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Alcohol-Related Dementia

Validation of Diagnostic Criteria

Received July 24, 2002; revised December 2, 2002; accepted December 16, 2002. From the Section of Geriatric Psychiatry, Department of Psychiatry, University of Pennsylvania, Philadelphia, PA (DWO), the Center for the Study of Addictions, Department of Psychiatry, University of Pennsylvania, Philadelphia, PA (DWO), the Philadelphia VA Medical Center and VISN 4, MIRECC (DWO), and the Department of Epidemiology and Biostatistics, University of Pennsylvania, Philadelphia, PA (MSC). Address correspondence to Dr. Oslin, University of Pennsylvania, 3535 Market Street, Room 3002, Philadelphia, PA 19104. e-mail: oslin{at}mail.med.upenn.edu

Objective: The authors sought to validate the diagnostic criteria for alcohol-related dementia. Methods: The sample consisted of veterans consecutively admitted to a 240-bed VA Nursing Home Care Unit. Baseline and follow-up assessments included measures of cognition and functioning. The diagnosis and type of dementia was determined within 2 months of admission by a geropsychiatrist using patient interviews, chart review, and information from a structured collateral interview. Residents were followed for up to 2 years. Results: Data were collected on 192 of the residents, of whom, 158 (82%) were diagnosed with some form of dementia. Alcohol-related dementia (ARD) was diagnosed in 16 residents (10.1%), probable Alzheimer dementia (AD), in 26 (16.5%); vascular dementia (VD), in 46 (29.1); and mixed or dementia of undetermined origin, in 70 (44.3%). Those with ARD were less cognitively impaired and were more often unmarried. Residents with ARD demonstrated a stabilization of both cognition and functional status, whereas those with AD and VD showed a general decline in both cognition and functional status. Conclusion: These results serve to validate the diagnostic criteria for ARD and suggest that abstinence may be of clinical value in treating patients with dementia and alcohol dependence. Further research needs to be conducted to confirm the value of abstinence.

Key Words: alcohol abuse • dementias • diagnostic criteria

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