The Influence of Social and Psychological Factors on Cognition Among Liver Transplant Recipients

IntroductionCognitive impairment in liver transplant recipients can lead to poor health outcomes, and identifying at-risk individuals is important to provide timely support. Poor social conditions, including poor socioeconomic status and lack of social support, have been suggested as potential contributors to cognitive impairment. Further, individuals with poor social conditions may experience psychological symptoms, such as depression and anxiety, which can further affect cognition.AimThis preliminary study explored longitudinal associations between social conditions, depression and anxiety symptoms, and cognition in liver transplant recipients.DesignA total of 23 adult liver transplant candidates were enrolled, with 9 receiving liver transplantation, who were followed for up to 1-year post-transplant. Cognition was assessed using the Repeatable Battery for the Assessment of Neuropsychological Status. Social conditions and psychological symptoms were assessed through surveys. Linear mixed-effects models adjusted for age and education were used to examine the relationships between social conditions, psychological symptoms, and cognition. Moderation analysis was also conducted to explore interactions between social conditions and psychological symptoms.ResultsCognitive scores remained stable over time. Social conditions were not associated with cognition, whereas higher levels of depression and anxiety symptoms were associated with worse cognitive performance. No significant interaction was found between social conditions and psychological symptoms on cognition.ConclusionDepression and anxiety symptoms, but not social conditions, showed associations with cognition in liver transplant recipients. These findings suggest the importance of assessing psychological symptoms in this population to identify those at risk for cognitive impairment.