title: Cognition Predicts Quality of Life Among Patients With End-Stage Liver Disease.
abstract: Impaired cognitive functioning and poor quality of life (QoL) are both common among patients with end-stage liver disease; however, it is unclear how these are related.
  
  
  
  This study examines how specific cognitive domains predict QoL among liver transplant candidates by replicating Stewart and colleagues' (2010) 3-factor model of cognitive functioning, and determining how variability in these cognitive domains predicts mental health and physical QoL.
  
  
  
  The sample included 246 patients with end-stage liver disease who were candidates for liver transplant at a large, Midwestern health care center. Measures, including the Repeatable Battery for the Assessment of Neuropsychological Status, Trail Making Test, Shipley Institute of Living Scale, Short-Form Health Survey-36 Version 2, and Hospital Anxiety and Depression Scale, comprised latent variables representing global intellectual functioning, psychomotor speed, and learning and memory functioning.
  
  
  
  Confirmatory factor analysis results indicate that the 3-factor solution model comprised of global intellectual functioning, psychomotor speed, and learning and memory functioning fit the data well. Addition of physical and mental health QoL latent factors resulted in a structural model also with good fit. Results related physical QoL to global intellectual functioning, and mental health QoL to global intellectual functioning and psychomotor functioning.
  
  
  
  Findings elucidate a relationship between cognition and QoL and support the use of routine neuropsychological screening with end-stage liver disease patients, specifically examining the cognitive domains of global intellectual, psychomotor, and learning and memory functioning. Subsequently, screening results may inform implementation of targeted interventions to improve QoL.
authors.affiliation: Department of Psychology, University of Central Florida, Orlando, FL; Consultation/Liaison Psychiatry, Henry Ford Health System, Detroit, MI.
authors.forename: Daniel
authors.initials: D
authors.lastname: Paulson
authors.affiliation: Department of Psychology, University of Central Florida, Orlando, FL. Electronic address: mshah@knights.ucf.edu.
authors.forename: Mona
authors.initials: M
authors.lastname: Shah
authors.affiliation: Consultation/Liaison Psychiatry, Henry Ford Health System, Detroit, MI.
authors.forename: Lisa Renee
authors.initials: LR
authors.lastname: Miller-Matero
authors.affiliation: Consultation/Liaison Psychiatry, Henry Ford Health System, Detroit, MI.
authors.forename: Anne
authors.initials: A
authors.lastname: Eshelman
authors.affiliation: Transplant Institute, Henry Ford Health System, Detroit, MI.
authors.forename: Marwan
authors.initials: M
authors.lastname: Abouljoud
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003072:Cognition Disorders / Q000175:diagnosis* / Q000523:psychology*; D019033:Delivery of Health Care, Integrated; D005260:Female; D006501:Hepatic Encephalopathy / Q000175:diagnosis* / Q000209:etiology / Q000523:psychology*; D006801:Humans; D017093:Liver Failure / Q000175:diagnosis* / Q000209:etiology / Q000523:psychology*; D016031:Liver Transplantation / Q000523:psychology; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D008960:Models, Psychological; D009483:Neuropsychological Tests / Q000706:statistics & numerical data; D011594:Psychometrics; D011788:Quality of Life / Q000523:psychology*; D013223:Statistics as Topic; D055815:Young Adult
keywords: cognitive functioning; hepatic encephalopathy; integrated care.; neuropsychological screening