Dementia due to metabolic causes is a deterioration of mental function caused by various metabolic disorders.
Causes, incidence, and risk factors
Dementia associated with metabolic disorders may cause reversible or irreversible confusion and changes in intellect or reasoning.
Metabolic causes of dementia include, but are not limited to:
Endocrine disorders
Addison's disease
Cushing's disease
Diabetic nephropathy
Diabetic ketoacidosis
Insulinoma or hypoglycemia
Hypoparathyroidism
Hyperparathyroidism
Hypothyroidism
Thyrotoxicosis
Pheochromocytoma
Metabolic disorders
Acid/base disorders of any type
Fluid electrolyte disorders of any type
Hyponatremia
Hypercalcemia
Kidney failure, with uremia
Liver disease
Porphyria
Nutritional disorders
Vitamin B-1 deficiency
Vitamin B-12 deficiency
Pellagra
Protein-calorie malnutrition
Symptoms
Slowly progressive loss of memory, judgment, or intellectual function
Personality changes
Decrease of movement, sensation, speech, hearing, vision, or other brain functions
Disorientation to person, place, or time
Language difficulties
Loss of bladder control
Note: Additional symptoms associated with the causative disorder may also be present.
Signs and tests
A neurologic examination shows various abnormalities depending on the cause. Abnormal reflexes may be present.
Tests for suspected causes may include, but are not limited to:
Thyroid function tests
Blood glucose level, glucose tolerance tests
Blood chemistry, electrolytes
Liver function tests
Ammonia level in the blood
BUN, creatinine (to test for kidney disorders)
Nutritional assessment
B-12 level
Urinalysis
EEG, electroencephalograph
Head CT scan
Head MRI scan
Other tests, sometimes including lumbar puncture (spinal tap)
Treatment
Treatment focuses on the cause of the disorder and controlling symptoms. Treatment of the cause may include medicines, dietary supplements, or other measures (see the specific cause). Progression of symptoms may require 24-hour monitoring and care in the home or in an institutionalized care setting.
Long-term care may includes environmental safety and control of aggression or agitated behavior through behavior modification or medications.
Expectations (prognosis)
The outcome varies depending on the cause and the extent of damage to the brain.
Complications
Irreversible brain injury
Inability to function or care for self
Inability to interact with others
Increased occurence of infections anywhere in the body
Other complications (see the specific cause of disorder)
Side effects of medications used to treat the disorder (see the specific medication)
Calling your health care provider
Call your health care provider if symptoms indicating dementia may be present.
Call for an appointment if symptoms worsen or persist despite treatment of metabolic causes, or if new symptoms develop.
Go to the emergency room or call the local emergency number (such as 911) if there is a sudden change in mental status, or if there is a life-threatening emergency.
Prevention
Treatment of associated disorders may reduce the risk of developing dementia due to metabolic causes. Update Date: 5/8/2003Updated by: Elaine T. Kiriakopoulos, M.D., M.Sc., Department of Neurology, Beth Israel Deaconess Medical Center, Harvard University, Boston, MA. Review provided by VeriMed Healthcare Network.
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