Dementia secondary to metabolic and nutritional abnormalities.

It is clear that dementia may result from nutritional and metabolic causes. Prior to labeling the demented person as having Alzheimer's disease or multi-infarct dementia, a thorough physical, historic, and laboratory evaluation is essential. Not only must other causes for the dementia be ruled out, but co-existing abnormalities that may confuse therapeutic intervention must be considered. Elderly persons notoriously under-report symptoms, in this case further complicated by the dementia. In addition, normal age-related changes, age-prevalent illness, and the atypical way in which diseases often present late in life may make the situation more confusing. Being aware of the wide variety of causes of dementia, however, will improve diagnostic abilities.