Association of Cognitive Impairment With Chronic Viral Hepatitis Among Older Adults in Taiwan

Abstract

Objective: To evaluate the risk of cognitive impairment among patients with chronic viral hepatitis.

Design: A cross-sectional study.

Setting: Population-based.

Participants: Individuals 60 years or older were enrolled from the Taiwan Biobank database from 2012.

Exposure: Hepatitis B virus and hepatitis C virus infections.

Measurement: Cognitive impairment was evaluated using the mini-mental state examination (MMSE). Logistic regression models were used to calculate odds ratios and 95% confidence intervals (CIs). The effects of APOE ε4 polymorphisms on the association between viral hepatitis and the risk of cognitive impairment were also investigated.

Results: We recruited 912 participants with cognitive impairment and 22 869 participants without cognitive impairment. The adjusted odds ratio (aOR) for cognitive impairment was 1.38 (95% CI: 1.03-1.85, p = 0.033) among participants with hepatitis C virus infection and 1.14 (95% CI: 0.91-1.43, p = 0.257) among participants with hepatitis B virus infection. Participants with hepatitis C virus infection and without hepatitis B virus infection had a higher risk of cognitive impairment (aOR: 1.52, 95% CI: 1.13-2.04, p = 0.006). The MMSE subcategories most associated with hepatitis C virus infection were orientation and design copying. The association between hepatitis C virus infection and cognitive impairment was higher among participants with ε4 alleles of the APOE gene than among those without alleles (aOR: 2.18, 95% CI: 1.21-3.91, p = 0.009).

Conclusions: Our findings suggest that individuals 60 years or older with chronic hepatitis C virus infection are at increased risk of cognitive impairment.

Keywords: Cognitive impairment; apolipoprotein E gene; viral hepatitis.