Clinical practice guidelines on addressing cognitive impairment in treatable dementias

Topic: Risk, prevention and care in population studies

This is because of the ambiguity surrounding the terminology used to characterize reversible dementia—the variation in the population being studied, or the existence of subclinical instances that are difficult to diagnose.[3] By and large however, the proportion of reversible dementias compared to the irreversible dementias is very low. While, the prevalence of potentially reversible aetiology has been reported 18% in patients under the age of 65 years, however only 5% in those over 65 years.[3] A meta-analysis showed that although potentially reversible causes were seen in 9% of the cases, only 0.6% of dementia cases could be reversed.[4] Optimum assessment of differential diagnosis and prompt treatment are therefore of paramount importance. The team then determined the scope of the guideline in consultation with the clinical practice committee members, in particular to make sure there are no significant overlaps between the various guidelines of the issue. Tables 1a-1f show the list of disorders in each of the classified reversible dementia subtypes as mentioned above and their clinical features.Table 1a: Intracranial (neurosurgical) disorders and their clinical featuresTable 1b: Intracranial (neuroinfections) disorders and their clinical featuresTable 1c: Systemic (including metabolic/endocrinal) disorders and their clinical featuresTable 1d: Toxicity and their clinical featuresTable 1e: Drugs causing cognitive dysfunction and associated featuresTable 1f: Mental and behavioural disorders and their clinical featuresCLINICAL COURSE OF “TREATABLE DEMENTIAS” In this section, we briefly describe the course of some of the highly prevalent causes of “treatable dementia” below: Alcohol-induced (related) dementia Several lines of research suggest that chronic consumption of alcohol leads to permanent damage, both structural and functional, to the brain. Patients with ARD are mostly male, have their onset of symptoms younger compared to other dementias and lack social support. Although it may be difficult to diagnose depressive cognitive disorder when there is a significant overlap of depressive and true dementia symptoms, there are aspects that help differentiate it from true dementias. Similarly, hyperthyroidism is linked to an increased risk of Alzheimer’s disease brain pathology due to greater thyroxine levels; however, there is minimal evidence that treating these abnormalities may enhance cognition. This is because thyroid disease can result in other proble

Key findings

• This is because of the ambiguity surrounding the terminology used to characterize reversible dementia—the variation in the population being studied, or the existence of subclinical instances that are difficult to diagnose.[3] By and large however, the proportion of reversible dementias compared to the irreversible dementias is very low.
• While, the prevalence of potentially reversible aetiology has been reported 18% in patients under the age of 65 years, however only 5% in those over 65 years.[3] A meta-analysis showed that although potentially reversible causes were seen in 9% of the cases, only 0.6% of dementia cases could be reversed.[4] Optimum assessment of differential diagnosis and prompt treatment are therefore of paramount importance.
• The team then determined the scope of the guideline in consultation with the clinical practice committee members, in particular to make sure there are no significant overlaps between the various guidelines of the issue.
• Tables 1a-1f show the list of disorders in each of the classified reversible dementia subtypes as mentioned above and their clinical features.Table 1a: Intracranial (neurosurgical) disorders and their clinical featuresTable 1b: Intracranial (neuroinfections) disorders and their clinical featuresTable 1c: Systemic (including metabolic/endocrinal) disorders and their clinical featuresTable 1d: Toxicity and their clinical featuresTable 1e: Drugs causing cognitive dysfunction and associated featuresTable 1f: Mental and behavioural disorders and their clinical featuresCLINICAL COURSE OF “TREATABLE DEMENTIAS” In this section, we briefly describe the course of some of the highly prevalent causes of “treatable dementia” below: Alcohol-induced (related) dementia Several lines of research suggest that chronic consumption of alcohol leads to permanent damage, both structural and functional, to the brain.
• Patients with ARD are mostly male, have their onset of symptoms younger compared to other dementias and lack social support.

Why it matters

This guideline discusses the low proportion of reversible dementias and the importance of prompt assessment and treatment of potentially reversible causes. It focuses on clinical management of treatable dementias, not on treating, curing, or preventing Alzheimer's disease itself.

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Study details

• Study designmeta-analysis
• Effect size7.4%; 0.6%
• Evidence strengthHigh

Read the original

• DOI: 10.4103/indianjpsychiatry.indianjpsychiatry_684_24
• PubMed: 40046486
• Original source →
• Free full text: Indian Journal of Psychiatry →

Full text: free to read — OpenAlex lists this copy as free to read: the link above (checked 6 Feb 1020).

@article{siddiqui2025-40046486,
  author  = {Siddiqui, M Aleem and Garg, Shobit and Tikka, Sai Krishna},
  title   = {{Clinical practice guidelines on addressing cognitive impairment in treatable dementias}},
  journal = {Indian Journal of Psychiatry},
  year    = {2025},
  doi     = {10.4103/indianjpsychiatry.indianjpsychiatry_684_24},
  pmid    = {40046486},
  url     = {https://doi.org/10.4103/indianjpsychiatry.indianjpsychiatry_684_24}
}

Studies this one cites

Referenced by this study and also in the alzhub library, so you can read them here.

• Prevalence of dementia in India: National and state estimates from a nationwide study Alzheimer's & dementia : the journal of the Alzheimer's Association · 2023-01-13 · usefulness score 76/100 · Disparities
• Changing demography and the challenge of dementia in India Nature reviews. Neurology · 2021-10-18 · usefulness score 57/100 · Disparities
• Recommendations of the 5th Canadian Consensus Conference on the diagnosis and treatment of dementia Alzheimer's & dementia : the journal of the Alzheimer's Association · 2020-07-29 · usefulness score 54/100 · Prevention and risk
• Alcohol-related dementia: an update of the evidence Alzheimer's research & therapy · 2013-01-25 · usefulness score 48/100 · Prevention and risk

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