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Background  The prevalence and outcomes of non-alcoholic fatty liver disease (NAFLD) among elderly have not been well described. Our aim was to assess the prevalence, risk factors and mortality of NAFLD in individuals older than 60 years.    Methods  The data from the Third National Health and Nutrition Examination Survey with linked mortality files were utilized. NAFLD was defined by United States Fatty Liver Index in the absence of other causes of liver disease. Cox proportional hazards models were used to assess all-cause and cardiovascular (CV) mortality. All analyses were performed using SAS software.    Results  Three thousand two hundred seventy-one NHANES-III participants were included. The prevalence rates from NAFLD were 40.3% (95% CI: 37.2–43.5%) and 39.2% (95% CI: 34.4–44.0%) among 60–74 and > 74 years old. Among aged 60–74, the risks for 5-year and 10-year all-cause mortality were associated with presence of NAFLD [adjusted hazard ratios: 1.60 (95% CI: 1.24–1.96) for 5-year and 1.22 (95%CI: 1.01–1.49) for 10-year]. CV mortality were higher in this group were (aHR: 2.12 (95% CI: 1.20–3.75) for 5-year and 1.06 (95%CI: 0.73–1.52) for 10-year]. In contrast, in individuals > 74 years old, diagnosis of NAFLD was not associated with all-cause or CVD mortality.    Conclusions  NAFLD is common among elderly population. Although NAFLD is associated with increased risk of mortality for 60–74-year-old individuals, this risk was not increased in those older than 74 years.    Electronic supplementary material  The online version of this article (10.1186/s12876-019-0972-6) contains supplementary material, which is available to authorized users.

Prevalence and long-term outcomes of non-alcoholic fatty liver disease among elderly individuals from the United States