Lamiaa Moustafa Elbosaty
Substance-Induced Persisting Dementia: The characteristics and course of the disease depend mostly on the causative substance. Substance known to evoke a persisting dementia are alcohol, sedatives, hypnotics, and medication such as anticonvulsants. Toxins are a well-known cause of dementia, and frequent offenders include lead mercury, carbon monoxide, organophosphate insecticides, and industrial solvents. Alcohol induced persisting dementia probably has the most data to support its description (Sadock & Sadock, 2005).
- Alcohol-Induced Persisting Dementia: It is estimated to account for approximately 4 percent of dementias. Milder forms of cognitive impairment are also frequently associated with chronic alcohol abuse but typically don't result in prolonged, irreversible cognitive deficit on cessation. The causal relationship between alcohol use and dementia is complicated, alcohol or its metabolites acetaldehyde, may have direct central nervous system neurotoxin effects. Dementia may also result from thiamine deficiency and subsequent cortical neuronal loss. Chronic alcohol abuse impairs gastrointestinal absorption of thiamine (APA, 2000).
In addition, alcoholism frequently results in liver disease, which, in turn affects thiamine homeostasis, and may also directly cause neurotoxicity and cognitive impairment. Descriptions of alcohol-related dementia in the literature have reported many features that include memory impairment, disorganized thoughts, poor attention, impaired judgment, and disorientation. Other psychiatric symptoms may include mood liability behavioral disinhibition, irritability, aggression, apathy, and paranoid ideation (Willenbring, 2000).
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