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According to a recent study, more than one in ten people diagnosed with dementia could ultimately suffer from a common liver disease… and above all, a treatable one!
According to a study published in June, 13% of people diagnosed with dementia may have been misdiagnosed. Symptoms associated with incurable memory loss may, in some cases, be linked to a completely reversible disease, hepatic encephalopathy (HE), triggered by cirrhosis of the liver.
Cirrhosis, the source of confusion
The study involved 68,000 people in their 60s who had been diagnosed with dementia between 2009 and 2019. Among these participants, the team also looked at blood test results to determine levels of certain compounds to help them calculate a fibrosis-4 or FIB-4 score – a common test for cirrhosis.
Cirrhosis of the liver, caused by excessive alcohol consumption, obesity or viral hepatitis, actually builds up scar tissue in the organ. Since the scars prevent the liver from filtering toxins from the blood as it should, they build up and can affect the brain in the long term, leading to hepatic encephalopathy.
Symptoms that are similar, but completely reversible
The apparent line between dementia and HE can be thin. Like dementia (a default diagnosis), early symptoms of hepatic encephalopathy include confusion, forgetfulness, personality or mood changes, changes in sleep patterns, and difficulty writing.
As it progresses, the disease can also cause unusual or slow movements, trembling hands and arms, extreme anxiety and increased confusion, slurred speech, and seizures. However, unlike dementia, which only gets worse over time, hepatic encephalopathy can be completely reversed with proper treatment, specific antibiotics, and nutritional supplements.
For the authors of the study, the revelation is important: “This means that thousands of people may have been wrongly told they have this incurable disease that takes away their memory – when in reality their problems are reversible.”they add.
A bias to be further verified
Raising awareness about the effects of cirrhosis is therefore essential for Dr Jasmohan Bajaj, the gastroenterologist who initiated the study.With the aging population, the risk of overlap between hepatic encephalopathy and dementia has increased and needs to be considered. Undiagnosed cirrhosis and potential hepatic encephalopathy may be a treatable cause or contributor to cognitive impairment in patients diagnosed with dementia.”
And even though experts and psychiatrists have been replying since they know “distinguish dementia from HE”, All agree that no one should be diagnosed with dementia without physical causes that can rule out delirium being ruled out.Simple tests should always be done, including a liver function test.” replied Dr Rob Howard, professor of old age psychiatry at University College London in the Daily mail.
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