Question Could patients with dementia have undiagnosed cirrhosis and possibly missed treatable cognitive impairment?

Findings In this cohort study including 177 422 veterans with a diagnosis of dementia, a high Fibrosis-4 score suggestive of advanced liver fibrosis to cirrhosis was observed in 5% to 10% of the patients who previously did not have a diagnosis of cirrhosis. These findings were supported by 2 validation cohorts within the Richmond VA Medical Center.

Meaning The findings of this study suggest that clinicians treating patients with dementia should investigate a reversible factor associated with cognitive decline, including missed or undiagnosed cirrhosis with hepatic encephalopathy.