the stigma associated with the term dementia, and distinguishes the non-progressive nature of ARD from other degenerative disorders. DSM-5 looks likely to adopt a similar inclusive approach, with plans to have categories of major and minor ‘neurocognitive disorder due to substance disorder’, which are likely to include an ‘amnestic-confabulatory (Korsakoff)’ subtype, although this is yet to be finalized [46]. Prevalence of alcohol-related cognitive disorders Given the lack of operationally defined diagnostic criteria, it is not surprising that incidence and prevalence estimates of ARD vary in the literature. Epidemiological findings generally have been derived from population studies that relate patterns of alcohol consumption and dementia.

A review by Ritchie and Villebrun [47] established that studies have indicated a high prevalence of alcohol abuse in patients with dementia (9% to 22%) and high rates of dementia in alcohol abusers (10% to 24%), although most studies did not specify the type of dementia. The range in rates may be explained at least partially by differences in criteria for ‘heavy’ alcohol use, varying age limits, and differences in sampling. ARD cases generally have a younger age of onset, and consequently studies that exclude those under 60 years of age may miss a significant proportion of cases [47]. Prevalence studies of dementia subtypes in nursing homes have reported ARD to account for 10% to 24% of all dementias [43,47,48], which is likely higher than in the general population.

Rates of ARD in dementia cases identified in neurology and memory clinics tend to be Carfilzomib lower (around 3% to 5% [49,50]), which may indicate the lack of referrals of these patients to such clinics. Rates of ARD of around 10% were found in an English epidemiological study of younger-onset dementia in specific London districts (onset of less than 65 years) inhibitor licensed [51].

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