Background/Aims: Various socioeconomic and racial disparities are well-documented for colon cancer. However, the association of dementia, which is a growing cause of mortality in the elderly, remains unexplored. We aim to understand the association between these two conditions, in the elderly population group. Methods: We utilized the 2020 National Inpatient Sample to investigate records admitted for colorectal cancer identified through ICD-10 CM codes. We divided records by the presence of dementia. Adjusted odds ratios (aORs) for predefined outcomes were determined using multivariable logistic and linear regression models, adjusting for comorbidities. The primary outcome assessed was inpatient mortality, while secondary outcomes include other inpatient complications. Results: We identified 33,335 hospitalizations with ages more than 60. The mean age was 75.2 and males constituted 50.4%. In a survey multivariable logistic and linear regression model adjusting for patient and hospital factors, utilizing propensity score matching, the presence of dementia is associated with lower inpatient mortality (aOR 0.49, 95% confidence interval [CI] [0.26, 0.92], p=0.03), lower hospitalization costs (beta coefficient -2,823, 95% CI [-5,266, -440], p=0.02), lower odds of acute respiratory failure (aOR 0.54, p=0.01), lower mechanical ventilation usage (aOR 0.26, p<0.01) but higher odds of mental status change (aOR 1.97, 95% CI [1.37, 2.84], p<0.01). Conclusions The presence of dementia is associated with a lower risk of inpatient mortality, and other clinical outcomes, in colorectal cancer cases admitted for hospitalization. Etiologies behind this relationship should be explored to understand this inverse relationship.

Background/Aims: Multi-society experts proposed the adoption of new terminology, metabolic dysfunctionassociated steatotic liver disease (MASLD) and steatotic liver disease (SLD). We studied the current prevalence of SLD and its subcategories in the US. Methods: Using the recent National Health and Nutrition Examination Survey from 2017 to 2023, we analyzed data from 12,199 participants (≥18 years) who completed transient elastography. SLD and its subcategories, including MASLD, metabolic and alcohol-related liver disease (MetALD), and alcohol-related liver disease (ALD), were categorized according to consensus nomenclature. Results: The age-adjusted prevalence of SLD (cut-off: 285 dB/m) was 35.0% (95% confidence interval [CI] 33.4–36.7). Within this category, the age-adjusted prevalence for MASLD was 31.9% (95% CI 30.4–33.4), MetALD 2.2% (95% CI 1.8–2.6), and ALD 0.8% (95% CI 0.6–1.1). The prevalence of SLD and MASLD showed a statistically insignificant decrease during COVID-19, while ALD increased without significance. In contrast, the prevalence of advanced fibrosis in SLD was significantly higher during the COVID-19 era, at 9.8% for 285 dB/m and 7.8% for 263 dB/m, compared to 7.4% (P=0.039) and 6% (P=0.041) in the pre-COVID-19 era. The proportion of advanced fibrosis and cirrhosis in individuals with ALD was two-fold higher than MASLD and MetALD, largely due to increases during the COVID-19 era. Conclusions While the prevalence of SLD and its subcategories remained stable, there was a significant increase in advanced fibrosis among SLD individuals during the COVID-19 era, with ALD having a proportion of advanced fibrosis and cirrhosis that was twice as high as MASLD and MetALD.

One-third of adults across the globe exhibit metabolic dysfunction-associated steatotic liver disease (MASLD)―formerly known as nonalcoholic fatty liver disease (NAFLD). To date, MASLD is the fastest-growing etiology of chronic liver disease and hepatocellular carcinoma (HCC). Besides the population with obesity, MASLD can also be found in lean populations, accounting for 13% of the global population, especially Asians. Notably, individuals with lean MASLD face equal or higher overall mortality rates compared to their non-lean counterparts. Risk modifiers encompass advanced age, hepatic fibrosis, and type 2 diabetes mellitus (T2DM). Moreover, the population with lean MASLD is associated with an increased risk of HCC, while their non-lean counterparts are more prone to cardiovascular outcomes and T2DM. Existing evidence indicates a similar risk of liver-related events and extrahepatic cancer between the two groups. However, MASLD-related genetic variants, such as PNPLA3 and TM6SF2, did not significantly affect mortality between the two populations. Still, underreporting alcohol consumption and regional representation limits the study’s comprehensiveness. Longitudinal studies and mechanistic explorations are needed to understand differences in lean versus non-lean MASLD populations. This review highlights the need for awareness and tailored interventions in managing MASLD, considering lean individuals’ unique risks.