Dementia due to metabolic causes
Dementia is loss of brain function that occurs with certain diseases. Dementia may also be referred to as major neurocognitive disorder.
Dementia
Dementia is a loss of brain function that occurs with certain diseases. It affects one or more brain functions such as memory, thinking, language, j...
Read Article Now Book Mark ArticleDementia due to metabolic causes is a loss of brain function that can occur with abnormal chemical processes in the body. With some of these disorders, if treated early, brain dysfunction can be reversed. Left untreated, permanent brain damage, such as dementia, can occur.
Causes
Possible metabolic causes of dementia include:
- Hormonal disorders, such as Addison disease, Cushing disease
- Heavy metal exposure, such as to lead, arsenic, mercury, or manganese
- Repeat episodes of low blood sugar (hypoglycemia), most often seen in people with diabetes who use insulin
Hypoglycemia
Low blood sugar is a condition that occurs when the body's blood sugar (glucose) decreases and is too low. Blood sugar below 70 mg/dL (3. 9 mmol/L) i...
Read Article Now Book Mark Article - High level of calcium in the blood, such as due to hyperparathyroidism
Hyperparathyroidism
Hyperparathyroidism is a disorder in which 1 or more of the parathyroid glands in your neck produce too much parathyroid hormone (PTH).
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Low level of thyroid hormone (hypothyroidism) or high level of thyroid hormone (thyrotoxicosis) in the body
Hypothyroidism
Hypothyroidism is a condition in which the thyroid gland does not make enough thyroid hormone. This condition is often called underactive thyroid....
Read Article Now Book Mark ArticleThyrotoxicosis
Hyperthyroidism is a condition in which the thyroid gland makes too much thyroid hormone. The condition is often called overactive thyroid.
Read Article Now Book Mark Article - Liver cirrhosis
Liver cirrhosis
Cirrhosis is scarring of the liver and poor liver function. It is the last stage of chronic liver disease.
Read Article Now Book Mark Article - Kidney failure
- Nutritional disorders, such as vitamin B1 deficiency, vitamin B12 deficiency, pellagra, or protein-calorie malnutrition
- Porphyria
- Poisons, such as methanol
- Severe alcohol use
- Wilson disease
- Disorders of the mitochondria (energy-producing parts of cells)
- Rapid changes in sodium level
Symptoms
Metabolic disorders may cause confusion and changes in thinking or reasoning. These changes may be short-term or lasting. Dementia occurs when the symptoms are not reversible. Symptoms can be different for everyone. They depend on the health condition causing the dementia.
Confusion
Confusion is the inability to think as clearly or quickly as you normally do. You may feel disoriented and have difficulty paying attention, remembe...
Read Article Now Book Mark ArticleThe early symptoms of dementia can include:
- Difficulty with tasks that take some thought but used to come easily, such as balancing a checkbook, playing games (such as bridge), and learning new information or routines
- Getting lost on familiar routes
- Language problems, such as trouble with names of familiar objects
- Losing interest in things previously enjoyed, flat mood
- Misplacing items
- Personality changes and loss of social skills, which can lead to inappropriate behaviors
- Mood changes that can cause periods of aggression and anxiety
- Poor performance at work resulting in demotion or loss of job
As the dementia gets worse, symptoms are more obvious and interfere with the ability to take care of yourself:
- Changing sleep patterns, often waking up at night
- Forgetting details about current events, forgetting events in one's life history
- Having difficulty doing basic tasks, such as preparing meals, choosing proper clothing, or driving
- Having hallucinations, arguments, striking out, and behaving violently
- More difficulty reading or writing
- Poor judgment and losing the ability to recognize danger
- Using the wrong word, not pronouncing words correctly, speaking in confusing sentences
- Withdrawing from social contact
The person may also have symptoms from the disorder that caused dementia.
Exams and Tests
Depending on the cause, a nervous system (neurologic) examination is done to identify the problems.
Tests to diagnose a medical condition causing the dementia may include:
- Ammonia level in the blood
- Blood chemistry, electrolytes
- Blood glucose level
Blood glucose level
A blood sugar test measures the amount of a sugar called glucose in a sample of your blood. Glucose is a major source of energy for most cells of the...
Read Article Now Book Mark Article - BUN, creatinine to check kidney function
- Liver function tests
- Lumbar puncture (spinal tap)
- Nutritional assessment
- Thyroid function tests
Thyroid function tests
Thyroid function tests are used to check whether your thyroid is working normally. The most common thyroid function tests are:Free T4 (the main thyro...
Read Article Now Book Mark Article - Urinalysis
Urinalysis
Urinalysis is the physical, chemical, and microscopic examination of urine. It involves a number of tests to detect and measure various compounds th...
Read Article Now Book Mark Article - Vitamin B12 level
To rule out certain brain disorders, an EEG (electroencephalogram), head CT scan, or head MRI scan is usually done.
EEG
An electroencephalogram (EEG) is a test to measure the electrical activity of the brain.
Read Article Now Book Mark ArticleHead CT scan
A head computed tomography (CT) scan uses many x-rays to create pictures of the head, including the skull, brain, eye sockets, and sinuses.
Read Article Now Book Mark ArticleHead MRI scan
A head MRI (magnetic resonance imaging) is an imaging test that uses powerful magnets and radio waves to create pictures of the brain and surrounding...
Read Article Now Book Mark ArticleTreatment
The aim of treatment is to manage and correct the underlying disorder and control symptoms. With some metabolic disorders, treatment may stop or even reverse the dementia symptoms.
Medicines used to treat Alzheimer disease have not been shown to work for these types of disorders. Sometimes, these drugs are used anyway, when other treatments fail to control the underlying problems.
Alzheimer disease
Dementia is a loss of brain function that occurs with certain diseases. Alzheimer disease (AD) is the most common form of dementia. It affects memo...
Read Article Now Book Mark ArticlePlans should also be made for home care for people with dementia.
Outlook (Prognosis)
Outcome varies, depending on the cause of the dementia and the amount of damage to the brain.
Possible Complications
Complications may include the following:
- Loss of ability to function or care for self
- Loss of ability to interact
- Pneumonia, urinary tract infections, and skin infections
Pneumonia
Pneumonia is a breathing (respiratory) condition in which there is an infection of the lung. This article covers community-acquired pneumonia (CAP). ...
Read Article Now Book Mark ArticleUrinary tract infections
A urinary tract infection, or UTI, is an infection of the urinary tract. The infection can occur at different points in the urinary tract, including...
Read Article Now Book Mark Article - Pressure sores
Pressure sores
A pressure sore is an area of the skin that breaks down when something keeps rubbing or pressing against the skin.
Read Article Now Book Mark Article - Symptoms of the underlying problem (such as loss of sensation due to a nerve injury from vitamin B12 deficiency)
When to Contact a Medical Professional
Call for an appointment with your health care provider if symptoms get worse or continue. Go to the emergency room or call 911 or the local emergency number if there is a sudden change in mental status or a life-threatening emergency.
Prevention
Treating the underlying cause may reduce the risk for metabolic dementia.
Reviewed By
Joseph V. Campellone, MD, Department of Neurology, Cooper Medical School at Rowan University, Camden, NJ. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
Budson AE, Solomon PR. Other disorders that cause memory loss or dementia. In: Budson AE, Solomon PR, eds. Memory Loss, Alzheimer's Disease, and Dementia. 3rd ed. Philadelphia, PA: Elsevier; 2022:chap 17.
Knopman DS. Cognitive impairment and dementia. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 374.
Peterson R, Graff-Radford J. Alzheimer disease and other dementias. In: Jankovic J, Mazziotta JC, Pomeroy SL, Newman NJ, eds. Bradley and Daroff's Neurology in Clinical Practice. 8th ed. Philadelphia, PA: Elsevier; 2022:chap 95.