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- Title
Clinical, neuroimaging, and behavioural risk factors for neurocognitive impairment in Chinese patients with haemophilia: A multicentre study.
- Authors
Cheung, Yin Ting; Ma, Chung Tin; Lam, Henry Hon Wai; Ling, Siu Cheung; Kwok, Kevin; Li, Chak Ho; Ha, Chung Yin; Yip, Sze Fai; Wong, Raymond Siu Ming; Chu, Winnie Chiu Wing; Li, Chi Kong
- Abstract
Background: Few studies have evaluated the impact of subclinical microstructural changes and psychosocial factors on cognitive function in patients with haemophilia. Objectives: To determine the prevalence and characteristics of cognitive impairment in patients with haemophilia, and identify associated risk factors. Methods: We recruited haemophilia A or B patients who were aged ≥10 years old from three public hospitals in Hong Kong. A neurocognitive battery was administered to evaluate their attention, memory, processing speed and cognitive flexibility performances. They also underwent magnetic resonance imaging to identify cerebral microbleeds. Validated self‐reported questionnaires were administered to assess their mental health status and adherence to prophylactic treatment. General linear modelling was used to investigate the association of neurocognitive outcomes with risks factors, adjusting for age and education attainment. Results: Forty‐two patients were recruited (median age 32.0 years; 78.6% haemophilia A; 80.9% moderate‐to‐severe disease). Six patients (14.3%) had developed cerebral microbleeds. A subgroup of patients demonstrated impairments in cognitive flexibility (30.9%) and motor processing speed (26.2%). Hemarthrosis in the previous year was associated with worse attention (Estimate = 7.62, 95% CI: 1.92–15.33; p =.049) and cognitive flexibility (Estimate = 8.64, 95% CI: 2.52–13.29; p =.043). Depressive (Estimate = 0.22, 95% CI: 0.10–0.55; p =.023) and anxiety (Estimate = 0.26, 95% CI: 0.19–0.41; p =.0069) symptoms were associated with inattentiveness. Among patients receiving prophylactic treatment (71.4%), medication adherence was positively correlated with cognitive flexibility (p =.037). Conclusion: A substantial proportion of patients with haemophilia demonstrated cognitive impairment, particularly higher‐order thinking skills. Screening for cognitive deficits should be incorporated into routine care. Future studies should evaluate the association of neurocognitive outcomes with occupational/vocational outcomes.
- Subjects
HONG Kong (China); HEMOPHILIACS; COGNITIVE processing speed; CHINESE people; CRITICAL thinking; COGNITIVE flexibility
- Publication
Haemophilia, 2023, Vol 29, Issue 4, p1074
- ISSN
1351-8216
- Publication type
Article
- DOI
10.1111/hae.14816