Assessment and Comparison of Cognitive Function and Depression level among patients with Chronic Liver Disease and Healthy Controls

Background & Aims: Chronic liver disease (CLD) is a progressive disorder which causes deterioration and regeneration of parenchymal cells in liver and has become an increasingly important public health issue worldwide. Cognitive impairment together with depression may substantially diminish the functional capacity of life in patients with CLD. Many a time’s both cognitive impairment and depression are not observed by health workers and not assessed in clinical area routinely. Therefore, studies in this area are vital to fulfil the gap of practice and this can facilitate the nursing personnel to support clinician in this challenging area. The aim of the present study was to assess the cognitive function and depression level of patients with CLD and compare withhealthy controls.Methods: A case control study was conducted in hepatology department of selected hospital on patients with CLD and healthy controls. Convenience sampling technique was used to select 220 subjects (110patients with CLD and 110 healthy controls). Matching was done in patients with CLD and healthy controls in terms of age and gender. Both the groups were examined with Modified Mini Mental State Examination and Beck Depression Inventory to assess the cognitive function and depression level respectively. Data was analysed using appropriatedescriptive (mean, standard deviation, frequency and percentage) and inferential statistics (independent sample t test, ANOVA and chi-square test). Results: Patients with CLD and healthy controls were comparable in terms of age, gender, marital status, employment status and monthly income. Significant difference was found between patients with CLD and healthy controls in terms of cognitive function (t=12.1, p<0.001) and depression level (χ 2 =56.7, p<0.001). Cognitive function score of patients with CLD was significantly associated with educational status (t=3.8, p<0.001), monthly income (F=7.8, p=0.001), presence of cirrhosis (t=2.3, p=0.025) and presence of Minimal Hepatic Encephalopathy (t=4.8, p<0.001). Depression level of patients with CLD was significantly associated only with gender (χ 2 =10.2, p=0.006). There was significant negative correlation between cognitive function and depression level (r= -0.298, p= 0.002) among patients with CLD and significant negative correlation between age and cognitive function score (r= 0.401, p<0.001) among healthy controls. Conclusions: Based on the findings, the study concluded that patients with CLD had poor cognitive function and severe depression compared to healthy controls.Cognitive function among patients with CLD was associated with educational status, monthly income, presence of cirrhosis and MHE. Depression level was associated with gender among patients with CLD. Keyword: Cognitive Function, Depression level, Patients with CLD, Healthy controls -------------------------------------------------------------------------------------------------------------------------------------Date of Submission: 17-06-2020 Date of Acceptance: 03-07-2020 -------------------------------------------------------------------------------------------------------------------------------------