Is atrophy connected with dementia?

[quish16]

I am not sure if anyone can help although I have seen a recent post about alcohol abuse and dementia.
My husband is 74 and has had several falls. In April, the scan taken at A and E showed brain atrophy advanced for his age, but in keeping with alcohol abuse. He then fell again in July, and ended up in a and e again and then was diagnosed with an acute on chronic hematoma and sent to a specialist unit then back to local hospital for a total of 2.5 weeks . He came out in august but is still drinking heavily, although he has cut it down to half a litre a day of vodka. My main worry is he is very forgetful. yesterday, he forgot he had taken his strong painkiller at 4pm and thought he had had it in the morning. (I monitor his blood pressure, lupus, gout and vitamin b tablets but he takes his painkillers as he needs them). He insists he is back to normal but forgot that the man from the brain injury trust has been out to see him in mid august. He also had a taxi to the hospital for blood tests but told them t take him to the chemist - fortunately it had been pre booked for the hospital.
My main issue is how to proceed. I did ask the consultant at the hospital if it could be dementia, but after brain surgery he said it wasn't the time to pursue. The doctor seemed to think prior to the hematoma that it was all down to the alcohol abuse. I have tried to get AA for him but had it turned down and am considering an appeal. Basically, I don't feel happy leaving him on his own. He has complained of dizziness and the 3 main risk factors for the heamatoma coming back are
being over 65
having had brain surgery
alcohol abuse.
#I found this on the NHS website.
I am terrified of him falling. He sleeps downstairs because he seems to have an overactive bladder and a bad cough. He also tends to sleep in the day, and whilst I am up at 6am and usually exhausted by 9, he is still wide awake. I don't sleep well due to his coughing and the sheer stress.
I can't get him to seek help for his drinking. His doctor thinks he has stopped and in fairness, when he came out of hospital he drank much less, but it went back up again. He is now trying to cut down again but I am convinced it is interfering with the medications and could actually be dangerous. If I try to talk to him he insists he is back to normal and I am overeacting. He also said some very abusive things when he had the heamatoma building up, and I am very wary, even frightened of him so dare not push him too far.
Basically I feel like a carer but unless he gets AA, I won't get any support. I am not sure if I am right about the dementia - but even last year, he was sleeping through oven timers and once when I came home had left the gas ring on. I don't feel able to leave the house and have only been out twice alone since he came home 8th august - both times to hairdressers, and both times worried sick.
I do at times doubt my instincts. He fell out with my doctor so has moved to a different surgery but I don't think I am allowed to discuss him with his doctor. In fairness, he now has let me come with him for appointments as he is quite deaf and struggles to hear what the doctor says. But I obviously dare not tell the doctor the amount he is drinking.
I just want to leave.........it isn't going to get any better. But we have been married for 22 years and most of it has been very happy but not the last few years.
Thanks for listening just needed to offload.

 

[loveahug]

Hi quish

A warm welcome to TP. It is an awful situation you are stuck with, I am full of admiration for anyone who has to cope with a spouse suffering in that way. Have you approached alcoholics anonymous and AgeUK for support for yourself?

May I suggest you write to your husband's doctor and tell him the whole story about what is going on, how it affects you, what your husband is like on a day to day basis. He may want to involve the community psychiatric team once he has the full picture. also, do you have any family or friends who could act on your behalf and let social services know that YOU are a vulnerable adult and need safeguarding.

Do try and keep yourself safe, set up a refuge room that you can lock yourself into , keep a grab bag packed if you have to leave suddenly, always have a phone with you so you can call for help.

Do take care of yourself first, that way you will always be in a position to do what you can for your husband.

Wishing you much strength, and lots of hugs x

 

[jaymor]

Hi,

There is an illness/disease called Korsakoff's syndrome. It is not exactly dementia but has the same memory loss problems etc. it is associated with heavy drinking. There is a lady in my husband's nursing home who has Korsakoff's syndrome and her behaviour is just the same as the other ladies on her floor who all have dementia. Maybe your husband is suffering from this syndrome and not dementia.

Try to read up on it And see if your Husbands behaviour fits with the symptoms so Korsakoff's and if you think it does try to have a word with your husband's doctor. He can listen to you even if he can't comment.


I hope you get some help soon, it really is a lot to deal with without any help.


Jay


Sent from my iPad using Talking Point mobile app

 

[sue38]

Just to add to what others have said the Society produces a factsheet on Korsakoff's syndrome which you can find >>here<<.

 

[Helenbak]

I am not sure if anyone can help although I have seen a recent post about alcohol abuse and dementia.
My husband is 74 and has had several falls. In April, the scan taken at A and E showed brain atrophy advanced for his age, but in keeping with alcohol abuse. He then fell again in July, and ended up in a and e again and then was diagnosed with an acute on chronic hematoma and sent to a specialist unit then back to local hospital for a total of 2.5 weeks . He came out in august but is still drinking heavily, although he has cut it down to half a litre a day of vodka. My main worry is he is very forgetful. yesterday, he forgot he had taken his strong painkiller at 4pm and thought he had had it in the morning. (I monitor his blood pressure, lupus, gout and vitamin b tablets but he takes his painkillers as he needs them). He insists he is back to normal but forgot that the man from the brain injury trust has been out to see him in mid august. He also had a taxi to the hospital for blood tests but told them t take him to the chemist - fortunately it had been pre booked for the hospital.
My main issue is how to proceed. I did ask the consultant at the hospital if it could be dementia, but after brain surgery he said it wasn't the time to pursue. The doctor seemed to think prior to the hematoma that it was all down to the alcohol abuse. I have tried to get AA for him but had it turned down and am considering an appeal. Basically, I don't feel happy leaving him on his own. He has complained of dizziness and the 3 main risk factors for the heamatoma coming back are
being over 65
having had brain surgery
alcohol abuse.
#I found this on the NHS website.
I am terrified of him falling. He sleeps downstairs because he seems to have an overactive bladder and a bad cough. He also tends to sleep in the day, and whilst I am up at 6am and usually exhausted by 9, he is still wide awake. I don't sleep well due to his coughing and the sheer stress.
I can't get him to seek help for his drinking. His doctor thinks he has stopped and in fairness, when he came out of hospital he drank much less, but it went back up again. He is now trying to cut down again but I am convinced it is interfering with the medications and could actually be dangerous. If I try to talk to him he insists he is back to normal and I am overeacting. He also said some very abusive things when he had the heamatoma building up, and I am very wary, even frightened of him so dare not push him too far.
Basically I feel like a carer but unless he gets AA, I won't get any support. I am not sure if I am right about the dementia - but even last year, he was sleeping through oven timers and once when I came home had left the gas ring on. I don't feel able to leave the house and have only been out twice alone since he came home 8th august - both times to hairdressers, and both times worried sick.
I do at times doubt my instincts. He fell out with my doctor so has moved to a different surgery but I don't think I am allowed to discuss him with his doctor. In fairness, he now has let me come with him for appointments as he is quite deaf and struggles to hear what the doctor says. But I obviously dare not tell the doctor the amount he is drinking.
I just want to leave.........it isn't going to get any better. But we have been married for 22 years and most of it has been very happy but not the last few years.
Thanks for listening just needed to offload.

Hi there, I am also fairly new on here.
My friend in Israel is over 70 and had a liver problem due to his alcohol use some years ago. More recently he began to act very strangely and according to his family had similar symptoms and experiences to those you have noted in your post. If treated with B12 via IV it is possible to achieve improvements and if abstinence remains there is a chance this could be temporary. In your husbands case, you wont know if its something more sinister until he stops drinking and using his painkillers. I wouldn't mind betting that the pills help lift his mood (which if they are opiate based may be why he takes them so frequently,) but in addition to the alcohol his entire system will be depressed to the point that he may well miss the oven alarm and behave in an unattractive manner.
As someone who worked in the drug and alcohol field in the uk for over ten years I feel I have to emphasise to you that you may find it very difficult to get him to access treatment. This perhaps due to a reluctance on your partners side to engage in treatment (you cannot force individuals,) and sometimes it is due to lack of appropriate services in your area. AA is only one of several approaches and in my experience there are those who take a little from each approach rather than commit to just the one so don't be alarmed if you have been "turned down" by AA.
I really do feel for you as I lived with someone who had a drink problem who also abused prescription painkillers, whilst I was trying to work in an environment stuffed with people drinking or using drugs!!! To put dementia into the equation is even more horrifying. My advice to you would be to research all services, try to ascertain how committed your partner is to making changes but most importantly, get some support for yourself and keep yourself safe - the life you are leading will drain you and you need to access services in order to keep sane!! Hope this helps, I am just on my way out so excuse my hurried text.
Best of luck and I do hope things improve for you and that you manage to find support for both of you .

 

[quish16]

Thank you everyone. Actually husband already is on 2 types of vitamin be tablets. AA have been out 3 x almost unheard of - they really tried to help. No critisism. I know I cannot force husband to get help because he has 'mental capacity' and it isn't actually a 'crime' to drink oneself to death.
I did have 6 sessions with a counsellor and she admitted she felt out of her depth. I do know about Alanon but cannot easily get to a meeting.
I breed cats and have 16 so leaving frankly is not an option.
I am glad that you have made me feel my worries are valid. Husband is very clever to the point that he could convince me black was white (he has 47 patents) but it isn't me who had a brain operation!!!!
I am keeping a log so if I do get to see the doctor or in the worst case, call out the emergency services, at least I can point out things that have happened. I frankly feel ihe is a ticking time bomb/accident waiting to happen.
He has said if I call out the ambulance he won't go into hospital and whilst he has mental capacity, he can do this! I do worry sometimes if he has alcohol intoxication or alcohol poisoning. The first set of paperwork for the heart problem puts AF secondary to alcohol toxicity.
I don't frankly know if he is serious about cutting down. He was offered help whilst in hospital but he wasn't interested, and after 2.5 weeks without alcohol, that would have been a great starting point. FYI they have 'alcohol dependant' on his discharge paperwork and other paperwork. I did tell them he drank nearly a litre of vodka a day because if I hadnt the sudden withdrawal could have killed him - they gave him something to help.
I do know about Wernicke Korsakoff syndrome but hopefully the b vitamins will help. I am seeing Age Uk next week for help in appealing against the AA refection.
At the moment, he is trying to cut down again.
Thanks for listening. My doctor is good but basically told me to leave but where do I go with the cats? I just cannot go and I do feel , alcoholism does eventually become an illness not a lifestyle choice. I have had a happy marriage for many years and in some ways feel husband is ill.

 

[quish16]

Oh dear - AA meant Attendance Allowance although we have had people from Alcoholics anon visit 3x. Sorry for confusion.

 

[Helenbak]

Oh dear - AA meant Attendance Allowance although we have had people from Alcoholics anon visit 3x. Sorry for confusion.

Hi again

Yes, not an easy situation for you. 16 units of alcohol is usually the benchmark - anything over this and you are talking dependency levels.
You obviously have been told this but do not go along with sudden cessation as it is very dangerous. A litre of vodka is around 38 units of alcohol so your husband would be at risk of seizure with withdrawals. A steady reduction is the key if he is not prepared to put his name down for a detox. If you have any questions on detox please get back to me but again I will assume you have been told all of this as you are familiar with the illness I referred in my original post to you.
I think you will get to a stage in the near future where you will make up your mind or the situation will worsen naturally. My ex has now been diagnosed with sclerosis of the liver and it is severely damaged. I had to call it a day and he had to leave (easier maybe when you are not married,) because I could not cope with what I deemed a self inflicted condition in addition to looking after my parents needs. I am not sorry I made that decision even though it was difficult to go through and now we are at least friends again which took a good 12 months after he moved out. But at least something was salvaged and if I hadn't have taken a stance he would have continued - as it is now he has really made significant changes. Maybe not soon enough but whilst we were together it was too easy for him to drink and use his pills etc with me being at work and usually the main breadwinner in the end. His teenage daughter was angry with me at first and wouldn't speak to me but over the months has realised that if I had not done what I did her Dad would not have been shocked into taking action and could have been dead now. Our livers can seemingly put up with a lot but when it goes believe me it happens very quickly and then takes some days before............
Anyway I don't want to frighten you but if he can consider a detox and is able to go as an inpatient rather than have a home detox (something that can be done in various areas but is supervised with trained staff,) it will give you time at home for at least a week or two to put things in place to avoid things getting to this stage again. And give you and your cats a bit of rest before he returns - if that is what you both want. His duty to himself (and you,) is then to embark on a relapse prevention programme but, as I said, this is not easy and people fail several times sometimes before they crack it. And they do crack it, I recall some individuals who had spent a lifetime drinking and were well into their 50's. Might take more than one intervention but it can be done if someone wants to do it - better to try than face a bleak future???
I do hope you can come to some agreement with your husband because I bet you don't recognise him sometimes. But there is a chance that if he acts now you may not have to see him go through the changes some of us are watching now with our loved ones who have got non alcohol related dementia.....
Good luck, I am sure many more will give you support on here ;-)

 

[quish16]

Thanks Helen for taking the time to reply.
I am not asking for medical advice but because you worked in detox do you have any opinion of the reliability of liver tests? AH's are ok - was with him when doctor said this. But I have lost cats over the years to kidney and liver failure and have been told that up to 70 even 80% of liver/kidney function can be lost before it shows up as abnormal in tests......also ah has had a sudden drop in cholesterol, with no change of diet and that can sometimes indicate liver problems. He does have very yellow feet that are sometimes lumpy.
No way can we split after 22 years of marriage. He wouldn't leave and I just won't leave the cats. But I am setting boundries - won't for example, buy alcohol for him, he has to do it himself from Tesco online. I don't think at the moment he could look after himself if he lived alone
I am gllad it worked out for your friend. I am trying not to enable him but it is so hard.

He doesn't want to detox and feels he can cut down. But I noticed 9 litres of vodka in the recycling in 14 days and that is rather more than the 400ml he has been writing down. I frankly wonder if he is having alcoholic blackouts and genuinely forgetting the last drink or two - usually in the night when I am in bed.
He has said he will phone the counsellor hospital put him onto today.
I guess the hardest thing is not really knowing what I am dealing with. But he isn't being abusive and he seems very depressed. If we can get back 'in the system' via the alcoholic advice service, run by the hospital, then I can get help for me too - even some
one just to discuss my concerns about alcohol poisoning with. The bottom line is that at 74, AH thinks alcohol hasn't killed him yet! He says he has to die of something. I don't think he realised how distressing a bleed or liver failure can be, not just for him, but for me who loves him. He has no intention of stopping - he has been drinking more years than I have been born and I am 51!
I cn only do my best and thank you for taking time to reply.

 

[greasysprout]

Thanks Helen for taking the time to reply.
I am not asking for medical advice but because you worked in detox do you have any opinion of the reliability of liver tests? AH's are ok - was with him when doctor said this. But I have lost cats over the years to kidney and liver failure and have been told that up to 70 even 80% of liver/kidney function can be lost before it shows up as abnormal in tests......also ah has had a sudden drop in cholesterol, with no change of diet and that can sometimes indicate liver problems. He does have very yellow feet that are sometimes lumpy.
No way can we split after 22 years of marriage. He wouldn't leave and I just won't leave the cats. But I am setting boundries - won't for example, buy alcohol for him, he has to do it himself from Tesco online. I don't think at the moment he could look after himself if he lived alone
I am gllad it worked out for your friend. I am trying not to enable him but it is so hard.

He doesn't want to detox and feels he can cut down. But I noticed 9 litres of vodka in the recycling in 14 days and that is rather more than the 400ml he has been writing down. I frankly wonder if he is having alcoholic blackouts and genuinely forgetting the last drink or two - usually in the night when I am in bed.
He has said he will phone the counsellor hospital put him onto today.
I guess the hardest thing is not really knowing what I am dealing with. But he isn't being abusive and he seems very depressed. If we can get back 'in the system' via the alcoholic advice service, run by the hospital, then I can get help for me too - even some
one just to discuss my concerns about alcohol poisoning with. The bottom line is that at 74, AH thinks alcohol hasn't killed him yet! He says he has to die of something. I don't think he realised how distressing a bleed or liver failure can be, not just for him, but for me who loves him. He has no intention of stopping - he has been drinking more years than I have been born and I am 51!
I cn only do my best and thank you for taking time to reply.

Hi quish16
I know how it feels to live with an alcoholic and it is not good. I don't blame you for wanting to leave. I had to seek help whilst living with my ex partner (died age 56 from drink). Did you know there is a support group for friends and relatives of alcoholics called Alanon? I can't recommend it highly enough. If you decide to look up a group near you, you will meet others in similar circumstances who can share their experience and strategies for coping with the terrible disease of alcoholism. For me it was a lifesaver as well as a life changer. Hope you decide to try it and that you can find some comfort there.

 

[Helenbak]

Thanks Helen for taking the time to reply.
I am not asking for medical advice but because you worked in detox do you have any opinion of the reliability of liver tests? AH's are ok - was with him when doctor said this. But I have lost cats over the years to kidney and liver failure and have been told that up to 70 even 80% of liver/kidney function can be lost before it shows up as abnormal in tests......also ah has had a sudden drop in cholesterol, with no change of diet and that can sometimes indicate liver problems. He does have very yellow feet that are sometimes lumpy.
No way can we split after 22 years of marriage. He wouldn't leave and I just won't leave the cats. But I am setting boundries - won't for example, buy alcohol for him, he has to do it himself from Tesco online. I don't think at the moment he could look after himself if he lived alone
I am gllad it worked out for your friend. I am trying not to enable him but it is so hard.

He doesn't want to detox and feels he can cut down. But I noticed 9 litres of vodka in the recycling in 14 days and that is rather more than the 400ml he has been writing down. I frankly wonder if he is having alcoholic blackouts and genuinely forgetting the last drink or two - usually in the night when I am in bed.
He has said he will phone the counsellor hospital put him onto today.
I guess the hardest thing is not really knowing what I am dealing with. But he isn't being abusive and he seems very depressed. If we can get back 'in the system' via the alcoholic advice service, run by the hospital, then I can get help for me too - even some
one just to discuss my concerns about alcohol poisoning with. The bottom line is that at 74, AH thinks alcohol hasn't killed him yet! He says he has to die of something. I don't think he realised how distressing a bleed or liver failure can be, not just for him, but for me who loves him. He has no intention of stopping - he has been drinking more years than I have been born and I am 51!
I cn only do my best and thank you for taking time to reply.

Sorry I haven't been on here over the weekend so only just got this!!!
Re reliability of liver tests .................... A basic liver function test is not to be considered a reliable indicator. The only way you can be more sure is to get a biopsy.
I didn't realise the age of your other half, I can see now why you were worried whether or not it is a form of dementia or completely alcohol related. Unfortunately it is quite likely that even if someone ceases drinking, the damage has already been done - we kill quite a few of the old brain cells when we use alcohol. Some in AA would call this a "wet brain".
I imagine the best you can hope for is that he does go and get help from the counsellor at the hospital. He probably is depressed. I think most drinkers seem to have the same problem, I always found that particular client group very negative. Possible he is not counting his units correctly or maybe he is just trying to kid himself as well as you. Hang on in there..................as I said, It can be a case of try try and try again but just remember you really do need to look after yourself too. If you get ill you will be no use to him.

 

[quish16]

Thanks for replying. Yes, I have heard about alanon but my local group would mean a £60 taxi fare and also I cannot easily get out at night. I haven't ruled it out though.
Thanks Helen - my research on liver tests agree with what you have put. I know cats can still give normal liver kidney test results when they have lost 70 even 80% of function.
AH is talking to counsellor and says he will try to cut down. I honestly think the health problems we have had last few days, fluntuating blood pressure and pulse plus dizziness and loud heart beat - maybe AF, are due to the interaction of the heart medication, even gout medication and the excess alcohol.
Yes I am looking after myself done a fair bit of research and know I didn't cause, and can't cure or . control his drinking but it is hard.
I did go to my doctor back in april about the personality changes in husband but was told it was late stage alcohol abuse and he didn't feel able to discuss it with me! But it wasn't just that - the hematoma was building up even then. I thought he had had a stroke that had maybe brought on the dementia.
I shall keep on doing my best and will hopefully try to build a relationship with his new doctor and if I am seriously worried again about personality changes, I can at least get advice. I am terrified the hematoma will come back and he must be high risk given his age, previous surgery, and the alcohol which I think can make one more susceptible to bleeding even after a small fall, even coughing fit in some (rare) cases. [