Around 10 million people around the world are diagnosed with dementia every single year and numbers continue to rise. However, a new study has revealed that as much as 13% of all new dementia cases in the US may actually be misdiagnosed. This means that many Americans are currently struggling with a condition that is actually treatable. Therefore, it is crucial that healthcare providers are made aware of the overlap between hepatic encephalopathy and dementia symptoms.
What Is Hepatic Encephalopathy?
Hepatic encephalopathy affects more than 40% of people diagnosed with cirrhosis (advanced liver disease). It refers to cognitive damage caused by liver failure which is often hard to distinguish from dementia-related damage. The liver plays over 500 essential functions in the human body, from detoxification to nutrient storage, bile production, and metabolism support. It regulates chemical levels in our bodies, filtering them out from our bloodstream. A range of lifestyle factors, such as diabetes, stress, and alcohol consumption can cause liver damage. Hepatitis, and obesity. However, if caught in its early stages, the damage can still potentially be reversed. This can be accomplished through simple changes in behavior and diet, with promising treatments also currently on the horizon.
Promising Early Results
Two patients who were previously diagnosed with dementia have already experienced cognitive improvement since being treated for hepatic encephalopathy. One patient resolved all of his symptoms, which included hallucinations, memory loss, and tremors. Recent studies involving mice suggest that even liver damage caused by aging can be reversed if detected soon enough. The researchers found that non-alcoholic liver diseases were exacerbated by factors such as again. They revealed that by reducing this impact, they are able to effectively reverse the damage it causes.
In 2024, the researchers examined the medical records of nearly 178,000 veterans in the United States who had been diagnosed with dementia from 2009 to 2019. They found that none of the patients had been diagnosed with liver disease despite the fact that more than 10% exhibited high fibrosis 4 scores. This is an index that measures the degree of scarring in the liver and the results indicate that they likely had undiagnosed cirrhosis. To see if these results reflected the entire population, the team then reviewed almost 69,000 records of non-veterans. Surprisingly, this group scored even higher, with up to 13% of the population exhibiting high fibrosis 4 scores.
Disparities and Factors
The majority of the individuals in the high FIB-4 group were not white. This stood out to the researchers when looking at how common a high FIB-4 was and what factors were linked to it. Although they are yet to look more into what caused these disparities, it is thought that a lack of comorbidity and dementia care accessibility could be contributing factors. What we do know is that looking after our livers is extremely important to our overall health. If they begin to work improperly, our body’s tissues become stressed, in addition to our brains, hearts, pancreas, and kidneys. According to one of the study’s authors, “This important link between dementia and liver health emphasizes the importance of screening patients for potentially treatable contributors to cognitive decline”.
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