Dementia due to metabolic causes

Definition

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
  o Addison's disease
  o Cushing's disease
  o Diabetic nephropathy
  o Diabetic ketoacidosis
  o Insulinoma or hypoglycemia
  o Hypoparathyroidism
  o Hyperparathyroidism
  o Hypothyroidism
  o Thyrotoxicosis
  o Pheochromocytoma
  
• Metabolic disorders
  o Acid/base disorders of any type
  o Fluid electrolyte disorders of any type
  o Hyponatremia
  o Hypercalcemia
  o Kidney failure, with uremia
  o Liver disease
  o Porphyria
  
• Nutritional disorders
  o Vitamin B-1 deficiency
  o Vitamin B-12 deficiency
  o Pellagra
  o 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)