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Cognitive impairment more prevalent in younger primary biliary cirrhosis patients

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BOSTON — Patients presenting with primary biliary cirrhosis at a younger age have significantly higher risk for cognitive impairment, according to data presented at The Liver Meeting.

Researchers analyzed the UK-PBC patient cohort (n=2,187) to assess the prevalence and risk factors of cognitive impairment using the PBC-40, the Orthostatic Grading Scale (OGS) and the Epworth Sleepiness Scale (ESS).

Clinically significant cognitive impairment was identified in 27% of patients, but 37% of those who did not have signs of advanced liver disease (normal bilirubin and albumin) had cognitive impairment. Notably, cognitive dysfunction was associated with younger age at diagnosis (r=-.14; P<.0001) and younger age at study enrollment (r=.11; P<.0001), compared with a positive correlation of r=.103 in a control population matched for age and sex.

Cognitive dysfunction was present in 35% of patients younger than age 50 years at presentation compared with 19% of patients aged older than 60 years (P<.0001), and it was not associated with disease duration or ursodeoxycholic acid response. There was a strong association between autonomic and cognitive symptoms in both age groups (mean OGS scores; 5.5 ± 3.7 vs. 2.3 ± 2.6; P<.0001), ESS scores were higher in the younger group with cognitive symptoms compared with the older group (P=.001), and social dysfunction was more common in younger patients with cognitive impairment compared with the older group (62% vs. 42%; P=.001).

Cognitive dysfunction occurs commonly in patients with PCB, but notably occurs most commonly in patients that present at a younger age, the researchers concluded. This evidence indicates that cognitive dysfunction in PBC may not just be a result of advancing age or hepatic encephalopathy, and according to the researchers, may instead be partially due to sleep disturbance in this age group, and autonomic dysfunction in both age groups. 

For more information:

Griffiths L. Abstract 301. Presented at: The Liver Meeting, Nov. 7-11, 2014; Boston, MA.

Disclosure: See the abstract for a full list of relevant financial disclosures.