July 23, 2024 – New research suggests that patients with dementia may as an alternative have a particular brain disease and needs to be tested for liver cirrhosis, a number one explanation for the disease.
The study of greater than 68,000 people diagnosed with dementia between 2009 and 2019 found that just about 13% of them had test results typical of cirrhosis of the liver and possibly the brain disease generally known as hepatic encephalopathy.
The results, recently published online In The American Journal of Medicineare consistent with the findings of the researchers previous workswhich found that about 10% of U.S. veterans diagnosed with dementia may very well be affected by hepatic encephalopathy.
“We need to raise awareness that cirrhosis of the liver and related brain complications are common and unnoticed, but are treatable when detected,” said one in all the study authors, Dr. Jasmohan Bajaj of Virginia Commonwealth University and Richmond VA Medical Center. “And they are increasingly being diagnosed in older people.”
“Liver cirrhosis can also increase patients' susceptibility to liver cancer and other complications, so it is important to diagnose it in all patients,” he said.
“Easy to miss”
Nancy Reau, MD, division chief of hepatology at Rush University Medical Center in Chicago, said of the study that it is straightforward for doctors to miss liver disease, which may progress and result in cognitive decline.
“Most of my patients have already been diagnosed with liver disease. However, it is not uncommon for a patient to come in from another specialist who believes their clinical picture is more indicative of liver disease than the problem they were referred for,” she said.
But even with metabolic disorders, the disease just isn’t advanced enough in most patients to cause symptoms just like dementia, says Reau, who was not involved within the study.
“It is more important that neurologists rule out liver disease and that hepatologists or gastroenterologists have the tools to rule out alternative explanations for neurocognitive symptoms,” she said. “It is important not to label a patient as having HE and then overlook alternative explanations.”