Liver Transplant Recipients Older Than 60 Years Show Executive and Memory Function Improvement Comparable to Younger Recipients.
Adult
Age Factors
Aged
Cognition Disorders
/ epidemiology
Executive Function
/ physiology
Female
Florida
/ epidemiology
Follow-Up Studies
Humans
Liver Transplantation
/ adverse effects
Male
Memory
/ physiology
Middle Aged
Neuropsychological Tests
/ statistics & numerical data
Postoperative Complications
/ epidemiology
Brief Test of Adult Cognition by Telephone neuropsychological
cognitive
elderly
hepatic encephalopathy
Journal
Psychosomatics
ISSN: 1545-7206
Titre abrégé: Psychosomatics
Pays: England
ID NLM: 0376506
Informations de publication
Date de publication:
Historique:
received:
26
12
2018
revised:
21
01
2019
accepted:
21
01
2019
pubmed:
18
2
2019
medline:
1
8
2020
entrez:
18
2
2019
Statut:
ppublish
Résumé
Increasing numbers of patients over the age of 60 are undergoing liver transplantation. We sought to determine whether age or clinical morbidities were associated with pre- and post-transplant executive and memory performance using the Brief Test of Adult Cognition by Telephone (BTACT). Participants included 36 recipients with n = 20 in the older group (>60 y) and n = 16 in the younger group (≤60 years). The BTACT was administered an average of 3 months before transplant, and at follow-up post-transplant intervals of 3, 6, and 9 months. BTACT composite scores for memory and executive function with age and education norms were obtained. Older recipients were more likely to have hepatocellular carcinoma, a lower biological MELD score at transplant, less cellular rejection, and fewer post-operative hospital days. Older and younger recipients showed comparable pre-transplant executive and memory function and comparable post-transplant improvement. Both older and younger patients showed statistically significant improvement in executive function scores at 3 months post-transplant and maintained improvement at 6 and 9 months. Memory function improved significantly in older patients by 6 months post-transplant but did not improve significantly in the younger group. Older liver transplant recipients were more likely to have hepatocellular carcinoma and a lower biological MELD score than younger recipients, but both age groups showed comparable pre-transplant cognitive performance and post-transplant cognitive improvement. Additionally, a normed telephone test can be used to effectively screen and track executive and memory function post-transplant.
Sections du résumé
BACKGROUND
Increasing numbers of patients over the age of 60 are undergoing liver transplantation.
OBJECTIVE
We sought to determine whether age or clinical morbidities were associated with pre- and post-transplant executive and memory performance using the Brief Test of Adult Cognition by Telephone (BTACT).
METHODS
Participants included 36 recipients with n = 20 in the older group (>60 y) and n = 16 in the younger group (≤60 years). The BTACT was administered an average of 3 months before transplant, and at follow-up post-transplant intervals of 3, 6, and 9 months. BTACT composite scores for memory and executive function with age and education norms were obtained.
RESULTS
Older recipients were more likely to have hepatocellular carcinoma, a lower biological MELD score at transplant, less cellular rejection, and fewer post-operative hospital days. Older and younger recipients showed comparable pre-transplant executive and memory function and comparable post-transplant improvement. Both older and younger patients showed statistically significant improvement in executive function scores at 3 months post-transplant and maintained improvement at 6 and 9 months. Memory function improved significantly in older patients by 6 months post-transplant but did not improve significantly in the younger group.
CONCLUSION
Older liver transplant recipients were more likely to have hepatocellular carcinoma and a lower biological MELD score than younger recipients, but both age groups showed comparable pre-transplant cognitive performance and post-transplant cognitive improvement. Additionally, a normed telephone test can be used to effectively screen and track executive and memory function post-transplant.
Identifiants
pubmed: 30772017
pii: S0033-3182(19)30023-4
doi: 10.1016/j.psym.2019.01.008
pii:
doi:
Types de publication
Comparative Study
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
488-498Informations de copyright
Copyright © 2019 Academy of Consultation-Liaison Psychiatry. Published by Elsevier Inc. All rights reserved.