According to the findings of a recent study, non-alcoholic fatty liver disease (NAFLD) and fibrosis were not linked with a raised risk of incident dementia. Furthermore, NAFLD presence was not related to cognitive function impairment.  Using ultrasound and transient elastography data, Tian Xiao et al. aimed to determine the relationship of fibrosis and NAFLD with cognition and incident dementia among elderly people.

In this prospective cohort study (Rotterdam study), three different sets were included.

For assessment of NAFLD, Set 1 incorporated patients aged 70 years (n = 3.975, follow-up 15.5 years) with available fatty liver index (FLI) and Set 2 encompassed patients 69.9 years of age (n = 4.577, follow-up 5.7 years) with an abdominal ultrasound. Set 3, a subset of set 2, included people aged 67.6 years (n = 3.300, follow-up 5.6 years) that also underwent liver stiffness measurement to evaluate fibrosis. To cross-sectionally determine the correlation with cognition, sets 2 and 3 were also utilized.

People with missing alcohol data,  prevalent dementia, and secondary causes for steatosis were eliminated. Fibrosis was characterized as liver stiffness ≥8.0kPa and NAFLD as FLI≥60 or steatosis on ultrasound. Dementia was characterized as per DSM-III-R. Utilising Cox regression, quantification of the relationship between NAFLD, fibrosis, and incident dementia was done. Evaluation of the link between cognitive function and NAFLD was done cross-sectionally.

In fully adjusted models, NAFLD and fibrosis were steadily not related to elevated risk for dementia (Fibrosis, hazard ratio [HR]: 1.07; NAFLD based on FLI, HR: 0.92; NAFLD based on ultrasound, HR: 0.84). NAFLD was linked with a considerably lowered risk for incident dementia until 5 years following FLI evaluation (HR: 0.48). Additionally, NAFLD was not related to poor cognitive functionality, covering various domains.

NAFLD was reported to be protective in the initial 5 years of follow-up. This indicated towards NAFLD regression prior to commencement of dementia.  To conclude, people suffering from NAFLD were not at elevated risk of dementia. Furthermore, no association existed between liver stiffness and dementia.