Dementia: Metabolic and Endocrinal Causes

A number of metabolic disorders are linked with personality changes and mental impairment.

Calcium and Sodium Imbalances

Adequate levels of the mineral calcium are essential for healthy body metabolism. However, an imbalance of calcium may trigger a number of metabolic disorders including hypoglycemia, depression and bipolar disorder (involving excess calcium levels). Depression, however, may be caused by lack of calcium.

Calcium acts with magnesium, phosphorus and vitamins A, C and D, whereas sodium works with potassium to maintain healthy metabolic function.

Calcium and sodium imbalances (either an excess or deficiency) may result in mental confusion, personality changes, severe mental dysfunction and dementia.

Endocrine Disorders and Dementia

Common endocrine disorders are associated with psychiatric and mental problems.

Thyroid Disorders: The thyroid gland in the neck plays an important role in the metabolic function of the body. Thyroid problems arise when the gland over- or under-produces the necessary amount of thyroid hormone for healthy metabolic function. The medical term for excess production is hyperthyroidism; under-production is called hypothyroidism.

Once diagnosed, thyroid disorders can generally be treated with hormone medication, including hormone replacement drugs or beta blockers.

Hypothyroidism: If left untreated, hypothyroidism, where the thyroid produces insufficient thyroid hormone, can lead to physical and mental impairment and, in severe cases, to dementia.

The causes of hypothyroidism include:

• Hashimoto's disease, an autoimmune disease
• heredity
• aging
• radiation treatment of the thyroid
• surgery to remove the thyroid
• iodine deficiency
• viral or bacterial infectious diseases.

Symptoms of thyroid dysfunction include:

• apathy
• drowsiness
• lethargy
• poor concentration
• depression
• memory loss
• dementia.

Hypoglycemia: The medical term hypoglycemia means low blood sugar. Hypoglycemia occurs when levels of glucose in the blood stream are abnormally low.

Symptoms of hypoglycemia can range from mild feelings of being slightly unwell to severe symptoms of coma or delirium. Symptoms include:

• tremor and palpitations
• confusion
• irritability
• personality changes
• coma
• mental and psychiatric disorders.

Hypoglycemia and Clinical Research

Urgent clinical trials are required to further scientific understanding of brain function in relation to hypoglycemia.

Nutritional Deficiencies and Dementia

Deficiency in the following nutritional elements have been linked with the onset of dementia:

• vitamin B1 (thiamine): Thiamine deficiency, often caused by chronic alcohol abuse, may result in severe mental and cognitive impairment and memory loss.
• vitamin B6: Acute vitamin B6 deficiency has been linked with the development of pellagra, a neurological disorder associated, in severe cases, with dementia.
• vitamin B12: Problems absorbing vitamin B12 (pernicious anemia) may cause a range of dementia-related symptoms including depression, irritability and altered personality.
• niacin (nicotinic acid): Niacin is important for maintaining cellular metabolism and for the prevention of oxidative stress. A deficiency of niacin and tryptophan (essential for the synthesis of niacin) is the most common cause for pellagra. Severe niacin deficiencies can lead to delirium and possible dementia.

Korsakoff's Amnesic Syndrome and Dementia

Korsakoff's amnesic syndrome, a neuro-degenerative memory disorder resulting from a lack of vitamin B1 (thiamine) is commonly associated with chronic alcohol abuse. Typical symptoms include disorientation, amnesia, an inability to reason, discuss and acquire new information, impaired memory recall and attention deficit.

Alcoholism and Alcoholic Dementia

Alcoholism is a disease that affects the central nervous system. Chronic alcohol abuse may lead to peripheral neuropathy, a disease affecting the peripheral nerves that connect with the spinal cord and brain, and dementia.

Alcoholic dementia is a slow and progressive condition, uncommon in young people under the age of twenty. Dementia resulting from chronic alcohol abuse may be permanent, even when alcohol abuse has ceased.

Alcohol Induced Dementia

Symptoms of alcohol-induced dementia include:

• cognitive impairment (often permanent)
• memory loss or poor memory recall
• lack of motivation
• poor concentration
• confusion
• aphasia (reduced ability to speak or write)
• inability to acquire new information
• apraxia (inability to perform simple co-ordination or manipulation tasks)
• agnosia (inability to identify objects or spoken words, despite intact sensory function)
• impaired ability to plan, organize or anticipate a sequence of events
• domestic, social or occupational dysfunction
• depression.

Light to Moderate Alcohol Consumption

A number of recent studies have revealed that one to three units of alcohol per day may reduce the risk of developing all forms of dementia including Alzheimer's-related dementia.

One particular study at Wake Forest University Baptist Medical Center concluded that, "moderate levels of alcohol intake may be associated with better cognition and reduced risk of significant cognitive decline" in women. (Espeland, 2005)

Resources

All Refer Health. (2002). Alcoholism.

Beers, M.H.