Nonalcoholic fatty liver disease (NAFLD) is commonly demonstrated in the elderly. NAFLD carries a more substantial burden of hepatic (nonalcoholic steatohepatitis, cirrhosis and hepatocellular carcinoma) and extra-hepatic manifestations and complications (cardiovascular disease, extrahepatic neoplasms) in the elderly than in younger age groups. 

Thus clinical geriatricians and geriatric hepatologists have a great burden of proper identification and management of this condition. The proper treatment strategy needs to involve the peculiarities of geriatric patients, thus mandating a multidisciplinary approach. 

Non-pharmacological treatment (diet and physical exercise) in this population needs to be customized in each elderly patient considering their physical limitations and the need for an adequate caloric supply. 

Likewise, the choice of drug treatment must carefully balance the benefits and risks in terms of adverse events and pharmacological interactions since they tend to have multiple health conditions and polypharmacy. 

Further epidemiological and pathophysiological insight is warranted to adequately address this population and to get a more accurate understanding of the molecular mechanisms of geriatric NAFLD. This will further aid in identifying the most appropriate diagnostic and therapeutic approach for individual elderly patients.

Source: Bertolotti M, Lonardo A, Mussi C, Baldelli E, Pellegrini E, Ballestri S, Romagnoli D, Loria P. Nonalcoholic fatty liver disease and aging: epidemiology to management. World J Gastroenterol. 2014;20(39):14185-204. doi: 10.3748/wjg.v20.i39.14185. PMID: 25339806; PMCID: PMC4202348.