This is the first study of its kind in Ireland into ARBI, a term used to describe the physical impairment to the brain sustained as a direct result of alcohol consumption. In the period 2005-2009 the survey found that 104 Donegal residents were admitted to hospital with ARBI. The total for the HSE North West region, covering Donegal, Sligo, Leitrim and Roscommon was 163.
Research suggests that ARBI also accounts for 10% of the dementia population and for 12.5% of dementias of people under-65.
This suggests that in Donegal alone up to 147 patients may have an ARBI within this group. The number of ARBI sufferers is expected to increase as a result of population trends and changing patterns of alcohol consumption. There is also evidence that the condition is under-diagnosed in Ireland.
The report outlines a summary of the work undertaken to identify the incidences of ARBI in the HSE West (Donegal, Sligo, Leitrim) and Western Health and Social Care Trust in Northern Ireland (Limavady, Derry, Strabane, Omagh & Fermanagh).
Explaining the motivation for undertaking this research, Eamon O’Kane, Director of NWAF, said:
“We felt that the lack of accurate research was impairing the diagnosis of ABRI within the North West/Cross Border region and as such the entire country. We embarked on a comprehensive study that set out to identify the number of people suffering from ARBI within a specific geographic area on the North West cross border axis. Our report outlines how best to respond and highlights best practice actions and recommendations that would greatly improve the care of patients with ARBI in this country.
“These are based on the research’s investigation into this complex condition in Australia, Scotland, Wales and England.”
ARBI is often described as the invisible condition because of its complexity in terms of diagnosis. The condition is associated with non-traumatic brain injury brought about by factors leading to a degeneration of physical and mental well-being. This is distinguished from injury brought about by physical trauma, known as acquired brain injury (ABI).
Given appropriate care half of those with an ARBI can make a complete or significant recovery, whilst a quarter will make no recovery at all. Often, people with ARBI may be placed in inappropriate care or accommodation settings.
Despite the lack of a formal care pathway for people with ARBI, work has been initiated in the HSE (Donegal) to develop a discharge pathway for patients with ARBI.
Mr. O’Kane continued: “Most patients do not have access to these multi-disciplinary teams, and for this very reason, creating and implementing a plan of action is imperative for proper recognition of, and treatment for, ARBI within our health and social care system.”
The study found that ARBI can also be associated with poor nutrition as well as a range of physical and mental health problems, and there is evidence of a concentration of ARBI in areas of high socio-economic deprivation.
In addition, people with ARBI are often socially isolated, many having incurred social, financial, occupational, physical and forensic difficulties as a consequence of years of problematic drinking.
There is no single cause of ARBI, which usually results from a combination of factors.
These include toxic effects of alcohol on brain cells, vitamin and nutritional deficiencies, head injuries and disturbances to the blood supply to the brain.
“Heavy drinkers are not likely to know that they could be developing an ARBI condition due to lack of insight and awareness,” Mr. O’Kane explained.
“Those heavy drinkers are not likely to turn up in the health system until they become sick, by which time cognitive decline is likely to already have begun.”
North West Alcohol Forum commenced this study in an effort to raise public awareness on the hidden implications of the damage excessive alcohol use can have on the brain.