1 in 10 People Are Misdiagnosed With Dementia, Study Says

Researchers found that some people experiencing symptoms of cognitive decline actually have a treatable liver condition that can cause dementia-like symptoms.

Diagnosing dementia can be a challenging process. Healthcare providers generally review an individual's medical and family history, ask questions about symptoms, and order cognitive tests and brain scans to determine whether the person does indeed have dementia.

However, several health issues can cause dementia or dementia-like symptoms, including normal pressure hydrocephalus, excessive alcohol use, and depression. When these conditions are appropriately diagnosed and treated, cognitive symptoms can disappear.

Recently, scientists discovered that another common, yet silent liver-related condition may be the reason behind dementia symptoms in some people. The researchers say these cognitive issues can stop or even be reversed once the issue is identified and treated.

Is it liver disease or dementia?

Previous research involving 177,422 veterans diagnosed with dementia found that 5 to 10% had cirrhosis of the liver and a related condition that can cause dementia-like symptoms called hepatic encephalopathy.

The first study's findings prompted the researchers to follow up with another study using non-veteran individuals to see if the same results occurred in the general population.

The study, published in The American Journal of Medicine, included 68,807 nonveteran participants diagnosed with dementia between 2009 and 2019. None of the participants had a history of liver cirrhosis.

The research team measured specific markers and calculated the participants' risk of liver disease using the FIB-4 index, a formula that can indicate the presence of liver cirrhosis. After analyzing the results, they found that nearly 13% of the participants had indicators for cirrhosis and potentially hepatic encephalopathy.

This means that around one in ten people who are told they have dementia, an incurable and progressive disease, might actually have a treatable condition.

Symptoms and treatment of cirrhosis

Regardless, cirrhosis is not reversible, as the damage is permanent, but in some cases, healthcare providers can treat the cause of the condition to help slow or reduce further damage. Treatments for hepatic encephalopathy include specific medications or antibiotics.

However, the problem lies in identifying these liver conditions, as they often only cause symptoms once they are in advanced stages. Symptoms associated with cirrhosis include fatigue, yellow discoloration of the skin and eyes, and itchy skin. Early signs of hepatic encephalopathy are dementia-like and include confusion, mood changes, and increased difficulty with handwriting.

The study's authors suggest that healthcare providers should consider screening patients diagnosed with dementia or individuals presenting with symptoms of cognitive decline for liver issues using the FIB-4 index.

Although not everyone diagnosed with dementia has cirrhosis or hepatic encephalopathy, the researchers say that identifying those who do could help prevent thousands of people from being misdiagnosed with an incurable and degenerative neurocognitive disease.