Core Concepts
Undiagnosed cirrhosis may contribute to cognitive impairment in veterans diagnosed with dementia.
Abstract
The research suggests that hepatic encephalopathy (HE) could be a significant factor in cognitive impairment among US veterans diagnosed with dementia. The study by Jasmohan S. Bajaj, MD, and colleagues highlights the importance of considering undiagnosed cirrhosis as a potential cause of cognitive decline. By analyzing medical records of veterans, the study aimed to identify the prevalence and risk factors of undiagnosed cirrhosis and its association with cognitive impairment.
Key Highlights:
- Veterans with cirrhosis may have concomitant dementia, making it challenging to differentiate from HE.
- The study analyzed the prevalence of undiagnosed cirrhosis among US veterans diagnosed with dementia.
- FIB-4 scores were used to assess advanced fibrosis and cirrhosis in the study participants.
- Older age, male sex, and certain health conditions were associated with higher FIB-4 scores.
- Screening for FIB-4 scores and HE is recommended for patients with altered mental status or dementia.
- Increased awareness of cirrhosis as a potential cause of cognitive impairment is crucial for early intervention and treatment.
Stats
A total of 18,390 (10.3%) veterans had a FIB-4 score > 2.67, and 9373 (5.3%) had a FIB-4 score > 3.25.
A FIB-4 score > 3.25 was associated with older age, male sex, congestive heart failure, viral hepatitis, problem drinking, and chronic kidney disease.
A FIB-4 score > 3.25 was inversely associated with the White race, diabetes, hyperlipidemia, stroke, tobacco use disorder, and rural residence.
Quotes
"My husband is a different person now." - Jasmohan S. Bajaj
"An elderly patient with cirrhosis used to be an oxymoron." - Jasmohan S. Bajaj
"This validates FIB-4 as a powerful tool for cirrhosis case-finding." - William Carey, MD