Older adults who have hepatitis C may have a higher risk of developing cognitive impairment, a study in the American Journal of Geriatric Psychiatry has found.
Fu-Hsiung Su, M.D., Ph.D., of Fu Jen Catholic University in New Taipei City, Taiwan, and colleagues examined data from 23,781 participants aged 60 years or older whose information was available in the Taiwan Biobank in 2012. Among the participants, 912 had cognitive impairment as measured by the Taiwanese version of the Mini-Mental State Examination (MMSE). Participants received blood tests for hepatitis B and C as well as genetic testing.
The researchers found the following:
- Participants who had hepatitis C had 1.38 times the odds of having cognitive impairment compared with those without hepatitis C.
- Participants with hepatitis C but without hepatitis B had 1.52 times the odds of having cognitive impairment compared with participants without either type of hepatitis.
- Participants who had hepatitis B had 1.14 times the odds of having cognitive impairment compared with those without hepatitis B.
- Participants with hepatitis B but without hepatitis C had 1.21 times the odds of having cognitive impairment compared with participants without either type of hepatitis.
The researchers offered possible explanations for the more pronounced increase in risk among participants who had hepatitis C, noting that hepatitis C infection has been associated with disturbances in neurotransmitters and that hepatitis C can cross the blood-brain barrier and have toxic effects on brain cells.
The results also suggest that risk may be even higher in people with hepatitis C who also have a variation of the gene that provides instructions for making apolipoprotein E (APOE). The researchers noted that this variant, called APOE epsilon 4, has been shown in prior research to raise the risk of cognitive decline in people with hepatitis C. (APOE ε4 is also known to increase the risk for Alzheimer’s disease and is associated with an earlier age of disease onset in certain populations.)
“We suggest that individuals 60 years or older with chronic [hepatitis C] infection should undergo routine assessment of cognitive function by using rapid screening instruments, such as the MMSE,” they wrote. “Additional clinical and neuropsychological examinations may be indicated for individuals with abnormal MMSE scores.”
For related information, see the Psychiatric Services article “Integrating Hepatitis C Virus Treatment Programs Within Community Mental Health.”
(Image: iStock/shironosov)
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