A nationwide study of 3,071,829 adults without baseline dementia found that over 5.4 years, steatotic liver disease raised dementia risk. Alcohol-related liver disease (ARLD) showed the highest risk, with 72,545 all-cause dementia cases recorded overall, including 56,999 Alzheimer’s disease and 8,923 vascular dementia cases. Metabolic dysfunction-associated steatotic liver disease (MASLD) followed ARLD in risk magnitude, while metabolic dysfunction-associated alcohol-related liver disease (MetALD) had largely neutral associations aside from a slight vascular dementia increase.
Alcohol intake pattern further stratified risk: individuals with MASLD and no alcohol consumption faced consistently higher dementia risks across all outcomes, whereas those with within-threshold drinking had mixed results.
The observational study, published in Hepatology International, highlights the importance of distinguishing liver disease subtypes and alcohol use when assessing long-term brain health. The researchers call for further validation with longitudinal assessments.