Abstract P422: Nonalcoholic Fatty Liver Disease and Cognitive Function in Middle-aged Adults: The CARDIA Study

Abstract

Background: Nonalcoholic fatty liver disease (NAFLD) is an obesity-related condition associated with cardiovascular disease (CVD) and its major risk factors. The latter have been linked to accelerated cognitive decline. Whether NAFLD is associated with decreased cognitive performance in midlife remains uncertain. Methods: Participants from the Coronary Artery Risk Development in Young Adults (CARDIA) study with CT-measured NAFLD and cognitive function assessment at year 25 (2010-2011; n=2,835) were included. Cognitive function was reassessed at year 30 (2015-2016; n=2,388). NAFLD was defined according to liver attenuation and categorized into 3 groups: none [>51 Hounsfield Units (HU)], probable (>40-51 HU), and definite (≤40 HU). Cognitive tests, including the Digit Symbol Substitution Test (DSST), Rey Auditory Verbal Learning Test (RAVLT), and Stroop were analyzed with standardized z scores. Linear models were constructed to examine (a) the cross-sectional association between NAFLD and cognitive scores (year 25) and (b) the predictive role of NAFLD in subsequent (year 30) cognitive scores. Results: The mean age at baseline was 50.1 (SD, 3.6) years (58% women; 48% blacks), with 398 (14%) and 286 (10%) having probable and definite NAFLD, respectively. In unadjusted models, an inverse association was shown between NAFLD and all cognitive tests. For DSST ( P interaction =.047) and RAVLT ( P interaction =.033), the association was stronger in whites than blacks. The association was attenuated after age and sex adjustment, and practically eliminated after further adjustment for sociodemographic and CVD risk factors (Table). NAFLD was not predictive of subsequent cognitive performance in any of the measures once baseline scores were adjusted for (all P >.10). Using liver attenuation as a continuous variable yielded similar results. Conclusion: Among middle-aged adults, an inverse association of NAFLD with cognitive function -evident in whites only- was attenuated by sociodemographic and CVD risk factor adjustment.