Cognitive decline is a common issue seen in older adults in the primary care setting. Assessment of cognitive decline in primary care includes a detailed history, physical examination, labs, imaging, and a formal cognitive assessment. Various tools are available for cognitive assessments. However, a short screening tool is more practical for cognitive evaluation. A decline in cognition should be correlated with the broader clinical picture, and a detailed cognitive assessment should be performed. This article focuses on some of the cognitive assessment tools used in clinical settings to assess cognition.
Nonalcoholic fatty liver disease (NAFLD) is a rapidly increasing cause of chronic liver disease with excess fat deposition in the liver, without an identifiable cause. NAFLD's benign form is called nonalcoholic fatty liver (NAFL), which can progress to nonalcoholic steatohepatitis (NASH) with or without fibrosis. Over time, NASH can progress to cirrhosis and eventually hepatocellular carcinoma (HCC) or progress to HCC without cirrhosis. Its incidence and prevalence are increasing to epidemic proportions, making it the most common cause of chronic liver disease in the western world. This review article attempts to understand the epidemiology, pathophysiology, evaluation, and management, and, most importantly, to generate awareness of this disease process.
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