Clin Mol Hepatol.
2022 Jul;28(3):510-521. 10.3350/cmh.2021.0332.
Association of non-alcoholic fatty liver disease with incident dementia later in life among elder adults
- Affiliations
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- 1Department of Biomedical Sciences, Seoul National University College of Medicine, Seoul, Korea
- 2Department of Biomedical Informatics, CHA University School of Medicine, CHA University, Seongnam, Korea
- 3Department of Family Medicine, Chung-Ang University Gwangmyeong Hospital, Chung-Ang University College of Medicine, Gwangmyeong, Korea
- 4Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
- 5Department of Internal Medicine, Hallym University Sacred Heart Hospital, Anyang, Korea
- 6Estherformula Medical Food R&D Center, Seoul, Korea
- 7Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA
- 8Division of Gastroenterology and Hepatology, Department of Internal Medicine, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, Korea
- 9Division of Endocrinology, Department of Internal Medicine, Seoul Metropolitan Government Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea
- 10Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
- 11Department of Family Medicine, Seoul National University Hospital, Seoul, Korea
- KMID: 2531375
- DOI: http://doi.org/10.3350/cmh.2021.0332
Abstract
- Background/Aims
Accumulating evidence suggests a link between non-alcoholic fatty liver disease (NAFLD) and brain health. However, population-based evidence on the association between NAFLD and dementia remains unclear. This study was conducted to determine the association between NAFLD and incident dementia.
Methods
The study population included 608,994 adults aged ≥60 years who underwent health examinations between 2009 and 2010. Data were collected from the Korean National Health Insurance Service database. NAFLD was assessed using the fatty liver index (FLI). A Cox proportional hazards regression model was used to determine the association between NAFLD and dementia.
Results
During the 6,495,352 person-years of follow-up, 48,538 participants (8.0%) developed incident dementia. The participants were classified into low (FLI <30), intermediate (FLI ≥30 and <60), and high (FLI ≥60) groups. In the overall study population, the FLI groups were associated with a risk of dementia (P for trend <0.001). After propensity score matching, a low FLI was associated with a reduced risk of dementia (adjusted hazard ration [aHR], 0.96; 95% confidence interval [CI], 0.93–0.98; P=0.002), whereas a high FLI (NAFLD) was associated with an increased risk of dementia (aHR, 1.05; 95% CI, 1.02–1.08; P=0.001). A higher risk of dementia in the high FLI group than in the intermediate FLI group was attributed to Alzheimer’s disease (aHR, 1.04; 95% CI, 1.01–1.07; P=0.004) rather than vascular dementia (aHR, 0.94; 95% CI, 0.75–1.18; P=0.602).
Conclusions
NAFLD was associated with an increased risk of dementia, which was attributed to an increased risk of Alzheimer’s disease.
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