{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T17:31:50Z","timestamp":1781199110357,"version":"3.54.1"},"reference-count":48,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2023,6,19]],"date-time":"2023-06-19T00:00:00Z","timestamp":1687132800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["pericles.pericles-gcp.literatumonline.com"],"crossmark-restriction":true},"short-container-title":["Haemophilia"],"published-print":{"date-parts":[[2023,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Few studies have evaluated the impact of subclinical microstructural changes and psychosocial factors on cognitive function in patients with haemophilia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives<\/jats:title><jats:p>To determine the prevalence and characteristics of cognitive impairment in patients with haemophilia, and identify associated risk factors.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We recruited haemophilia A or B patients who were aged \u226510 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\u2010reported 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.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Forty\u2010two patients were recruited (median age 32.0 years; 78.6% haemophilia A; 80.9% moderate\u2010to\u2010severe 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\u00a0=\u00a07.62, 95% CI: 1.92\u201315.33;<jats:italic>p<\/jats:italic>\u00a0=\u00a0.049) and cognitive flexibility (Estimate\u00a0=\u00a08.64, 95% CI: 2.52\u201313.29;<jats:italic>p<\/jats:italic>\u00a0=\u00a0.043). Depressive (Estimate\u00a0=\u00a00.22, 95% CI:\u00a00.10\u20130.55;<jats:italic>p<\/jats:italic>\u00a0=\u00a0.023) and anxiety (Estimate\u00a0=\u00a00.26, 95% CI:\u00a00.19\u20130.41;<jats:italic>p<\/jats:italic>\u00a0=\u00a0.0069) symptoms were associated with inattentiveness. Among patients receiving prophylactic treatment (71.4%), medication adherence was positively correlated with cognitive flexibility (<jats:italic>p<\/jats:italic>\u00a0=\u00a0.037).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>A substantial proportion of patients with haemophilia demonstrated cognitive impairment, particularly higher\u2010order 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.<\/jats:p><\/jats:sec>","DOI":"10.1111\/hae.14816","type":"journal-article","created":{"date-parts":[[2023,6,19]],"date-time":"2023-06-19T15:29:04Z","timestamp":1687188544000},"page":"1074-1086","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Clinical, neuroimaging, and behavioural risk factors for neurocognitive impairment in Chinese patients with haemophilia: A multicentre study"],"prefix":"10.1111","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9874-8938","authenticated-orcid":false,"given":"Yin Ting","family":"Cheung","sequence":"first","affiliation":[{"name":"School of Pharmacy Faculty of Medicine The Chinese University of Hong Kong Hong Kong SAR China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chung Tin","family":"Ma","sequence":"additional","affiliation":[{"name":"School of Pharmacy Faculty of Medicine The Chinese University of Hong Kong Hong Kong SAR China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henry Hon Wai","family":"Lam","sequence":"additional","affiliation":[{"name":"Hong Kong Haemophilia Society Hong Kong SAR China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Siu Cheung","family":"Ling","sequence":"additional","affiliation":[{"name":"Department of Paediatrics &amp; Adolescent Medicine Princess Margaret Hospital Hong Kong SAR China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin","family":"Kwok","sequence":"additional","affiliation":[{"name":"Division of Haematology Department of Medicine &amp; Geriatrics Princess Margaret Hospital Hong Kong SAR China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chak Ho","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Paediatrics &amp; Adolescent Medicine Tuen Mun Hospital Hong Kong SAR China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chung Yin","family":"Ha","sequence":"additional","affiliation":[{"name":"Division of Haematology Department of Medicine and Geriatrics Tuen Mun Hospital Hong Kong SAR China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sze Fai","family":"Yip","sequence":"additional","affiliation":[{"name":"Division of Haematology Department of Medicine and Geriatrics Tuen Mun Hospital Hong Kong SAR China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raymond Siu Ming","family":"Wong","sequence":"additional","affiliation":[{"name":"Division of Haematology Department of Medicine and Therapeutics Faculty of Medicine The Chinese University of Hong Kong Hong Kong SAR China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Winnie Chiu Wing","family":"Chu","sequence":"additional","affiliation":[{"name":"Department of Imaging and Interventional Radiology Faculty of Medicine The Chinese University of Hong Kong Hong Kong SAR China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chi Kong","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Paediatrics Faculty of Medicine The Chinese University of Hong Kong Hong Kong SAR China"},{"name":"Department of Paediatrics &amp; Adolescent Medicine Hong Kong Children's Hospital Hong Kong SAR China"},{"name":"Hong Kong Hub of Paediatric Excellence The Chinese University of Hong Kong Hong Kong SAR China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,6,19]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijscr.2016.10.046"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.2450\/2019.0036\u201019"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.3978\/j.issn.2224\u20104336.2014.12.01"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365\u20102516.2011.02632.x"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.thromres.2014.08.005"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/hae.13398"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/s1474\u20104422(09)70013\u20104"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1080\/03007995.2018.1521787"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/hae.13159"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/hae.14571"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyt.2022.892321"},{"issue":"3","key":"e_1_2_11_13_1","first-page":"189","article-title":"A synopsis of current haemophilia care in Hong Kong","volume":"17","author":"Au WY","year":"2011","journal-title":"Hong Kong Med J"},{"key":"e_1_2_11_14_1","unstructured":"South China Morning Post \u201c\u2018No centralised system\u2019 for haemophilia patients\u201dPublished April 17 2016. 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