Quality of life of patients with Korsakoff's syndrome and patients with dementia: a cross-sectional study.

OBJECTIVES: Korsakoff's syndrome (KS) is a chronic disorder caused by thiamine (vitamin B1) deficiency and alcoholism. The disorder is characterized by severe amnesia and often compared with dementia. The purpose of this study was to compare the quality of life between patients with KS and patients with dementia from the same nursing homes. DESIGN: Cross-sectional study design. SETTING: Three nursing homes in the Netherlands. PARTICIPANTS: Participants were 72 patients diagnosed with KS and 75 patients diagnosed with dementia through extensive neuropsychological evaluation and multidisciplinary diagnostics. MEASUREMENTS: Quality of life (QoL) was scored with the QUALIDEM scale. Multivariate linear regression analysis was used to compare QoL between patients with KS and patients with dementia, applying the covariates "age," "gender," and "nursing home." RESULTS: Of the 147 included patients, 72 (48.9%) were diagnosed with KS. Overall QoL was higher in KS. Patients with KS scored better than patients with dementia on the QUALIDEM subscales "Restless tense behavior," "Social relations," and "Having something to do." A trend toward a better score was found for the subscale "Positive affect"; a trend toward a lower score was found for "Feeling at home." CONCLUSIONS: KS is associated with profound differences in QoL compared with dementia. Patients with KS tend to have more social relationships and more positive emotions than patients with dementia. Furthermore, patients with dementia show more restless behavior than patients with KS; however, patients with KS tend to feel less at home in a nursing home than patients with dementia. Results suggest that both patients with dementia and patients with KS are in need of specialized nursing homes and care programs to accomplish their specific needs.

Evolution of Wernicke-Korsakoff syndrome in self-neglecting alcoholics: preliminary results of relation with Wernicke-delirium and diabetes mellitus.

We present a descriptive, retrospective study of initial symptoms, comorbidity, and alcohol withdrawal in 73 alcoholic patients with subsequent Korsakoff syndrome. In 25/73 (35%) of the patients the classic triad of Wernicke's encephalopathy with ocular symptoms, ataxia and confusion, was found. In at least 6/35 (17%) of the initial deliria (95% confidence interval: 10-25%) we observed no other underlying causes, thus excluding other somatic causes, medication, (recent) alcohol withdrawal, or intoxication. We suggest that these deliria may have been representing Wernicke's encephalopathy. A high frequency (15%) of diabetics may reflect a contributing factor of diabetes mellitus in the evolution of the Wernicke-Korsakoff syndrome.