{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T14:41:15Z","timestamp":1787755275309,"version":"build-2784847793"},"reference-count":23,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T00:00:00Z","timestamp":1787702400000},"content-version":"vor","delay-in-days":237,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["International Journal of Hepatology"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Nonobese metabolic dysfunction\u2010associated steatotic liver disease (MASLD) may carry disproportionate neurodegenerative risk, but whether body habitus modifies cognitive risk within MASLD remains unresolved. We compared cognitive impairment between nonobese and obese adults aged 50 years or older with MASLD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and Results<\/jats:title>\n                    <jats:p>\n                      Retrospective cohort study with 1:1 propensity score matching in the TriNetX Research Network, a federated electronic health record network. Adults with a first MASLD diagnosis (2016\u20132022) meeting a metabolic\u2010risk criterion were classified by index body mass index as nonobese (18.50\u201329.99\u2009kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      ) or obese (\u2265 30.00\u2009kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      ); underweight patients were excluded. The primary outcome was a composite of incident cognitive impairment (mild cognitive impairment [MCI] through dementia) over Days 366\u20131825. Hazard ratios (HRs) were estimated with Kaplan\u2013Meier and log\u2010rank methods; a negative control (acute appendicitis) and an\n                      <jats:italic>E<\/jats:italic>\n                      \u2010value assessed bias. Matching yielded 36,021 patients per group (mean age 64.3 years; 57% women; all standardized mean differences &lt; 0.10). Nonobese MASLD was associated with a higher risk of the composite cognitive outcome (2.9% vs 2.6%; HR 1.126, 95% confidence interval [CI] 1.031\u20131.230;\n                      <jats:italic>p<\/jats:italic>\n                      = 0.008;\n                      <jats:italic>E<\/jats:italic>\n                      \u2010value 1.50), driven by MCI (HR 1.221, 95% CI 1.078\u20131.384;\n                      <jats:italic>p<\/jats:italic>\n                      = 0.002). Estimates were null for incident Alzheimer disease, all\u2010cause dementia, vascular dementia, all\u2010cause mortality, and the negative control.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Among adults aged 50 years or older with MASLD, nonobese status was associated with a modestly higher risk of incident cognitive impairment. Prospective validation in imaging\u2010 or biomarker\u2010confirmed MASLD cohorts is warranted.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1155\/ijh\/7550224","type":"journal-article","created":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T13:40:25Z","timestamp":1787751625000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Incident Cognitive Impairment in Nonobese Versus Obese Adults Aged 50 Years or Older With Metabolic Dysfunction\u2010Associated Steatotic Liver Disease: A Propensity Score\u2013Matched Cohort 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