Wobbly walking and clumsy moves are classic signs that someone's been drinking, and a new study suggests balance problems can afflict heavy drinkers for years after they sober up.
Researchers at Neurobehavioral Research Inc., in Honolulu, compared the balance abilities and gaits of diagnosed alcoholics who had been sober for several weeks, those who had been sober for an average of seven years, and people with no history of alcohol dependence.
Each participant was put through a three-part test "similar to the things that might be done in field sobriety tests," said Dr. George Fein, principal investigator for the study published today (Sept. 15) in the journal in Alcoholism: Clinical and Experimental Research.
The volunteers were first screened for recent drug and alcohol use, then asked to perform a series of balance tests such as standing heel-to-toe with their arms folded across the chest for 60 seconds, standing on one leg, or walking along a line. Each test was repeated with the volunteers' eyes closed.
Of the more than 200 volunteers, the 70 recently sober ones — who had not had alcohol for six to 15 weeks — performed the worst. But in tasks with their eyes closed, the 82 long-sober volunteers also performed noticeably worse than the 52 people who had never been alcoholics. (The researchers controlled for the effect of age on balance.)
"There's an 80 to 90 percent recovery, but there's still some residual effects," said Fein, the senior scientist and lab director at the company.
Alcohol's effects on the brain
Balance problems are commonly seen among the recently sober in detoxification centers.
"In the first year of recovery, generally, more minor accidents occur than in the year preceding," said Dr. Ken Thompson, medical director at Caron Treatment Centers.
Addiction experts attribute this "temporary ataxia," or lack of muscle coordination, to damage to the cerebellum in the brain, said Dr. Kevin P. Hill, psychiatrist-in-charge at the Alcohol and Drug Abuse Treatment Center at McLean Hospital in Belmont, Mass.
Until now, balance problems that continue for years after sobriety have usually been noted only in extreme cases, such as in people whose alcohol abuse led to a form of psychosis, said Fein.
"What we have shown is that these [coordination] effects are present in alcoholics in the general population," Fein said.
While the study implies there is "a point of no return where the brain cannot recover," Hill said the findings underline the importance of viewing alcohol addiction as a disease.
"A lot of people don't think about addictions as chronic medical illnesses, but they are in every way," Hill said, explaining that alcohol addiction has a genetic link and long-term health effects.
"Just as a person with diabetes might ultimately develop loss of sensation and feeling in extremities, people with alcohol addiction might permanently lose balance and coordination," Hill said.
Thompson said improvement in many measures of coordination and brain function will show up years after the start of sobriety. "The findings of balance problems in long-term recovering alcoholics might not be clinically significant in the majority of clients," he said.
Fein said researchers would have to keep track individuals through their sobriety years to show a stronger link between drinking and balance problems after their recovery.
From a safety viewpoint, Fein said his team would like to study the elderly, who are at most risk for health consequences after a fall.
Pass it on: Years after sobering up, heavy drinkers may still suffer balance problems.