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Subjective Cognition Among Liver Transplant Recipients

D. Ko1, M. S. Dietrich2, K. A. Gifford3, S. H. Ridner2

1School of Nursing, Northeastern University, Boston, MA, 2School of Nursing, Vanderbilt University, Nashville, TN, 3Department of Neurology, Vanderbilt University Medical Center, Nashville, TN

Meeting: 2021 American Transplant Congress

Abstract number: 1076

Keywords: Elderly patients, Liver transplantation, Quality of life

Topic: Clinical Science » Liver » Liver: Retransplantation and Other Complications

Session Information

Session Name: Liver: Retransplantation and Other Complications

Session Type: Poster Abstract

Session Date & Time: None. Available on demand.

Location: Virtual

*Purpose: Regular assessment of cognition is highly suggested to facilitate the early detection and treatment of cognitive impairment in the liver transplant (LT) population. While objective cognitive assessment is a gold standard diagnostic tool for cognitive impairment, it may not be feasible in LT practice since objective measures are often time-consuming. Subjective cognition, patients’ self-ratings or caregivers’ ratings of cognition for patients, can be used as an alternative to objective assessment. This cross-sectional, single-center study examined correlations between subjective and objective cognition in LT recipients.

*Methods: A total 60 pairs of adult LT recipients (median age = 61) and their respective caregivers (median age = 59) participated in this study. The Everyday Cognition (ECog) was used to assess subjective global and domain-specific cognition, by measuring perceived difficulties in performing daily activities. The Repeatable Battery for the Assessment of Neuropsychological Status (RBANS), Trail Making Test parts A&B, Digit Span Backward, and Rey-Osterrieth Complex Figure were used to assess objective global and domain-specific cognition of LT recipients. Agreement between LT recipients and caregivers on subjective cognition was examined using the intraclass correlation coefficient (ICC) and the reliable change index. Correlations between subjective and objective cognition were examined using Spearman’s rho correlation.

*Results: LT recipients reported few difficulties in performing daily activities. ICCs between LT recipients’ and caregivers’ subjective cognition scores were rather low (ICC = 0.48 for global score; 0.35-0.56 for domain scores) and agreements within reliable ranges were approximately 50%. Rather weak but significant correlations were found between subjective and objective cognitive scores. Recipients’ ECog memory scores were correlated with RBANS immediate and delayed memory scores (rs = -0.27 and -0.33, both p < .05); caregivers’ ECog global and attention scores were respectively correlated with RBANS global and attention scores (rs = -0.27 and -0.33, both p < .05).

*Conclusions: Findings demonstrate the potential utility of subjective cognition, reported either by recipients and/or caregivers, as a screening tool for expeditiously identifying recipients who are at risk of or experiencing cognitive impairment. Since recipients and caregivers may provide supporting but unique information, clinicians should consider including both of them in cognitive assessment.

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To cite this abstract in AMA style:

Ko D, Dietrich MS, Gifford KA, Ridner SH. Subjective Cognition Among Liver Transplant Recipients [abstract]. Am J Transplant. 2021; 21 (suppl 3). https://atcmeetingabstracts.com/abstract/subjective-cognition-among-liver-transplant-recipients/. Accessed May 16, 2025.

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