In a recent study of US veterans, researchers found that 10% of those that had been diagnosed with dementia actually were suffering from a liver condition called hepatic encephalopathy (HE) – a treatable condition.
According to the British Liver Trust, some of the early symptoms of HE mimic those that are often present in dementia, including confusion, forgetfulness, personality or mood changes and poor concentration.
Ashwin Dhanda, Associate Professor of Hepatology at the University of Plymouth explained: “The liver can be damaged by several things, including alcohol, fatty deposits and hepatitis viruses. When the damage continues over several years, the liver becomes scarred (known as cirrhosis) and, at a certain point, can no longer perform one of its critical tasks: detoxifying the blood.
“Toxins (mainly ammonia) can build up and get into the brain, interfering with brain function. This is HE.”
Why hepatic encephalopathy is often missed
Dhanda explained that HE is easier to identify and treat if doctors are aware that the patient has cirrhosis.
However, cirrhosis is often a silent condition until it reaches late stages and the liver starts to fail. He added: “HE is much harder to diagnose in the general population. The symptoms of change of mood, behaviour, confusion and forgetfulness are also all seen in people with dementia.”
Dhanda said that this study suggests that potentially, around 10% of people diagnosed with dementia may actually have underlying silent liver disease with HE causing or contributing to the symptoms.
This diagnosis could be life-changing for some dementia patients as it is treatable.
What this means for future dementia diagnosis
This study is hopeful but Dhanda warns that it should still be treated with some caution: ”[This study] raises the awareness of checking for liver disease in people with general symptoms of dementia. This is likely to be a growing problem as the rates of both dementia and cirrhosis are increasing.
“But we still need better data to fully understand the number of people with HE incorrectly given a diagnosis of dementia and how best to identify and treat them.”
Here’s hoping.