These studies have asserted that individuals who are undergoing mild withdrawal without treatment still have the formation of toxic oxidative products which have the hypothetical potential of producing neuronal damage and perhaps some cell death. Lending support to this argument is the fact that alcohol withdrawal appears to be progressive in that it worsens with each successive episode (Malcolm et al. 2000) and that some patients dependent on alcohol develop evidence of dementia over time. On the other hand, age, nutritional status, trauma, co-occurring conditions, and other unspecified events also probably contribute to this process.