ArticleBMC gastroenterology2021
Non-alcoholic fatty liver disease and cognitive function in middle-aged adults: the CARDIA study.
Article in BMC gastroenterology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 2 of them syntheses that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
24 citing papers in PubMed, 2 syntheses or guidelines pooled it, 42 citations in OpenAlex.
- Global epidemiology of type 2 diabetes in patients with NAFLD or MAFLD: a systematic review and meta-analysis.BMC medicine · 2024Pooled it
- Impact of smoking cessation on non-alcoholic fatty liver disease prevalence: a systematic review and meta-analysis.BMJ open · 2023Pooled it
- Association of chronic liver disease with cognition and brain volumes in two randomized controlled trial populations.Journal of the neurological sciences · 2022Trial
- The Mind From Within: Visceral Roots of Human Cognition.Advanced science (Weinheim, Baden-Wurttemberg, Germany) · 2026Review
- Metabolic dysfunction-associated steatotic liver disease as a risk factor for cognitive decline: Findings from the ELSA-Brasil cohort.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2026Article
- Pathways from Adverse Childhood Family Environment to Lower Urinary Tract Symptoms and Impact Among Women.Journal of women's health (2002) · 2025Article
- The association between depressive symptoms and lower urinary tract symptoms and impact among women: Investigating behavioural, cognitive and physiological pathways.British journal of health psychology · 2025Article
- Metabolic Parkinson's disease.Frontiers in aging neuroscience · 2025Review
- The Metabolic Impact of Nonalcoholic Fatty Liver Disease on Cognitive Dysfunction: A Comprehensive Clinical and Pathophysiological Review.International journal of molecular sciences · 2024Review
- Liver integrity and the risk of Alzheimer's disease and related dementias.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2024Article
- Dietary Inflammatory Index and Cognitive Function: Findings from a Cross-Sectional Study in Obese Chinese Township Population from 45 to 75 Years.Journal of inflammation research · 2024Article
- Correspondence on Letter regarding "Non-alcoholic fatty liver disease: Definition and subtypes".Clinical and molecular hepatology · 2023Article
- Synergistic Effect of Diet and Physical Activity on a NAFLD Cohort: Metabolomics Profile and Clinical Variable Evaluation.Nutrients · 2023Article
- Role of Nutrition in the Etiopathogenesis and Prevention of Nonalcoholic Fatty Liver Disease (NAFLD) in a Group of Obese Adults.Medicina (Kaunas, Lithuania) · 2023Article
- The association between regional adiposity, cognitive function, and dementia-related brain changes: a systematic review.Frontiers in medicine · 2023Review
- Association of liver disease with brain volume loss, cognitive decline, and plasma neurodegenerative disease biomarkers.Neurobiology of aging · 2022Article
- Nonalcoholic Fatty Liver Disease and Risk of Dementia: A Population-Based Cohort Study.Neurology · 2022Article
- Severe Hepatic Steatosis by Controlled Attenuation Parameter Predicts Quality of Life Independent of Fibrosis.Digestive diseases and sciences · 2022Article
- Novel insights into non-alcoholic fatty liver disease and dementia: insulin resistance, hyperammonemia, gut dysbiosis, vascular impairment, and inflammation.Cell & bioscience · 2022Review
- Article
Corrections and comments
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Authors and funding
7 authors at 6 institutions in 2 countries.
Funding
Abstract
backgroundNon-alcoholic fatty liver disease (NAFLD) is associated with cardiovascular disease (CVD) risk factors that have been linked to cognitive decline. Whether NAFLD is associated with cognitive performance in midlife remains uncertain.
methodsCoronary Artery Risk Development in Young Adults study participants with CT examination and cognitive assessment at Y25 (2010-2011; n = 2809) were included. Cognitive function was reassessed at Y30. NAFLD was defined according to liver attenuation and treated both continuously and categorically (using ≤ 40 and ≤ 51 Hounsfield units to define severity) after exclusion for other causes of liver fat. Cognitive tests including the Digit Symbol Substitution (processing speed), Rey Auditory Verbal Learning (verbal memory), and Stroop (executive function) were analyzed with standardized z-scores. Linear models were constructed to (a) examine the cross-sectional associations of NAFLD with cognitive scores and (b) evaluate its predictive role in 5-year change in cognitive performance.
resultsParticipants' mean age (Y25) was 50.1 (SD 3.6) years (57% female; 48% black), with 392 (14%) having mild NAFLD and 281 (10%) having severe NAFLD. NAFLD was positively associated with CVD risk factors and inversely associated with cognitive scores. However, after adjustment for CVD risk factors, no associations were shown between NAFLD and cognitive scores (all βs ≈ 0). Similarly, no associations were observed with 5-year cognitive decline. CVD history, hypertension, smoking, diabetes and hypertriglyceridemia showed stronger associations with baseline cognitive scores and were predictive of subsequent cognitive decline (all P ≤ .05).
conclusionAmong middle-aged adults, inverse associations between NAFLD and cognitive scores were attenuated after adjustment for CVD risk factors, with the latter predictive of poorer cognitive performance both at baseline and follow-up.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.