Some researchers have found evidence of an enzyme deficiency in alcoholic Korsakoff patients that prevents their bodies from metabolizing thiamine (vitamin B) efficiently (Blass and Gibson 1977; Bowden 1990; see also the article by Langlais, pp. 113–121). This deficiency could be genetically inherited or environmentally induced. Therefore, people who suffer from a metabolic disorder that does not permit the body’s normal use of thiamine or who do not eat enough thiamine-containing foods (e.g., if alcohol comprises most of their diets) may be at risk for developing cognitive impairments (and structural brain changes, which may occur before the impairments arise) associated with Korsakoff’s syndrome.4 Regardless of the actual cause of alcoholic Korsakoff’s syndrome, its incidence is quite low. According to one estimate, only 10 per 1 million (.001 percent) of patients admitted for the first time into a psychiatric clinic exhibit characteristics of alcoholic Korsakoff’s syndrome (Centerwall and Criqui 1978).
