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Association of liver fibrosis with cognitive test performance and brain imaging parameters in the UK Biobank study

Parikh NS, Kamel H, Zhang C, Gupta A, Cohen DE, de Leon MJ, Gottesman RF, Iadecola C

Alzheimer's & dementia : the journal of the Alzheimer's Association, 2023

105,313 participants

Abstract

INTRODUCTION: We hypothesized that liver fibrosis is associated with worse cognitive performance and corresponding brain imaging changes.

METHODS: We examined the association of liver fibrosis with cognition and brain imaging parameters in the UK Biobank study. Liver fibrosis was assessed using the Fibrosis-4 (FIB-4) score. The primary cognitive outcome was the digit symbol substitution test (DSST); secondary outcomes were additional executive function/processing speed and memory tests. Imaging outcomes were hippocampal, total brain, and white matter hyperintensity (WMH) volumes.

RESULTS: We included 105,313 participants with cognitive test data, and 41,982 with magnetic resonance imaging (MRI). In adjusted models, liver fibrosis was associated with worse performance on the DSST and tests of executive function but not memory. Liver fibrosis was associated with lower hippocampal and total brain volumes, without compelling association with WMH volume.

DISCUSSION: Liver fibrosis is associated with worse performance on select cognitive tests and lower hippocampal and total brain volumes.

HIGHLIGHTS: It is increasingly recognized that chronic liver conditions impact brain health. We performed an analysis of data from the UK Biobank prospective cohort study. Liver fibrosis was associated with worse performance on executive function tests. Liver fibrosis was not associated with memory impairment. Liver fibrosis was associated with lower hippocampal and total brain volumes.

How strong is the evidence?

Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 105,313 participants or records.

How the five levels of evidence work. The level is assigned automatically from the abstract and can be wrong, so check the paper.

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