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Hope for Veterans diagnosed with dementia and cirrhosis:

Dr. Jasmohan Bajaj, a gastroenterology specialist at the Richmond VA Medical Center and professor of medicine at Virginia Commonwealth University.
Dr. Jasmohan Bajaj is a gastroenterology specialist at the Richmond VA Medical Center and professor of medicine at Virginia Commonwealth University. Dr. Bajaj is a world-renowned expert in hepatic encephalopathy.
By Jeff Clements, Public Affairs Specialist

For many Veterans and their caregivers, the loss of cognitive function and the ability to communicate patient needs can be one of the most daunting hurdles to overcome when dealing with dementia.

Symptoms can cause distress to Veterans and their families alike. In some cases, dementia can be coupled with advanced liver disease, such as cirrhosis, and health care can become extremely difficult to manage. 

According to a new study published in the Journal of the American Medical Association (JAMA), developing research could help Veterans in just such situations. 

“The main focus of the research is to find out whether Veterans diagnosed with dementia could have a treatable and reversible brain disease,” said Dr. Jasmohan Bajaj, a gastroenterology specialist at the Richmond VA Medical Center and professor of medicine at Virginia Commonwealth University.
Hepatic encephalopathy affects patients with liver cirrhosis and is now increasingly found in elderly patients, Bajaj explained. Prior studies done by his group have shown there can be an extensive overlap between this disease’s symptoms and those of dementia.
Hepatic encephalopathy occurs when the liver no longer filters toxins like it should. Toxins then build up in the bloodstream and can affect brain function. The results can be confusion, disorientation, and erratic behavior. 
The testing of Veterans for liver disease and catching cirrhosis in its early stages could allow physicians to address and treat symptoms masquerading as dementia.
“Our research shows that as many as 10% of Veterans with a dementia diagnosis could have cirrhosis and potentially even hepatic encephalopathy,” Bajaj said. “Treatment of which could reverse some of these symptoms.”
This new research, which was conducted at VA medical centers across the country, studied medical records of more than 175,000 U.S. Veterans over a 10-year period who were diagnosed with dementia but not cirrhosis. 
By making the patients, caregivers, and clinicians aware of these potentially overlapping symptoms, Bajaj hopes to encourage Veterans diagnosed with dementia to reassess their case. 
Liver disease in some form is estimated to affect as many as 30% of the 18.6 million U.S. Veterans living today.
With treatment comes the potential of providing relief and recovery from reversible cognitive effects and restoring some quality of life for Veterans and their caregivers.

Read the full research article here: Undiagnosed Cirrhosis and Hepatic Encephalopathy in a National Cohort of Veterans With Dementia | Gastroenterology and Hepatology | JAMA Network Open | JAMA Network