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Review
. 2022 Aug;20(8S):S20-S29.
doi: 10.1016/j.cgh.2022.04.035.

Specific Challenges in Geriatric Cirrhosis and Hepatic Encephalopathy

Jasmohan S Bajaj  1 , Angela Gentili  2 , James B Wade  3 , Michael Godschalk  2
Affiliations
Review

Specific Challenges in Geriatric Cirrhosis and Hepatic Encephalopathy

Jasmohan S Bajaj et al. Clin Gastroenterol Hepatol. 2022 Aug.

Abstract

As the world's population ages, diseases predominantly found in the elderly now overlap with diseases that were thought to be the purview of younger patients. This includes chronic liver disease, which affects more than 2 billion people worldwide. Owing to the obesity epidemic (and associated metabolic diseases), nonalcoholic fatty liver disease has become the most common cause of chronic liver disease and cirrhosis. A major complication of cirrhosis is hepatic encephalopathy (HE), which becomes challenging to diagnose in elderly patients. HE is usually included in the differential diagnosis of acute delirium but not of reversible dementias. To illustrate this point, we present 2 cases of older patients that were misdiagnosed as having dementia and Parkinson's disease or a parkinsonian syndrome but had contributions from cirrhosis. Both cognitive impairment and tremor resolved with treatment of HE.

Keywords: Alcohol; Dementia; EncephalApp; Lewy Body Dementia; Parkinson’s disease; Progressive Supranuclear Palsy; Wernicke’s Encephalopathy.

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Conflict of interest statement

Conflict of Interest: None for any author

Figures

Figure 1
Figure 1
Venn diagram of major symptoms of overt hepatic encephalopathy, Lewy Body dementia and Parkinsonian Disease Dementia
See this image and copyright information in PMC

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