ArticleNeurology2022
Association of Nonalcoholic Fatty Liver Disease and Fibrosis With Incident Dementia and Cognition: The Rotterdam Study.
Article in Neurology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 34 papers, 3 of them syntheses that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
34 citing papers in PubMed, 3 syntheses or guidelines pooled it, 54 citations in OpenAlex.
- Population attributable fractions of a wide range of peripheral diseases for the burden of dementia.Nature human behaviour · 2026Pooled it
- Nonalcoholic fatty liver disease, liver fibrosis, and structural brain imaging: The Cross-Cohort Collaboration.European journal of neurology · 2024Pooled it
- Non-alcoholic fatty liver disease and the risk of dementia: A meta-analysis of cohort studies.Clinical and molecular hepatology · 2022Pooled it
- MASLD in the oldest-old: lack of association with cognition or functional autonomy and poor predictive utility of the hepatic steatosis index.GeroScience · 2026Observational
- Aqueous Extract ofFoods (Basel, Switzerland) · 2026Article
- Cross-trait genomic modeling reveals the polygenic architecture and systemic impact of MASLD.Science advances · 2026Article
- Long-term dementia risk in metabolic dysfunction-associated steatotic liver disease: a population-based study.Metabolic brain disease · 2026Article
- Liver Fibrosis and the Risks of Impaired Cognition and Dementia: Mechanisms, Evidence, and Clinical Implications.Medical sciences (Basel, Switzerland) · 2026Review
- The Influence of Metabolic Dysfunction-Associated Steatotic Liver Disease and Body Mass Index on the Incidence of Alzheimer Disease: A Nationwide Cohort Study.Gut and liver · 2026Article
- Article
- Increased Risk of Alzheimer Disease-Associated Mortality in Nonobese vs Obese Metabolic Dysfunction-Associated Steatotic Liver Disease: A 30-Year National Cohort Study.Gastro hep advances · 2026Article
- Metabolic dysfunction-associated steatotic liver disease as a risk factor for cognitive decline: Findings from the ELSA-Brasil cohort.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2026Article
- Liver Fibrosis and Risk of Incident Dementia in the General Population: Systematic Review With Meta-Analysis.Health science reports · 2025Review
- Review
- Metabolic Dysfunction-Associated Steatotic Liver Disease Is Associated With Accelerated Brain Ageing: A Population-Based Study.Liver international : official journal of the International Association for the Study of the Liver · 2025Article
- Metabolic dysfunction-associated steatotic liver disease, metabolic alcohol-related liver disease, and incident dementia: a nationwide cohort study : MASLD, MetALD, and dementia risk.BMC gastroenterology · 2025Article
- Association Between Handgrip Strength and Cardiovascular Disease Risk in MASLD: A Prospective Study From UK Biobank.Journal of cachexia, sarcopenia and muscle · 2025Article
- A narrative review about cognitive impairment in Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD): Another matter to face through a holistic approach.Journal of advanced research · 2025Review
- Baseline liver fibrosis-4 score correlates to the progression of anxiety and cognitive impairment in patients with Parkinson's disease.Frontiers in aging neuroscience · 2025Article
- Causal relationships between Alzheimer's disease and metabolic dysfunction associated with fatty liver disease: insights from bidirectional network Mendelian Randomization analysis.Metabolomics : Official journal of the Metabolomic Society · 2024Article
Corrections and comments
- Commented on by
- Commented on by
- Erratum issued
Authors and funding
5 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND AND
objectivesNonalcoholic fatty liver disease (NAFLD) might affect brain health via the so-called liver-brain axis. Whether this results in an increased risk for dementia remains unclear. Therefore, we investigated the association of NAFLD and fibrosis with incident dementia and cognition among the elderly.
methodsWe performed longitudinal and cross-sectional analyses within the Rotterdam Study, an ongoing prospective cohort. Participants visiting between 1997 and 2002 with available fatty liver index (FLI) (set 1) or participants visiting between 2009 and 2014 with abdominal ultrasound (set 2) and liver stiffness (set 3) were included. Exclusion criteria were secondary causes for steatosis, prevalent dementia, and missing alcohol data. NAFLD was defined as FLI ≥60 or steatosis on ultrasound and fibrosis as liver stiffness ≥8.0 kPa. Dementia was defined according to the
resultsSet 1 included 3,975 participants (age 70 years, follow-up 15.5 years), set 2 4,577 participants (age 69.9 years, follow-up 5.7 years), and set 3 3,300 participants (age 67.6 years, follow-up 5.6 years). NAFLD and fibrosis were consistently not associated with an increased risk for dementia (NAFLD based on ultrasound, hazard rate [HR] 0.84, 95% CI 0.61-1.16; NAFLD based on FLI, HR 0.92, 95% CI 0.69-1.22; fibrosis, HR 1.07, 95% CI 0.58-1.99) in fully adjusted models. Of interest, NAFLD was associated with a significantly decreased risk for incident dementia until 5 years after FLI assessment (HR 0.48; 95% CI 0.24-0.94). Moreover, NAFLD was not associated with worse cognitive function, covering several domains.
conclusionsNAFLD and fibrosis were not associated with an increased risk for incident dementia, nor was NAFLD associated with impaired cognitive function. In contrast, NAFLD was even protective in the first 5 years of follow-up, hinting toward NAFLD regression before dementia onset. TRIAL REGISTRATION INFORMATION: Clinical Trial Number: NTR6831.
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