Metabolic-associated fatty liver disease

Nonalcoholic fatty liver disease (NAFLD), also known as metabolic-associated steatotic liver disease (MASLD), occurs when excess fat accumulates in the liver, leading to inflammation, scarring and liver failure, with prevalence increasing significantly among older adults. As NAFLD progresses, it will lead to liver inflammation, scarring and even liver failure. If left untreated, NAFLD can advance to more severe liver conditions such as nonalcoholic steatohepatitis (NASH), cirrhosis and liver cancer.

In 2023, the term NAFLD was replaced with MASLD (metabolic dysfunction-associated steatotic liver disease) to more accurately highlight its root cause — metabolic dysfunction. Unlike NAFLD, which primarily excluded other causes of liver disease, MASLD requires evidence of metabolic dysfunction alongside liver fat accumulation.

A study published in BMC Gastroenterology found that 40.3% of individuals aged 60 to 74 and 39.2% of those over 74 have NAFLD. For those between 60 and 74 years old, NAFLD is linked to a 60% higher risk of all-cause mortality within five years and a 22% higher risk within 10 years. Cardiovascular mortality also more than doubles in this age group over a five-year period. However, these increased risks are not observed in those older than 74, indicating that the disease’s impact could lessen with advanced age.