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June 25, 2008

Alcohol Use, Thiamine Deficiency, and Cognitive Impairment

JAMA. 2008;299(24):2853-2855. doi:10.1001/jama.299.24.2853

To the Editor: In his Clinical Crossroads article, Dr Brust1 discussed the patient Mr E, an older, moderate to heavy alcohol drinker experiencing memory difficulty and an apparently unrelated polyneuropathy. Mild cognitive impairment (MCI), early Alzheimer disease (AD), Wernicke-Korsakoff syndrome, and “alcoholic dementia” were considered as possible diagnoses. Appropriate management of the suggested diagnosis of MCI or early AD for this patient included measures to reduce alcohol dependence and to delay progression of the cognitive impairment. However, many epidemiological studies have failed to identify a positive relationship between moderate alcohol intake (usually up to 1 or 2 drinks daily) and risk of dementia, and they have also found such amounts to be protective.2,3