Consider referring a patient with Korsakoff syndrome to specialist services for further evaluation and management when:
- They have moderate or severe cognitive impairment requiring supported 24-hour care, as specialist services can provide an adapted environment and support to maintain abstinence from alcohol.
- They have mild cognitive impairment and may benefit from supported independent living arrangements facilitated by specialist services.
- There is a need for long-term placement planning to ensure appropriate care and support tailored to the severity of cognitive impairment.
Referral to specialist inpatient alcohol services is also indicated when patients are entering planned assisted alcohol withdrawal and are malnourished or at risk of malnourishment, or have decompensated liver disease, to provide parenteral thiamine and prevent progression to or worsening of Wernicke-Korsakoff syndrome.
Additionally, if the patient has significant comorbid mental health disorders or is assessed to be at high risk of suicide, referral to a psychiatrist is recommended to ensure effective assessment, treatment, and risk management.
These steps ensure comprehensive management of Korsakoff syndrome and its complications, including cognitive impairment and associated mental health issues.
References: NICE CG115