Think of it as Yoga for the brain, we are going to stretch a bit.
The Curious Case of
“Fixable Dementia”
Here’s a tale fit for our times: Up to 13 percent of dementia cases may not be dementia at all, but something doctors could actually fix if they looked past the obvious. A new study dug through U.S. medical records and found that many folks labeled with dementia had high scores on the FIB-4 index — a simple blood test that estimates liver fibrosis.
Now, what’s the liver got to do with memory? More than you’d think. When that big chemical factory in your gut goes bad, toxins like ammonia and other nasties build up in the blood. They slip past the brain’s defenses, muddle thinking, and — presto — you’ve got hepatic encephalopathy. The poor fellow forgets his grandchildren’s names, stares off into space, and the diagnosis stamp says “dementia.” But in truth, his liver’s whispering: “Don’t blame the brain, blame me.”
Doctors have already seen a few miracles in miniature. Treat the liver disease — lower ammonia, manage the fibrosis, sometimes with medications like lactulose or rifaximin — and the patient’s mind sharpens right back up. In at least two reported cases, people once told they had dementia saw their confusion fade after the liver was cared for.
That’s not to say all 13 percent of cases are reversible. No, sir. Some will still be true neurodegeneration, tangled with Alzheimer’s plaques or vascular damage. But the numbers are big enough to matter. For every hundred families bracing themselves for the long night of dementia, perhaps a dozen could instead find the light switch — if only someone checked the liver.
And here’s where I can’t resist the Twain chuckle: in a world of billion-dollar dementia drugs and brain scans lit up like fireworks, we may forget that the humble liver — sitting there like a silent janitor — can sometimes explain the mystery. Maybe before we condemn the house as haunted, we ought to look at the plumbing.
Moral of the story: not all forgetfulness is final, and not every diagnosis is destiny. Sometimes, the best cure for “dementia” is to stop ignoring the liver that’s been hollering all along.
🩺 Clinical Sidebar
FIB-4 Index: A blood test calculation using age, AST, ALT, and platelet count to estimate liver fibrosis.
Hepatic Encephalopathy (HE): A decline in brain function due to buildup of toxins (especially ammonia) when the liver fails to filter blood properly.
Key Symptoms: Confusion, forgetfulness, difficulty concentrating, sleep disturbances, even tremors. Can mimic dementia.
Treatments:
Lactulose (a non-absorbable sugar that helps reduce ammonia absorption in the gut).
Rifaximin (an antibiotic that reduces ammonia-producing gut bacteria).
Study Finding: Nearly 13% of dementia-labeled patients had high FIB-4 scores suggesting undiagnosed liver fibrosis; at least two cases reversed cognitive decline after liver treatment.
