Alcohol Use in the Elderly and the Risk for Wernicke-Korsakoff Syndrome

Two diseases linked with alcohol-related brain damage are Wernicke's encephalopathy (WE) and Korsakoff syndrome (KS) or psychosis, also referred to as Wernicke-Korsakoff syndrome (WKS). Thiamine deficiency is the underlying etiology for alcohol-related WKS. Persons older than 65 who have consumed alcohol at levels exceeding recommendations over a long period, even without a diagnosis of alcohol dependence, are at risk for WKS. Obtaining an alcohol-use history from people over 65 is essential to preventing WKS. The main purpose of this article is to provide the nurse practitioner with strategies for identifying persons over 65 at risk for alcohol-related thiamine deficiency, including screening for alcohol use and obtaining an alcohol-use history. This is followed by a review of the role and physiology of thiamine, laboratory tests that can be used to screen for thiamine deficiency, and prevention and early treatment.