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<p>Metabolic dysfunction-associated steatotic liver disease (MASLD) is a prevalent condition increasingly recognized in aging populations. However, its clinical relevance in older adults—particularly in relation to sarcopenia, cognitive function, and rehabilitation outcomes—remains poorly defined. This retrospective observational study included in-patients admitted for geriatric rehabilitation in 2022 with available abdominal ultrasound. MASLD was defined according to AASLD/EASL criteria. Demographics, comorbidities, medications, and the hepatic steatosis index were recorded. Cognitive function (MMSE, clock-drawing, GDS), hand grip strength, mobility (Tinetti, Timed Up and Go), and functional status (Barthel Index, discharge autonomy) were assessed. Analyses included regression and AUROC, with significance at p below 0.05. MASLD was present in 49.6% of the study population. No significant association was observed between MASLD and cognitive impairment. Patients with higher hand grip strengths showed higher proportions of MASLD (p = 0.01). In this cohort, hepatic steatosis index has poor capacity to detect hepatic steatosis (AUC = 0.503, 95%-CI: 0.437–0.570). Furthermore, MASLD did not predict poorer functional outcomes following the rehabilitation stay. In adjusted models, Barthel Index —but neither MASLD nor hand grip strength— was independently associated with reduced functional autonomy at discharge (p = 0.006). In elderly patients, MASLD was associated with diabetes mellitus and higher hand grip strength, while sarcopenia was linked to a lower prevalence of steatosis. MASLD showed no association with cognitive performance, functional outcomes, or prediction by the hepatic steatosis index. These findings highlight age-specific characteristics of MASLD requiring tailored clinical approaches.</p> Graphical Abstract <p></p>

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MASLD in the oldest-old: lack of association with cognition or functional autonomy and poor predictive utility of the hepatic steatosis index

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年12月24日

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  • Maximilian Joseph Brol,
  • Martin Groth,
  • Frank Erhard Uschner,
  • Juliana Stadtmann,
  • Tina Schomacher,
  • Jonel Trebicka,
  • Michael Praktiknjo,
  • Elena Vorona

摘要

Metabolic dysfunction-associated steatotic liver disease (MASLD) is a prevalent condition increasingly recognized in aging populations. However, its clinical relevance in older adults—particularly in relation to sarcopenia, cognitive function, and rehabilitation outcomes—remains poorly defined. This retrospective observational study included in-patients admitted for geriatric rehabilitation in 2022 with available abdominal ultrasound. MASLD was defined according to AASLD/EASL criteria. Demographics, comorbidities, medications, and the hepatic steatosis index were recorded. Cognitive function (MMSE, clock-drawing, GDS), hand grip strength, mobility (Tinetti, Timed Up and Go), and functional status (Barthel Index, discharge autonomy) were assessed. Analyses included regression and AUROC, with significance at p below 0.05. MASLD was present in 49.6% of the study population. No significant association was observed between MASLD and cognitive impairment. Patients with higher hand grip strengths showed higher proportions of MASLD (p = 0.01). In this cohort, hepatic steatosis index has poor capacity to detect hepatic steatosis (AUC = 0.503, 95%-CI: 0.437–0.570). Furthermore, MASLD did not predict poorer functional outcomes following the rehabilitation stay. In adjusted models, Barthel Index —but neither MASLD nor hand grip strength— was independently associated with reduced functional autonomy at discharge (p = 0.006). In elderly patients, MASLD was associated with diabetes mellitus and higher hand grip strength, while sarcopenia was linked to a lower prevalence of steatosis. MASLD showed no association with cognitive performance, functional outcomes, or prediction by the hepatic steatosis index. These findings highlight age-specific characteristics of MASLD requiring tailored clinical approaches.

Graphical Abstract