Here’s a sobering thought for the holidays: Chronic heavy drinking can cause insidious damage to the brain, even in people who never seem intoxicated or obviously addicted.

Experts say alcohol-related brain damage is underdiagnosed and often confused with Alzheimer’s disease, other forms of dementia or just getting older.

Now, brain imaging is revealing how long-term alcohol abuse can change the structure of the brain, shrinking gray-matter cells in areas that govern learning, memory, decision-making and social behavior, as well as damaging white-matter fibers that connect one part of the brain with others.

“As we get older, we all lose a little gray-matter volume and white-matter integrity, but in alcoholics, those areas break down more quickly. It looks like accelerated aging,” says Edith Sullivan, a professor of psychiatry and behavioral science at Stanford University, who has studied alcohol’s effects for years.

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