One in Eight Dementia Diagnoses May Be Linked to Liver Disease, Study Suggests

One in eight people diagnosed with dementia could be experiencing cognitive symptoms stemming from liver disease rather than dementia, according to recent research.

The study highlights that the cognitive symptoms of dementia closely resemble those of hepatic encephalopathy (HE), a condition caused by liver cirrhosis.

Factors such as viral infections, excessive alcohol consumption, and obesity can lead to liver cirrhosis, which in turn can cause HE.

This condition results in symptoms like confusion, memory loss, tremors, and slurred speech as toxins accumulate in the bloodstream and affect brain function due to the liver’s inability to detoxify effectively.

Researchers examined the medical records of over 68,000 American patients diagnosed with dementia between 2009 and 2019.

The average age of these patients was 72 years old.

The analysis aimed to determine the likelihood that these individuals actually had undiagnosed HE due to liver cirrhosis.

The study found that 12.8% of the patients were likely suffering from undiagnosed cirrhosis.

The scientists noted that "risk factors for potential undiagnosed cirrhosis include alcohol use disorder and viral hepatitis."

They added, "In up to 13% of patients with dementia, treatable hepatic encephalopathy might contribute to cognitive impairment."

These findings align with a previous study that discovered 10% of veterans with dementia might have had HE caused by cirrhosis.

Unlike dementia, which is a progressive disease, hepatic encephalopathy is treatable with medication, and its symptoms can be reversed.

"We need to increase awareness that cirrhosis and related brain complications are common, silent, but treatable when found," said Dr. Jasmohan Bajaj of Virginia Commonwealth University, the study's lead author.

"Undiagnosed cirrhosis and potential hepatic encephalopathy can be a treatable cause of or contributor to cognitive impairment in patients diagnosed with dementia."

The study also revealed that individuals with viral hepatitis were more than twice as likely to have cirrhosis, while those with alcohol abuse disorders had a 39% increased risk.

While the study acknowledges that liver disease and dementia share overlapping symptoms, some experts believe that doctors can distinguish between the two conditions.

Dr. Rob Howard, a professor of old age psychiatry at University College London, commented, "Full-blown hepatic encephalopathy looks different from dementia. The symptoms of hepatic encephalopathy fluctuate in a way that Alzheimer’s doesn’t, and anyone working in a memory clinic will be familiar with that."

He added, "No one should be diagnosed with dementia without physical causes for their confusion being excluded. Simple tests, including liver function tests, should always be done. But I don’t think it’s credible to say people with dementia have been misdiagnosed based on this evidence."