Dementia Causes More Treatable Than Though Earlier

Summary: Emerging data suggests that we might have underestimated the other reversible causes of dementia. Thus, one of the new retrospective studies found elevated FIB-score in 13% of dementia patients. Considering that poorly managed hepatic disease may cause hepatic encephalopathy, leading to a dementia-like condition, it is evident that other causes of dementia are probably much more common. It also suggests that many dementia cases can be prevented with early interventions.

 It is true that there is no cure for Alzheimer’s. However, Alzheimer’s is not the only cause of dementia. Moreover, dementia symptoms start occurring when significant damage to brain cells has happened. It is a decompensatory phase. It means that significant cases of dementia can be prevented by early identification and management of diseases known to cause dementia.

Dementia can occur due to tens of reasons, and science has started learning more about various dementia reasons. When dementia used to be a rare disease, Alzheimer’s was the most common dementia cause. However, in modern times, when dementia has become one of the leading causes of death and disability, the share of Alzheimer’s as dementia’s cause has been declining.

Even further, many studies and researchers say that we might have underestimated the role of other dementias. So, just take an example: the above image shows what is widely accepted, that other causes of dementia contribute to about 5% of dementia cases. However, now, new studies show that perhaps the reality is different. It is quite likely that in many cases, dementia causes remain wrongly identified, resulting in poor understanding of these types of dementia.

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New studies suggest that other dementia causes may be responsible for 10-15% of dementia, or even more. This means that untreatable causes like Alzheimer’s are responsible for far fewer dementia cases than traditionally imagined and concluded.

New studies are increasingly showing the role of metabolic disorders in increasing dementia risk. It appears that researchers and scientists underestimated this factor. This also means that significant dementia causes are treatable, and hence, it also means that many dementia cases are entirely preventable. 

Considering that 10% of Americans now have dementia, the numbers are rising due to the aging population, better dementia identification, and also due to a significant rise in dementia cases. All these statistics highlight how important it is to identify dementia causes appropriately.

Many people develop dementia because the disease that causes dementia remains unidentified till late. It means that precious time is lost when that underlying disease could have been treated with great success. 

Just take the example of liver disease. Severe liver diseases are on the rise, and they can cause encephalopathy, thus leading to conditions that may mimic dementia. However, if those patients are not treated in a timely manner, it may result in permanent loss of brain cells.

In one of the studies, researchers evaluated the records of 68,000 patients diagnosed with mild cognitive deficit, often an early stage/sign of dementia. However, they found that 13% of these patients had elevated Fibrosis-4 (FIB-4) scores for cirrhosis. This score can be easily calculated using some of the readily available blood tests. This score shows the risk of developing liver fibrosis or cirrhosis. 

Researchers were amazed by such a high number of patients showing elevated FIB-4 scores. This shows that the number of cases caused by other causes of dementia is underestimated. It is worth understanding that most diseases causing elevated FIB-4 scores are treatable or curable. This means that if those conditions are treated earlier, they can help prevent dementia in many cases.

So, it is true that there is still no cure for dementia. However, it is also worth realizing that many dementia cases are caused due to treatable diseases. It means that a significant number of dementia cases are preventable. Moreover, many of these conditions can be readily diagnosed using commonly available blood tests. Thus, there is a need to increase awareness that cases of dementia due to other causes are rising. Both the doctors and patients need to realize that, in many instances, dementia may occur due to treatable causes.

Source:

Silvey, S., Sterling, R. K., French, E., Godschalk, M., Gentili, A., Patel, N., & Bajaj, J. S. (2024). A Possible Reversible Cause of Cognitive Impairment: Undiagnosed Cirrhosis and Potential Hepatic Encephalopathy in Patients with Dementia. The American Journal of Medicine, 0(0). https://doi.org/10.1016/j.amjmed.2024.06.014