Social Drivers of Health and Cognition in Cirrhosis: A Scoping Review.
Niharika Gummaraj Srinivas, Samadhi Wijethunga, Alyson Kaplan and 2 others
PMID 41147249WHAT IT FOUND
In cirrhosis, higher education and employment were linked to better cognitive test scores.
Most studies measured people at one time, so these are associations, not causes. Education and job history may flag patients for cognitive screening.
Key findings
01Higher education was associated with better neuropsychological test scores in 18 of the 28 studies that examined education.
02Employment and higher personal or family income were associated with better cognitive test scores in the studies that examined them.
03Education was the most frequently examined social driver, while healthcare access and quality was not examined in any included study.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Most included studies measured people at one time, so they cannot show whether social drivers cause cognitive test differences. Twenty-three studies did not primarily aim to investigate the link between social drivers and cognition, and most examined education only. Many studies had small samples, with fewer than 200 participants, so results may not apply broadly. Different study designs and neuropsychological tests prevent direct comparison of results. The review searched English articles and included studies that described social drivers in abstracts, so relevant studies may have been missed. Only two U.S.-based studies examined race and ethnicity, and their findings were inconsistent.
Declared interests
The authors received no financial support for the research, authorship, or publication of this article, and declared no potential conflicts of interest.
The easy way to misread this
Do not read the education and employment findings as proof that low education or unemployment causes cognitive impairment in cirrhosis. Most included studies were cross-sectional, and the review did not show cause and effect.