Association between liver fibrosis and cognition in a nationally representative sample of older adults.
cognitive impairment
epidemiology
liver disease
liver fibrosis
risk factors
Journal
European journal of neurology
ISSN: 1468-1331
Titre abrégé: Eur J Neurol
Pays: England
ID NLM: 9506311
Informations de publication
Date de publication:
10 2020
10 2020
Historique:
received:
13
04
2020
accepted:
30
05
2020
pubmed:
6
6
2020
medline:
7
7
2021
entrez:
6
6
2020
Statut:
ppublish
Résumé
Liver fibrosis, a common yet often subclinical manifestation of chronic liver disease, may have an unrecognized role in cognitive impairment. We evaluated the association between a validated liver fibrosis index and cognitive measures among older adults. We examined the association between liver fibrosis and cognitive performance among participants aged 60 years and older in the US National Health and Nutrition Examination Survey. Liver fibrosis was measured with the validated Fibrosis-4 (FIB-4) liver fibrosis score. The outcomes were performance on four standardized cognitive tests of immediate and delayed verbal learning, verbal fluency, and attention/concentration. We used linear regression to evaluate the association between FIB-4 score and performance on cognitive tests while adjusting for potential confounders. In sensitivity analyses, we examined this association in participants without known liver disease. Among 3217 adult participants, the mean age was 69 years, and 54% were women. Standard liver chemistries were largely in the normal range. However, 5.0% [95% confidence interval (CI) 4.0-6.0] had liver fibrosis based on a validated cut-off. In adjusted linear regression models, higher liver fibrosis scores were associated with worse immediate recall (β -0.39; 95% CI -0.58, -0.21), language fluency (β -0.46; 95% CI -0.72, -0.21), and attention/concentration (β -1.34; 95% CI -2.25, -0.43), but not delayed recall (β -0.10; 95% CI -0.20, 0.01). Results were similar when limiting the study population to participants without known clinical liver disease. Liver fibrosis, including subclinical liver fibrosis, may be an independent risk factor for cognitive impairment among older adults.
Sections du résumé
BACKGROUND AND PURPOSE
Liver fibrosis, a common yet often subclinical manifestation of chronic liver disease, may have an unrecognized role in cognitive impairment. We evaluated the association between a validated liver fibrosis index and cognitive measures among older adults.
METHODS
We examined the association between liver fibrosis and cognitive performance among participants aged 60 years and older in the US National Health and Nutrition Examination Survey. Liver fibrosis was measured with the validated Fibrosis-4 (FIB-4) liver fibrosis score. The outcomes were performance on four standardized cognitive tests of immediate and delayed verbal learning, verbal fluency, and attention/concentration. We used linear regression to evaluate the association between FIB-4 score and performance on cognitive tests while adjusting for potential confounders. In sensitivity analyses, we examined this association in participants without known liver disease.
RESULTS
Among 3217 adult participants, the mean age was 69 years, and 54% were women. Standard liver chemistries were largely in the normal range. However, 5.0% [95% confidence interval (CI) 4.0-6.0] had liver fibrosis based on a validated cut-off. In adjusted linear regression models, higher liver fibrosis scores were associated with worse immediate recall (β -0.39; 95% CI -0.58, -0.21), language fluency (β -0.46; 95% CI -0.72, -0.21), and attention/concentration (β -1.34; 95% CI -2.25, -0.43), but not delayed recall (β -0.10; 95% CI -0.20, 0.01). Results were similar when limiting the study population to participants without known clinical liver disease.
CONCLUSION
Liver fibrosis, including subclinical liver fibrosis, may be an independent risk factor for cognitive impairment among older adults.
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
1895-1903Subventions
Organisme : New York State Empire Clinical Research Investigator Program
Pays : International
Organisme : Leon Levy Foundation, New York State Empire Clinical Research Investigator Program, and Florence Gould Foundation
Pays : International
Organisme : Florence Gould Foundation
Pays : International
Commentaires et corrections
Type : CommentIn
Informations de copyright
© 2020 European Academy of Neurology.
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