When Dementia Isn’t Dementia: A Surprising Misdiagnosis
Imagine being told you or a loved one has dementia - a life-altering diagnosis with no known cure. Now imagine learning later that the real culprit might be something else entirely and treatable. An article in Science Alert shed light on a surprising misdiagnosis that was exactly that.
According to a 2024 study, up to 13% of dementia cases in the U.S. may be misdiagnosed. Instead of true cognitive decline, these individuals could be suffering from hepatic encephalopathy, a condition caused by advanced liver disease. The liver is the body’s unsung hero—filtering toxins, supporting digestion, and regulating vital chemicals. When it starts to fail, toxins build up in the bloodstream, including those that affect the brain. This results in symptoms that can look almost identical to dementia: confusion, memory loss, personality changes, and poor concentration.
More than 40% of patients with cirrhosis (severe liver scarring) experience hepatic encephalopathy, noted the article. Yet many go undiagnosed, especially since the condition mimics Alzheimer’s and other forms of dementia. These individuals continue to struggle with a disease that can be treated. When the proper diagnosis is finally made, there is the potential for patients to regain cognitive function after receiving liver care.
In the study, researchers looked at the medical records of over 177,000 U.S. veterans who had been diagnosed with dementia between 2009 and 2019. None of them had officially been diagnosed with liver disease, but more than 10% had high FIB-4 scores—a test that estimates liver scarring. That suggests many likely had cirrhosis, a serious liver condition caused by long-term damage. Cirrhosis happens when healthy liver tissue is slowly replaced with scar tissue and the liver stops working properly.
The same researchers checked records for nearly 69,000 people from the general U.S. population (not veterans) to see if the same pattern showed up. Surprisingly, they found that nearly 13% had high FIB-4 scores—meaning signs of possible cirrhosis were even more common. They also noticed that more people with high FIB-4 scores were from non-white racial backgrounds. The researchers didn’t explore the reasons, but they suggested that unequal access to medical care might play a role—both for dementia and other health issues.
This research shows a strong connection between liver health and brain health. It supports the idea that doctors should screen for treatable causes—like liver issues—when someone is showing signs of dementia.
If you suspect that you or a loved one is a victim of misdiagnosis at a hospital or doctor’s office, contact one of Philadelphia’s top attorneys for misdiagnosis cases. In the last few years, almost every teaching hospital in the city of Philadelphia has paid 8-figure verdicts and settlements to clients of Tom Duffy.