Alcohol-Related Cognitive Impairment - A Continuum from Subthreshold Drop in Efficiency up to Severe Dementia?

Alcohol abuse may contribute to cognitive impairment by several different ways. Cognitive impairment may reach from subtle deficits to severe dementia, which may be reversible (at least in part) or permanent. Chronic cognitive impairment caused by direct neurotoxic effects of ethanol alone is very rare; mostly it is combined with neurological or other somatic syndromes due to alcohol or alcohol is acting as a co-factor. Neurobiological correlates are not highly specific. Different pathogenetic pathways are matter of debate, the perspective of neurogenesis may lead to a better understanding. Wernicke-Korsakoff syndrome is holding a privileged position, but traditional concepts of Wernicke-Korsakoff complex probably must be reversed. Only abuse of alcohol does increase risk of dementia, whereas moderate consumption is related to decreased risk, even compared to abstainers. ''Alcohol-relatedcognitive'' impairment appears to be suitable as a collective term to mark these syndromes. With regard to symptomatically therapeutic approaches there is not yet sufficient evidence.