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. 2021 Sep;66(9):3179-3185.
doi: 10.1007/s10620-020-06644-1. Epub 2020 Oct 10.

Incident Dementia in Elderly Patients with Nonalcoholic Fatty Liver Disease in Germany

Christian Labenz  1   2   3 , Karel Kostev  4 , Leonard Kaps  1   3 , Peter R Galle  1   2 , Jörn M Schattenberg  5   6   7
Affiliations
Free PMC article

Incident Dementia in Elderly Patients with Nonalcoholic Fatty Liver Disease in Germany

Christian Labenz et al. Dig Dis Sci. 2021 Sep.
Free PMC article

Abstract

Dementia and NAFLD are two frequent conditions that share underlying risk factors mainly in the realm of metabolic disease. Additionally, an association between NAFLD and brain aging has been proposed. Therefore, we investigated the hypothesis if NAFLD is an independent risk factor for emerging dementia. In this population-based cohort study, elderly patients (≥ 65 years) with NAFLD diagnosed between 2000 and 2015 were matched 1:1 to a cohort without NAFLD based on ICD-10 coding in the Disease Analyzer database. Matching criteria were age, sex, physician, index year, and co-diagnoses associated with dementia. The primary outcomes of this study were all-cause dementia diagnoses, the incidence of vascular dementia, and antidementive drug prescription. A total of 22,317 patients with NAFLD were matched to 22,317 patients without NAFLD. Within 10 years of the index date, 16.0% of patients with NAFLD and 15.6% of the patients without NAFLD were diagnosed with dementia. On Cox regression analysis, there is no association between NAFLD and the incidence of all-cause dementia (HR 0.97, 95% CI 0.92-1.04), vascular dementia (HR 0.89, 95% CI 0.78-1.02), or the new prescription of antidementive therapy (HR 0.87, 95% CI 0.76-1.01). In sensitivity analyses, there was no association between NAFLD and dementia in different age-groups as well as men or women. In conclusion, in this database study of elderly patients coded with NAFLD no independent association with incident dementia was detected. Risk assessment regarding dementia in patients with NAFLD should be carried out in the same way as for metabolic burdened patients.

Keywords: Aging; Cognitive decline; Cognitive impairment; Database research study; Metabolic inflammation.

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Conflict of interest statement

JMS has received personal fees for consultancy to BMS, Echosens, Genfit, Gilead Sciences, Intercept Pharmaceuticals, Madrigal, Novartis, Pfizer, and Roche. Research funding is obtained from Gilead Sciences that serves on the speakers’ bureau for the Falk Foundation. KK is an employee of IQVIA. The other authors disclose no potential financial or non-financial conflict of interests.

Figures

Fig. 1
Fig. 1
Selection of study patients
Fig. 2
Fig. 2
Cumulative incidence of all-cause dementia diagnosis in patients with and without NAFLD/NASH
Fig. 3
Fig. 3
Cumulative incidence of vascular dementia diagnosis in patients with and without NAFLD/NASH
Fig. 4
Fig. 4
Cumulative incidence of antidementive drug prescription in patients with and without NAFLD/NASH
See this image and copyright information in PMC

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