According to a recent study, individuals with advanced liver fibrosis have an 18% higher risk of developing dementia compared to those without fibrosis.
The nationwide retrospective cohort study, published in Alzheimer’s and Dementia, assessed the association between liver fibrosis and incident dementia among individuals without dementia at the time of enrollment aged 40-69 years from Clalit Health Services (CHS) in Israel. Researchers utilized the liver fibrosis score (FIB-4) score, a serum-based algorithm derived from routine laboratory measurements, to estimate liver fibrosis. Participants were classified into three categories: no fibrosis (n = 636,967; 77%), inconclusive fibrosis (n = 180,114; 21.8%), and high-risk fibrosis (n = 9,497; 1.2%).
The initial cohort included 1,098,582 members enrolled for at least one year on January 1, 2006. After excluding individuals with existing dementia, excessive alcohol consumption, and liver/gastrointestinal diseases, the final sample consisted of 826,578 participants. Liver fibrosis was assessed using the FIB-4 score based on lab data from 2001-2005. Dementia diagnoses were sourced from CHS records. Covariates such as sociodemographic, lifestyle, and health factors were included. Multivariate Cox regression models evaluated the relationship between FIB-4 categories and dementia risk, with multiple sensitivity analyses conducted.
Over a median follow-up period of 17 years, 41,089 dementia cases were documented. Cox regression analyses revealed that both inconclusive liver fibrosis and advanced fibrosis status were significantly associated with an increased risk of dementia. Specifically, individuals with inconclusive fibrosis had a hazard ratio (HR) of 1.09 (95% CI: 1.07–1.11), while those with advanced fibrosis had an HR of 1.18 (95% CI: 1.10–1.27). These associations remained consistent across seven sensitivity analyses, reinforcing the robustness of the findings.
“Previous findings regarding the link between liver fibrosis and dementia risk are sparse and conflicting,” stated researchers. “Our findings imply that the association between estimated liver fibrosis and dementia risk may be strongest when fibrosis was assessed in midlife rather than later life.”
The researchers added that future research is warranted to validate these findings across diverse populations and to elucidate the biological mechanisms underpinning the association between liver fibrosis and cognitive decline.
The authors reported no conflicts of interest.