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

Only 23 participants were studied, and only 9 received transplant during follow-up, so the post-transplant analyses were very small. Only four participants completed the 12-month assessment, so the 12-month cognition change is unstable. Participants were recruited from one transplant center and had to be fluent in English and meet transplant eligibility, so results may not apply to other groups. Many participants reported strong social support, low isolation, and satisfaction with social roles, which may have limited the range of social vulnerability scores. People entered the study at different times before transplant, and the time from baseline to transplant varied, which could affect cognition results. Graft function and other clinical outcomes were not included, and hepatic encephalopathy and MELD score were only available before transplant and were not adjusted for. The study measured associations, not cause. It cannot show that depression or anxiety caused lower cognition, or that treating them would improve cognition.

Funding was from Northeastern University. Author AB reported consulting for GSK and Intercept, clinical trial funding from Chemomab, CymaBay, Gilead, Intercept, and Mirum, and editorial roles for Clinical Liver Disease and DynaMed.

Do not conclude that treating depression or anxiety will improve cognition. The study measured an association after adjustment, did not test treatment, and the direction of the relationship was not determined.