Metabolic Dementia

Dementia is a condition that is more common in elderly adults. It involves a decline in your ability to think (cognition) and your memory. Cognitive changes and memory loss are often subtle at first and increase over time. Most cases of dementia are not detected until months or years after they begin.

Various health conditions can contribute to the development of dementia. One particular type of dementia can occur as a result of changes in metabolism. It is known as metabolic dementia.

Metabolism refers to physical and chemical processes that occur in your body. Certain health conditions such as those that affect the liver, uncontrolled diabetes or conditions caused by abnormal functioning of glands such as the thyroid, the hyperparathyroid and the adrenal glands can change your metabolism. If these conditions are not treated, they can cause long-term changes in your metabolism. These long-term changes can result in the development of metabolic dementia.

Metabolic dementia can be caused by various health conditions that change normal physical and chemical processes that occur in your body. Examples of conditions that can lead to metabolic dementia include:

• endocrine disorders (such as Addison’s disease or Cushing’s disease)
• exposure to heavy metals (such as lead, arsenic, or mercury)
• frequent episodes of hypoglycemia (low blood sugar)
• high levels of calcium in the blood caused by hyperparathyroidism
• low or high levels of thyroid hormone
• cirrhosis of the liver
• vitamin deficiencies (including B1 and B12)

The symptoms of metabolic dementia are different for each affected person. However, dementia often results in confusion and changes in thinking. These changes may last for several minutes or several months. In the early stages of the disease, confusion may be mild and may not be readily recognized. Specific examples include:

• the inability to perform simple tasks (such as cooking or washing clothes)
• getting lost on the way to familiar places (such as the grocery store)
• difficulty with finding the name for familiar objects
• misplacing items
• changes in mood
• changes in personality
• loss of social skills

As dementia progresses, the symptoms may become more obvious. These symptoms may prevent the patient from caring for himself or herself. Symptoms common in later stages of dementia can include:

• forgetting one’s life history and important events
• difficulty completing basic tasks (such as cooking, bathing, or dressing)
• difficulty reading or writing
• hallucinations
• argumentative or violent behavior
• inability to recognize danger
• withdrawing from social contact
• inability to pronounce words correctly

The diagnosis of metabolic dementia requires both the diagnosis of dementia and the diagnosis of problems with metabolism. Dementia is typically diagnosed by your doctor. Your doctor will review your current symptoms and health history. Your doctor may also perform a neurological exam (an exam of your nervous system).

If you are diagnosed with dementia, your doctor may order additional tests. These tests will be used to determine if your condition is caused by a metabolic problem. Blood tests for metabolic disorders are common and they can include:

• ammonia levels
• electrolytes
• blood glucose levels
• BUN (blood urea nitrogen) and creatinine to measure kidney function
• liver function tests
• thyroid function tests
• vitamin B12 level

In addition, your doctor may also order:

• a spinal tap (lumbar puncture)
• a urine test (urinalysis)
• a nutritional assessment
• a head CT or MRI to rule out other conditions such as a brain tumor

Information collected from all of these tests will help your doctor to determine if you have metabolic dementia.

There is no cure for metabolic dementia. Treatment involves controlling the symptoms of the disorder. Drugs have been developed to treat other forms of dementia including Alzheimer’s disease. These drugs have not been shown to be effective for the treatment of metabolic dementia. However, the metabolic conditions that are causing the dementia are often treatable.

Treatment may include intervention to control the underlying health problem. In patients with diabetes, better control of blood sugar may slow the progression of the disease. Prognosis will depend on the severity of symptoms and the amount of brain damage that occurs. Sometimes, the progression of the dementia caused by nutritional disorders or by high blood pressure, can be stopped or even reversed. The reversal will depend a great deal on how much damage has occurred to the brain.

Metabolic dementia occurs because of a change in the body’s metabolism. Changes in metabolism are often linked to specific health issues such as diabetes or thyroid disease. Treatment and management of the underlying disorder may aid in preventing metabolic dementia.

The complications of metabolic dementia are significant and include the following:

• inability to care for one’s self
• inability to interact with others
• infections of the skin, lungs or urinary tract ( kidney )
• pressure sores or decubitus ulcers can occur on parts of the body from remaining in one position too long
• health problems due to the underlying metabolic disorder