Symptoms:

Dementia that occurs with metabolic disorders may cause confusion and changes in thinking or reasoning. These changes may be short-term or lasting.

The early symptoms of dementia can include:

• Difficulty performing tasks that 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 having trouble finding the name of familiar objects
• Losing interest in things you previously enjoyed, flat mood
• Misplacing items
• Personality changes and loss of social skills

As the dementia becomes 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
• Having more difficulty reading or writing
• Using 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

Note: The person may also have symptoms from the disorder that caused dementia.

Signs and tests:

An examination of the nervous system (neurologic examination) can show different problems, depending on the cause. Abnormal reflexes may be present.

Tests to diagnose a medical condition causing the dementia may include:

• Ammonia level in the blood
• Blood chemistry, electrolytes
• Blood glucose level
• BUN, creatinine to check kidney function
• Liver function tests
• Lumbar puncture (spinal tap)
• Nutritional assessment
• Thyroid function tests
• Urinalysis
• Vitamin B12 level

To rule out certain brain disorders, a head CT scan or head MRI scan is usually done.