This sheds new light on potential causes of cognitive decline.
As of 2017, it is estimated that approximately 112 million people worldwide are grappling with cirrhosis, a progressive liver disease with significant global health implications. Liver diseases, including cirrhosis, contribute to roughly 4% of all deaths globally.
Regrettably, there is presently no definitive cure for cirrhosis. As the disease advances, it can lead to various complications such as blood clotting abnormalities, abdominal fluid accumulation (ascites), leg swelling (edema), elevated blood pressure in liver-related veins, and hepatic encephalopathy—a condition characterized by toxin buildup in the brain, resulting in cognitive decline.
Recent research conducted by experts from Virginia Commonwealth University sheds light on a concerning trend: up to 10% of older U.S. veterans diagnosed with dementia may actually be suffering from misdiagnosed hepatic encephalopathy, a condition that is treatable and potentially reversible.
Published in the esteemed journal JAMA Network Open, the study emphasizes the critical importance of screening individuals with cognitive impairment for underlying liver disease. Dr. Jasmohan S. Bajaj, the lead author and a professor in the Division of Gastroenterology, Hepatology, and Nutrition at Virginia Commonwealth University, highlighted that hepatic encephalopathy, affecting nearly 60% of cirrhosis patients, can manifest through symptoms such as mental sluggishness, tremors, confusion, and even coma, attributable to the liver’s compromised ability to eliminate toxins from the gut.
The decision to focus on the veteran population was prompted by the potential overlap and confusion between hepatic encephalopathy and dementia in this demographic. Dr. Bajaj cited various factors supporting this hypothesis, including the heightened likelihood of cirrhosis patients developing dementia-like symptoms, the intertwined nature of brain dysfunction in cirrhosis and dementia, alterations in the gut-brain axis in older individuals, and instances where patients initially diagnosed with dementia were later discovered to have hepatic encephalopathy.
Dr. David Frank, a neurologist at Hackensack Meridian Neuroscience Institute, acknowledged the study’s significance in identifying potentially reversible causes of cognitive decline. Meanwhile, Dr. Anurag Maheshwari, a gastroenterologist and hepatologist at Mercy Medical Center, stressed the crucial importance of provider awareness and education regarding the possibility of hepatic encephalopathy masquerading as dementia.
The study underscores the urgent need for heightened vigilance and comprehensive screening protocols to accurately diagnose and manage hepatic encephalopathy, particularly among at-risk populations, to ensure timely intervention and improved patient outcomes.
Discussion about this post