4% of all patients with diagnosed dementia novel but in 22% of dementia patients under 65 [52]. Individuals with ARD are often male, have co-morbid mental and physical conditions (including liver and digestive diseases), and are likely to be identified through hospital admissions [43,52]. Social isolation appears to be a significant factor in the poor identification and treatment of ARD, and a high proportion of patients are unmarried or do not have the support of family or friends [43,53]. These gender and social findings are consistent with reported characteristics of individuals who are heavy users of alcohol [2]. There has been little examination of the prevalence of co-morbid substance abuse, head injuries, or psychological co-morbidities in the ARD population despite evidence that these are linked to the presence and maintenance of substance use disorders in both younger and older adults [13,54].

Most cases of WKS in developed countries relate to the misuse of alcohol, although WKS syndromes following gastrointestinal disorders and systemic diseases can also contribute. While there is no direct correlation between the prevalence of WE and per capita consumption of alcohol, the introduction of thiamine supplementation programs in some countries, as well as general dietary habits, also influences overall rates [16]. Prevalence rates of WKS identified post-mortem are thought to be between 1% and 2% of the general population and around 10% of alcohol misusers in Western countries [16,19].

A study of KS in The Netherlands reported a prevalence of 48 per 100,000 inhabitants [55], and incidence rates of KS in the East End of Glasgow, Scotland, were estimated at around 8 per 100,000 in 1995, a seven-fold increase from 1990 GSK-3 [56]. A study of hospital admissions of patients at least 50 years selleck chem inhibitor old identified 126 cases of KS (0.05% of all admissions) and 77 cases of WE (0.03% of admissions), although there was some overlap in diagnostic groups [52]. There is a need for further epidemiological study of this population by using standardized criteria for diagnosis to increase accuracy in identification of underlying WKS neuropathology and allow overall prevalence rates to be established. Neuropsychological findings Alcohol can have acute and chronic effects on cognitive function. Direct intoxication impairs most cognitive skills and in excess may lead to stupor and respiratory depression. Acute withdrawal in long-term alcohol abusers can result in tremor, hallucinations, seizures, agitation, and fluctuating levels of alertness [14]. Cognitive and behavioral changes specific to ARD have received limited investigation.