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causes of dementia

Etiology: 1) primary dementia without other signs a) Alzheimer's disease b) Pick's disease c) frontal lobe degeneration d) cortical-basal ganglionic degeneration 2) dementia with vascular disease a) leukoaraiosis (pericyte dysfunction?) b) multi-infarct dementia* - diabetes, obesity, hypertension, & dyslipidemia risk factors for atherosclerosis & vascular dementia - often coexists with Alzheimer's disease - midlife hypertension associated with risk for later dementia only in women [11] - atrial fibrillation [28] c) thalamic infarction d) Binswanger's disease* & lacunar state e) vasculitis* - systemic lupus erythematosus - polyarteritis nodosa - granulomatous angiitis of the CNS - Behcet's disease f) blood-brain barrier breakdown (BBB) is an early marker of cognitive dysfunction in humans independent of beta-amyloid & MAP-tau [17] 3) dementia with chronic infection a) AIDS dementia complex b) syphilis* c) progressive multifocal leukoencephalopathy (papovavirus) d) subacute sclerosing panencephalitis e) prion-associated disorders - Creutzfeldt-Jakob disease - Gerstmann-Straussler-Scheinker disease f) tuberculosis* g) fungal infection* h) protozoal infection* i) Whipple's disease* 4) secondary dementia, neoplastic disorders a) primary & secondary tumors* b) carcinomatous meningitis c) paraneoplastic encephalitis d) chronic subdural hematoma* e) hydrocephalus* 5) secondary dementia, movement disorders a) Parkinson's disease b) Lewy body dementia c) Huntington's disease d) progressive supranuclear palsy (Steel-Richardson syndrome) e) Shy-Drager syndrome f) hereditary ataxias g) ALS-parkinsonism-dementia complex of Guam 6) secondary dementia, other neurologic diseases a) multiple sclerosis b) amyotrophic lateral sclerosis (ALS) c) late-onset seizures of unknown etiology [19] 7) dementia following diffuse brain injury a) traumatic brain injury (TBI) - acute head injury - subdural hematoma* - postconcussion syndrome [5] - dementia pugilistica - even mild TBI without loss of consciousness increases risk for dementia in veterans [13] - traumatic brain injury (TBI) in female veterans (RR=1.5) [16] b) anoxia c) encephalitis d) noise - residential exposure to transportation noise [24] 8) endocrine & metabolic disorders a) hypothyroidism* b) vitamin B12 deficiency c) thiamine deficiency* d) nicotinic acid deficiency* (pellagra) e) adrenal insufficiency* f) Cushing's disease* g) hypoparathyroidism* h) hyperparathyroidism* i) chronic hypoglycemia* j) hypomagnesemia & hypermagnesemia [10] 9) toxic disorders a) drug & narcotic poisoning* b) alcoholic dementia* - heavy alcohol use associated with early-onset dementia [12] c) heavy metal intoxication* d) organic toxins* e) dialysis dementia* f) trans fats, elaidic acid [18] g) air pollution - fine particulate matter PM2.5 h) carbon monoxide poisoning [29] 10) psychiatric disorders a) chronic schizophrenia; 66% at age 66 years [23] b) pseudodementia (depression)* - depression in female veterans (RR=1.7) [16] c) acute intermittent porphyria* d) personality disorders [7] - neuroticism [6,7] - social isolation [7] e) PTSD in female veterans (RR=1.8) [16] f) mental health disorders > risk than chronic physical diseases [] 11) granulomatous diseases - sarcoidosis* 12) cardiovascular disease - hypertension - hypertension at age 50 [15] - treatment reduces risk 7.0% vs 7.5% within 4 years [21] - multimorbidity associated with 63% increased risk of dementia within 15 years [26] - risk highest in patients with cardiovascular disease [26] - people born in states with high stroke mortality are at increased risk for dementia, regardless of where they live as adults (Alabama, Alaska, Arkansas, Louisiana, Mississippi, Oklahoma, Tennessee, South Carolina, or West Virginia) [9] 13) sleep disorders - sleep duration < 5 hours (RR=2.6) or > 10 hours (RR=1.7) per night associated with increased risk for dementia [14] - similar U-shaped associations for Alzheimer's disease & vascular dementia [14] - hypnotic use for insomnia associated with increased risk for dementia (RR=1.7-1.8) [14] 14) migraine in midlife (RR=1.5) [22] 15) higher plasma neurofilament associated with a 54% greater risk for all-cause dementia & a 49% greater risk for Alzheimer's dementia [20]. 16) hearing loss linked to dementia: use of hearing aids reduces risk [27] 17) conditions in adolescents & young adults a) Wilson's disease* b) Hallervorden-Spatz disease c) tuberous sclerosis d) progressive myoclonic epilepsy* e) metabolic diseases - leukodystrophies - mitochondrial cytopathies - glycogen storage diseases - Leigh's disease - homocystinuria 18) also see risk factors for dementia & etiology of Alzheimer's disease * condition in which treatment may reverse or prevent progression of dementia

Related

dementia; Alzheimer's disease & related dementias (ADRD) risk factors for dementia

Specific

etiology/risk of Alzheimer's disease

References

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