The association between the ALBI score and cognitive impairment as assessed by various diagnostic methods

Background : The association between the Albumin-Bilirubin (ALBI) score and the risk of cognitive impairment remains unclear. This study aims to analyze the relationship between ALBI score and cognitive function. Methods : Data from the 2011–2014 National Health and Nutrition Examination Survey (NHANES) were analyzed using multivariable logistic regression and subgroup analyses to assess the relationship between the ALBI score and cognitive impairment diagnosed through various methods. Restricted cubic spline (RCS) models were employed to evaluate potential nonlinear associations between ALBI and cognitive function. Results : A total of 2,215 participants were included. In fully adjusted models, each 1-unit increase in the ALBI score was associated with a 2.61-fold higher risk of cognitive impairment, as measured by the Digit Symbol Substitution Test (DSST) (adjusted OR = 2.61; 95% CI: 1.17–5.82; P = 0.023). Associations with cognitive impairment identified using the other two assessment methods were not statistically significant. Age appeared to differentially affect various domains of cognitive function. RCS analysis indicated a linear association between the ALBI score and cognitive impairment across all three diagnostic approaches after adjustment for confounders. Conclusion : A higher ALBI score may be associated with increased risk of cognitive impairment. Further research is warranted to investigate potential causal pathways linking liver function and cognitive decline.