Health Encyclopedia

Dementia due to metabolic causes

Definition

Dementia due to metabolic causes is a loss of mental function that can occur with diabetes, thyroid disease, and other metabolic disorders.

Causes, incidence, and risk factors

How often this condition affects different ages, genders, and races varies based on the disorder that's causing the dementia.

Metabolic causes of dementia include:

Endocrine disorders
Metabolic disorders
- Acid/base disorders of any type
- Fluid electrolyte disorders of any type
- Hypercalcemia
- Hyponatremia
- Kidney failure with uremia
- Liver disease
- Porphyria
Nutritional disorders
- Vitamin B1 deficiency
- Vitamin B12 deficiency
- Pellagra
- Protein-calorie malnutrition

Symptoms

Dementia that occurs with metabolic disorders may cause confusion and changes in intellect or reasoning. These changes may be temporary or permanent.

Decrease in:
- Feeling (sensation)
- Hearing
- Movement
- Speech
- Vision
Difficulty making sense of person, place, or time
Language difficulties
Loss of bladder control
Personality changes
Slowly worsening loss of:
- Intellectual function
- Judgment
- Memory

Note: The person may also have symptoms from the disorder that caused dementia.

Signs and tests

An examination of the nervous system (neurologic examination) can show different problems, depending on the cause. Abnormal reflexes may be present.

Tests may include:

Ammonia level in the blood
Blood chemistry, electrolytes
Blood glucose level, glucose tolerance tests
BUN, creatinine
Electroencephalograph (EEG)
Head CT scan
Head MRI scan
Liver function tests
Lumbar puncture (spinal tap)
Mental status test
Nutritional assessment
Thyroid function tests
Urinalysis
Vitamin B12 level

Treatment

Treatment focuses on the cause of the disorder and on controlling symptoms. Treatment of the cause may include:

Dietary supplements
Medicines

As the symptoms get worse, the person may need 24-hour monitoring and care in the home or in a care facility.

Long-term care may include:

Controlling aggression or agitation with behavior modification or medication
Safety measures to protect the person from injury

Expectations (prognosis)

The outcome varies depending on the cause of the dementia and the amount of damage to the brain.

Complications

Brain injury that is not reversible
Complications from the condition that is causing the dementia
Inability to function or care for self
Inability to interact with others
Increased infections anywhere in the body
Side effects of medications used to treat the disorder

Calling your health care provider

Call your health care provider if you have symptoms of dementia.

Call for an appointment if your symptoms get worse or continue, even with treatment for the metabolic cause, or if you have new symptoms.

Go to the emergency room or call the local emergency number (such as 911) if there is a sudden change in mental status or a life-threatening emergency.

Prevention

Treating the metabolic disorder may reduce the risk of developing this type of dementia.

References

Farlow MR, Cummings JL. Effective pharmacologic management of Alzheimer's disease. Am J Med, 2007;120:388-397.

Goetz CG. Goetz: Textbook of Clinical Neurology. 3rd ed. Philadelphia, Pa: Saunders;2007.

Review Date:2/13/2008
Reviewed By:Luc Jasmin, MD, PhD, Departments of Anatomy & Neurological Surgery, University of California, San Francisco, CA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

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