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July 24, 2024 – A recent study has revealed that a notable number of dementia diagnoses may actually be misdiagnosed cases of hepatic encephalopathy, a treatable brain disorder caused by cirrhosis. The research, encompassing over 68,000 individuals diagnosed with dementia between 2009 and 2019, found that nearly 13% exhibited test scores indicative of cirrhosis and the associated brain disorder.
These groundbreaking findings, published in The American Journal of Medicine, underscore the importance of thorough diagnostic processes in dementia patients. The study aligns with prior research from the same team, which indicated that around 10% of U.S. veterans diagnosed with dementia might actually suffer from hepatic encephalopathy.
Increased Awareness Needed
“We need to increase awareness that cirrhosis and related brain complications are common, silent, but treatable when found,” stated Dr. Jasmohan Bajaj of Virginia Commonwealth University and Richmond VA Medical Center. He emphasized the rising incidence of these conditions in older populations, stressing the necessity of accurate diagnosis to prevent further health complications such as liver cancer.
Dr. Nancy Reau, section chief of hepatology at Rush University Medical Center in Chicago, noted that liver disease often goes unnoticed, potentially leading to cognitive decline that can be misattributed to dementia. “Most of my patients are already labeled with liver disease; however, it is not uncommon to receive a patient from another specialist who felt their presentation was more consistent with liver disease than the issue they were referred for,” Reau commented.
Diagnostic Precision Imperative
The study highlights the crucial need for collaboration between neurologists and hepatologists. Dr. Reau pointed out that specialists in neurology must rule out liver disease when diagnosing cognitive decline, while hepatologists and gastroenterologists should be equipped to consider alternative explanations for neurocognitive symptoms.
“It is important to not label a patient as having hepatic encephalopathy and then miss alternative explanations,” Reau said, emphasizing the balance required in accurate diagnosis and treatment.
Conclusion
This research calls for heightened vigilance and comprehensive testing in patients diagnosed with dementia, to ensure conditions like hepatic encephalopathy are not overlooked. With proper diagnosis and treatment, many patients could potentially see significant improvements in their cognitive health.
The study is a critical reminder of the complexities in diagnosing dementia and the need for ongoing research and awareness to enhance patient care and outcomes.
