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. 2021 Dec 8:13:748888.
doi: 10.3389/fnagi.2021.748888. eCollection 2021.

Liver Health and Dementia in an Italian Older Population: Findings From the Salus in Apulia Study

Luisa Lampignano  1 , Rossella Donghia  1 , Chiara Griseta  1 , Gianvito Lagravinese  2 , Sabrina Sciarra  1 , Roberta Zupo  1 , Fabio Castellana  1 , Ilaria Bortone  1 , Vito Guerra  1 , Sarah Tirelli  1 , Sara De Nucci  1 , Rossella Tatoli  1 , Madia Lozupone  3 , Giancarlo Sborgia  3 , Antonio Leo  4 , Giovanni De Pergola  1   5 , Gianluigi Giannelli  1 , Francesco Panza  1 , Rodolfo Sardone  1
Affiliations
Free PMC article

Liver Health and Dementia in an Italian Older Population: Findings From the Salus in Apulia Study

Luisa Lampignano et al. Front Aging Neurosci. .
Free PMC article

Erratum in

Abstract

Objectives: Non-alcoholic fatty liver disease (NAFLD) currently affects a quarter of the global population. Systemic inflammation, metabolic syndrome, and coronary artery disease, all conditions associated with NAFLD, have also been related to cognitive dysfunction in older age. The present study aimed to investigate the relationship between NAFLD risk and a dementia diagnosis in a large population-based sample aged > 65 years. Methods: We selected 1,542 participants (723 men) from the Salus in Apulia Study. To assess the risk of fat distribution in the liver, we used the Fatty Liver Index (FLI). Dementia was diagnosed according to the American Psychiatric Association criteria (DSM-5). Results: The overall prevalence of dementia was 8.5% [95% confidence interval (CI): 7-10%]. Subjects with dementia were older [effect size (ES): -0.89, 95% CI: -1.07 to -0.70], had a lower level of education (ES:0.88, 95% CI:0.69-1.06), higher levels of gamma-glutamyl transferase (ES: -0.21, 95% CI: -0.39 to -0.03), lower levels of total cholesterol (ES: -0.24, 95% CI: -0.42 to -0.06) and low-density lipoprotein cholesterol (ES: -0.20, 95% CI: -0.38 to 0.02), and a higher FLI (ES: -0.22, 95% CI: -0.39 to -0.04). In the logistic regression model adjusted for age, sex, education, hypertension, diabetes mellitus, alcohol consumption, smoking habits, stroke, cholesterol, and Apo-E, a dementia diagnosis was positively associated with FLI > 60 [odds ratio (OR):1.81; standard error (SE): 0.53; 95% CI: 1.02-3.21]. Conclusion: Our findings suggested that an increased NAFLD risk may be associated to dementia and cognitive decline in older age. Considering the high NAFLD prevalence, the possible adverse disease effects on cognitive performance pose a health problem with significant social and economic implications.

Keywords: NAFLD (non-alcoholic fatty liver disease); aging; dementia; liver; neurodegenerative diseases; older population.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

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References

    1. American Psychiatric Association [APA] (2000). Diagnostic and Statistical Manual of Mental Disorders: DSM-IV-TR. Washington: American Psychiatric Association.
    1. Anstey K. J., Ashby-Mitchell K., Peters R. (2017). Updating the evidence on the association between serum cholesterol and risk of late-life dementia: review and meta-analysis. J. Alzheimers. Dis. 56 215–228. 10.3233/JAD-160826 - DOI - PMC - PubMed
    1. Bassendine M. F., Taylor-Robinson S. D., Fertleman M., Khan M., Neely D. (2020). Is Alzheimer’s disease a liver disease of the brain? J. Alzheimer’s Dis. 75 1–14. 10.3233/jad-190848 - DOI - PMC - PubMed
    1. Bedogni G., Bellentani S., Miglioli L., Masutti F., Passalacqua M., Castiglione A., et al. (2006). The Fatty Liver Index: a simple and accurate predictor of hepatic steatosis in the general population. BMC Gastroenterol. 6:33. 10.1186/1471-230X-6-33 - DOI - PMC - PubMed
    1. Bedogni G., Miglioli L., Masutti F., Tiribelli C., Marchesini G., Bellentani S. (2005). Prevalence of and risk factors for non-alcoholic fatty liver disease: the Dionysos nutrition and liver study. Hepatology 42 44–52. 10.1002/hep.20734 - DOI - PubMed

Grants and funding

This study was funded by the Italian Ministry of Health with the “Ricerca Corrente 2019” Grant. The Salus in Apulia Study was funded by Apulia Government and Italian Ministry of Health, under the Studies on Aging Network, at Italian Research Hospitals (IRCCS).