{
  "abstract": "Introduction\n\nMetabolic dysfunction-associated steatotic liver disease (MASLD) has been associated with poorer cognitive performance and greater cognitive decline. However, the liver-brain axis and the role of liver health in cognitive decline are still poorly understood. Thus, using both cross-sectional and longitudinal designs, we aimed to study how liver fibrosis score (ELF), an indicator of liver fibrosis, is associated with cognitive performance.Methods\n\nThis study was based on the Health 2000 Survey and its follow-up, the Health 2011 survey, which collected data from a nationally representative sample of the Finnish adult population. At baseline, verbal fluency, wordlist learning, delayed wordlist recall, and simple and multiple-choice reaction time tests were conducted. At follow-up, all tests except the reaction time tests were repeated. A global z-score was derived from the individual cognitive domains. Multivariable regression analysis was performed to study the association between ELF and cognitive performance while adjusting for demographic, metabolic, and cardiovascular covariates.Results\n\nCross-sectionally (n=5115; mean age 53.2 y; 58.6% women), high ELF was associated with poorer global cognition and slower simple and multiple-choice reaction times compared with low ELF. High ELF was also associated with worse global cognition and performance in the wordlist learning test, both cross-sectionally and longitudinally (n=2490; mean age 48.7 y at baseline; 58.0% women).Discussion\n\nHigh ELF, an indicator of liver fibrosis, was associated with poorer global cognition both cross-sectionally and longitudinally. Worse performance was observed in cognitive domains that reflect poorer processing speed and executive function, verbal learning, attention, and working memory. These results imply that liver fibrosis could represent an early modifiable marker of cognitive vulnerability.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Internal Medicine, University of Turku, Turku, Finland.",
    "Finnish Institute for Health and Welfare, Helsinki, Finland.",
    "University of Eastern Finland, Kuopio, Finland.",
    "Institute for Nutrition and Health Research, Helsinki, Finland.",
    "Department of Transplantation and Liver Surgery, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.",
    "Department of Neurology, Wellbeing Services County of Southwestern Finland, Turku, Finland.",
    "Turku PET Centre, University Hospital of Turku, Turku, Finland.",
    "Turku PET Centre, University of Turku, Turku, Finland.",
    "Institute of Clinical Physiology, National Research Council (CNR), Pisa, Italy.",
    "Department of Geriatrics, Wellbeing Services County of Southwestern Finland, Turku, Finland."
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 12,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Emilia Vataja"
    },
    {
      "affs": [
        1
      ],
      "name": "Katri Sääksjärvi"
    },
    {
      "affs": [
        1,
        2
      ],
      "name": "Jenni Lehtisalo"
    },
    {
      "affs": [
        3
      ],
      "name": "Iris Erlund"
    },
    {
      "affs": [
        3
      ],
      "name": "Terhi Vihervaara"
    },
    {
      "affs": [
        1,
        2
      ],
      "name": "Tiia Ngandu"
    },
    {
      "affs": [
        1
      ],
      "name": "Seppo Koskinen"
    },
    {
      "affs": [
        4
      ],
      "name": "Fredrik Åberg"
    },
    {
      "affs": [
        1
      ],
      "name": "Antti Jula"
    },
    {
      "affs": [
        5,
        6,
        7
      ],
      "name": "Juha Rinne"
    },
    {
      "affs": [
        6,
        7,
        8
      ],
      "name": "Miikka-Juhani Honka"
    },
    {
      "affs": [
        6,
        7,
        9
      ],
      "name": "Laura Ekblad"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/2c8t0grpxjzhk.bib",
  "cited_by": 0,
  "doi": "10.1097/hc9.0000000000001059",
  "fulltext_url": "https://europepmc.org/articles/PMC13682807",
  "id": "2c8t0grpxjzhk",
  "issns": [
    "2471-254X"
  ],
  "landing_url": "https://europepmc.org/article/MED/42900153",
  "language": "eng",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2713|Liver Disease Diagnosis and Treatment"
    ]
  ],
  "openalex": "W7223155353",
  "pdf_url": "https://europepmc.org/articles/PMC13682807?pdf=render",
  "pmcid": "PMC13682807",
  "pmid": "42900153",
  "published": "2026-10-19",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/2c8t0grpxjzhk.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:19:33Z",
      "native_id": "MED:42900153",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42900153"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2713|Liver Disease Diagnosis and Treatment",
      "subfield": "epidemiology-public-health"
    }
  ],
  "title": "Enhanced liver fibrosis score is associated with cognitive performance during an 11-year follow-up period.",
  "title_text": "Enhanced liver fibrosis score is associated with cognitive performance during an 11-year follow-up period.",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:19:33Z",
  "url": "https://research.draconitic.com/paper/2c8t0grpxjzhk",
  "venue": "Hepatology communications",
  "versions": []
}