The association between liver fibrosis score and incident dementia: A nationwide retrospective cohort study

Author:

Weinstein Galit1ORCID,Schonmann Yochai234,Yeshua Hanny45,Zelber‐Sagi Shira1

Affiliation:

1. School of Public Health University of Haifa Haifa Israel

2. Siaal Research Center for Family Medicine and Primary Care Faculty of Health Sciences Ben‐Gurion University of the Negev Beer‐Sheva Israel

3. Department of Quality Measurements and Research Clalit Health Services Tel‐Aviv Israel

4. Department of Family Medicine Tel‐Aviv District, Clalit Health Services Tel‐Aviv Israel

5. Faculty of Medicine Tel‐Aviv University Tel‐Aviv Israel

Abstract

AbstractBACKGROUNDWe assessed the relationship of liver fibrosis score with incident dementia in a large, national sample.METHODSFor this retrospective cohort study, data of dementia‐free individuals aged 40‐69 years were derived from electronic records of the largest healthcare provider in Israel. The association between liver fibrosis score (FIB‐4), assessed from routine laboratory measurements, and incident dementia was explored through multivariate cox regression models.RESULTSOf the total sample (N = 826,578, mean age 55 ± 8 years at baseline), 636,967 (77%) had no fibrosis, 180,114 (21.8%) had inconclusive fibrosis status and 9497 (1.2%) had high risk for advanced fibrosis. Over a median follow‐up of 17 years, 41,089 dementia cases were recorded. Inconclusive liver fibrosis and advanced fibrosis were associated with increased dementia risk (HR = 1.09, 95%CI: 1.07–1.11 and HR = 1.18, 95%CI: 1.10–1.27, respectively). This association remained robust through seven sensitivity analyses.CONCLUSIONSLiver fibrosis assessed through a serum‐based algorithm may serve as a risk factor for dementia in the general population.Highlights Liver fibrosis may predict dementia diagnosis in the general population. Inconclusive liver fibrosis was associated with 9% increased dementia risk. Advanced liver fibrosis was associated with 18% increased dementia risk. Findings remained robust in sensitivity analyses and after adjustments.

Publisher

Wiley

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