41 Korsakoff’s syndrome: neurocognitive domains impairments and potential therapeutic interventions

Abstract

Objectives/aims To explore the burden of neurocognitive impairments in a cohort of Individuals with Korsakoff’s psychosis requiring current long stay psychiatric care. To consider additional therapeutic interventions to target the health care burden potentially created by these comorbidities. Methods As part of a comprehensive systematic review of Korsakoff’s Psychosis, an audit was performed of 114 Individuals currently requiring long-term care in an approved psychiatric facility during the year of 2018. Medical and psychiatric diagnoses as well as pharmacological histories were examined. Alcoholic and non-alcoholic aetiologies were considered, the latter may be underdiagnosed (Nikolakaros et al, 2018). Results Thirteen individuals were identified with a formal diagnosis of Korsakoff’s syndrome (KS) and all continue to require structured Inpatient care due to their levels of neurocognitive impairment and psychiatric presentations. Episodic memory is severely affected, as is the learning of new semantic memories. Patients with Korsakoff’s psychosis are capable of new learning in a calm, structured environment with cued new information (Kopelman et al, 2009). Conclusions Individuals with Korsakoff’s psychosis may have comorbid psychiatric symptoms including mood, anxiety, aggression or psychotic disorders that command therapeutic interventions. Specific memory targeting intervention may not prioritized. Potential therapeutic interventions include Errorless learning (EL) which target levels of competence and independence (Rensen et al, 2017). EL is reported to improve symptoms of psychosis, aggression, apathy or mood disorders. Behavioural Interventions include environmental adaptations and cognitive remediation, which may be combined with pharmacological approaches such as donepezil or memantine to target cognition (Johnson and Fox, 2018). However, these approaches are not identical to those required by Alzheimer’s disease or other dementing disorders. Epidemiological and genomic studies could be preformed to identify those particularly at risk of developing this potentially life-altering condition. References Nikolakaros, G., Kurki, T., Paju, J., Papageorgiou, S.G., Vataja, R., llonen, T. Korsakoff Syndrome in Non-alcoholic Psychiatric Patients Variable Cognitive Presentation and Impaired Frontotemporal Connectivity. Frontiers in Psychiatry 2018;9(204). Kopelman M.D., Thomson, A.D., Guerrini, I., Marshall, E.J. The Korsakoff Syndrome: Clinical Aspects, Psychology and Treatment. Alcohol & Alcoholism 2009;44(2):148–154. Rensen, Y, Egger, J, Westhoff, J., Walvoort, S., Kessels, R. (2017) The effect of errorless learning on quality of life in patients with Korsakoff’s syndrome. Neuropsychiatric Disease and Treatment 2017;13:2867–2873. Johnson, J.M., and Fox, V. Beyond Thiamine: Treatment for Cognitive Impairment in Korsakoff’s Syndrome. Psychosomatics 2018;59(4):311–317.