Dementia Due to Metabolic Causes: A Guide for Family Caregivers

What Are the Common Causes and Risk Factors?

Possible metabolic causes of dementia include:

• Hormonal diseases, 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

• High level of calcium in the blood, such as due to

  hyperparathyroidism

• Low level of thyroid hormone (

  hypothyroidism

  ) or high level of thyroid hormone (

  thyrotoxicosis

  ) in the body

• Liver cirrhosis

• Kidney failure

• Nutritional diseases, such as vitamin B1 deficiency,

  vitamin B12

  deficiency,

  pellagra

  , or protein-calorie

  malnutrition

• Porphyria

• Poisons, such as methanol

• Severe alcohol use

• Wilson disease

• Diseases of the mitochondria (energy-producing parts of cells)
• Rapid changes in blood sodium level

What Are the Symptoms and Warning Signs?

Metabolic disorders may cause

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.

The 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, (for example, seeing or hearing things that are not there), 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 disease that caused dementia.