One in 8 dementia cases 'may have liver disease instead'

One in eight people diagnosed with dementia may actually have liver disease, a study published in the American Journal of Medicine stated. The cognitive symptoms of dementia are similar to those caused by Hepatic Encephalopathy (HE), a condition caused by liver cirrhosis.

Consuming alcohol regularly, obesity and viral infection can lead to the disease which further causes scarring on the organ.

Furthermore, the condition can lead to confusion, forgetfulness, slurred speech and shaking as toxins build up in the bloodstream and impact the brain because the liver cannot clean them properly.

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Scientists analysed the medical records from a database of American people, of over 68,000 patients, who were diagnosed with dementia between 2009 and 2019.

The average age was 72 and they analysed each person's records to calculate how likely it was they had undiagnosed HE caused by liver cirrhosis.

How it lead to "cognitive impairment"?

According to the data, 12.8 per cent of patients in the group, were likely suffering from an undiagnosed case of cirrhosis.

“Risk factors for potential undiagnosed cirrhosis include alcohol use disorder and viral hepatitis," the scientists said, adding, "In up to 13 per cent of patients with dementia, treatable hepatic encephalopathy might contribute to the cognitive impairment.”

Study author Dr Jasmohan Bajaj from Virginia Commonwealth University, said, “We need to increase awareness that cirrhosis and related brain complications are common, silent, but treatable when found."

“Undiagnosed cirrhosis and potential hepatic encephalopathy can be a treatable cause of or contributor towards cognitive impairment in patients diagnosed with dementia," Dr Bajaj added.

What increases the risk of Cirrhosis?

As per the data, having viral hepatitis more than doubles the likelihood of a person having cirrhosis, while alcohol abuse increases the risk by 39 per cent.

However, while the liver condition and dementia have "symptom overlap", some experts believed that the subtle differences in the conditions would allow a doctor to highlight the difference.

“Full-blown hepatic encephalopathy looks different to dementia," Dr Rob Howard, professor of old age psychiatry at University College London, told the MailOnline.

“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. No one should be diagnosed with dementia without physical causes for their confusion being excluded.”

Dr Howard added, "Simple tests should always be done and these include a liver function test. But I don’t think it’s credible to say people with dementia have been misdiagnosed, based on this evidence.”

(With inputs from agencies)