Link Between Cirrhosis and Cognitive Decline in Veterans with Dementia

A groundbreaking study in JAMA Network Open reveals that up to 10% of elderly U.S. veterans diagnosed with dementia may actually be experiencing cognitive decline related to cirrhosis, emphasizing the critical need for early liver assessments to address potentially reversible causes of impairment.

  • Uncovering a Surprising Connection in Elderly Veterans
  • Crucial Role of Liver Health in Cognitive Screening
  • Addressing Disparities and the Path Forward

A recent study published in JAMA Network Open has unveiled a surprising revelation about elderly U.S. veterans initially diagnosed with dementia. Up to 10% of these veterans may actually be experiencing cognitive decline related to advanced liver disease, specifically cirrhosis. This finding raises concerns about the challenge physicians face in distinguishing between dementia and hepatic encephalopathy—a cognitive decline caused by cirrhosis. If undetected, patients may miss out on appropriate treatment that could potentially reverse or halt the impairment.

Lead author Jasmohan Bajaj, a renowned expert in hepatic encephalopathy, emphasizes the importance of screening patients for liver disease, even in the absence of an initial cirrhosis diagnosis. The study highlights the unexpected link between dementia and liver health, urging clinicians, particularly those dealing with dementia patients, to incorporate liver assessments into routine care. Early detection of liver issues can lead to targeted interventions, offering a chance to address treatable factors contributing to cognitive decline and potentially improve the lives of these patients.

The study revealed that dementia disproportionately affected Black and Hispanic veterans, who were also more likely to be diagnosed later in the disease course. Non-Hispanic white veterans without tobacco use or diabetes were less likely to have elevated FIB-4 scores. Moving forward, the focus is on raising awareness among healthcare providers about the potential overlap between cirrhosis-related hepatic encephalopathy and dementia. The study suggests incorporating routine FIB-4 index evaluations in dementia cases, providing an opportunity to identify and treat cognitive impairment linked to liver disease.