Rédaction Africa Links 24 with Isabella Cueto
Published on 2024-01-31 16:00:49
A new study in JAMA Open Network suggests that some dementia patients may actually have undiagnosed liver disease and accompanying neurological problems, with the possibility of resolving their liver-related brain symptoms with treatment. The study was conducted by a group of Veterans Affairs doctors and included 177,000 veterans who had been diagnosed with dementia in at least two clinic visits, and who had never been diagnosed with cirrhosis of the liver.
The study found that up to 10% of the patient pool had a FIB-4 score high enough to indicate potentially serious liver disease. However, the most crucial tie between liver disease and dementia is hepatic encephalopathy, a condition in which toxins and waste circulate to the brain due to the liver’s inability to remove them from the blood. This has a poisonous effect on brain cells and can lead to cognitive, motor, sleep, and mood changes. However, hepatic encephalopathy is reversible and can be treated with antibiotics or lactulose.
The study also found that for providers, telling apart patients with hepatic encephalopathy and dementia is nearly impossible in a brief appointment, as there is no simple blood test to differentiate between the two. As a result, there may be misdiagnoses. The FIB-4 score could be a useful screening tool for providers, even though it cannot diagnose cirrhosis. It is more of a “pointer that you need to look harder and rule cirrhosis out.”
However, cirrhosis is hard to catch and often develops silently without major symptoms. Many veterans have risk factors for both cirrhosis and dementia, so the conditions could coexist and feed into each other, particularly for Hispanic veterans. Given these findings, providers need to rule out a reversible cause of brain issues in order to ensure that patients receive appropriate treatment.
This study was supported by a grant from Bloomberg Philanthropies.
