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    Relationship Between Cognitive Function and Balance, Fatigue, and Physical Activity Levels in Patients with Liver Cirrhosis
    (Mdpi, 2026) Demir, Ilker; Demir, Bilsev
    Background: Liver cirrhosis is a chronic and progressive disease, and it affects liver parenchymal cells. Although it is known that during the course of this disease, cognitive function, balance, and physical activity levels decrease, and fatigue severity increases, the relationship between these variables remains unclear. This study is the first to examine the relationship between cognitive function level and balance, fatigue, and physical activity levels in patients with liver cirrhosis and was conducted to provide a new perspective on treatment. Aim: This study aims to investigate the relationship between cognitive function and balance, physical activity, and fatigue in patients with liver cirrhosis. Method: A total of 132 patients were included in the study. Cognitive function levels of the patients were measured with the Montreal Cognitive Assessment Scale, balance performance using the One-Legged Stance Test and timed up and go tests, physical activity levels with the International Physical Activity Scale-Short Form, and fatigue levels with the Fatigue Severity Scale. Results: Correlation analyses showed that cognitive function (MoCA) was significantly associated with static balance (r = 0.232, p = 0.007) and fatigue severity (r = -0.297, p = 0.001), whereas no statistically significant relationships were observed with dynamic balance (r = -0.068, p = 0.441) or physical activity (r = -0.011, p = 0.903). Multivariable regression analyses indicated that disease duration (beta = 0.02, p = 0.009) and exercise habits (beta = 0.65, p = 0.031) were independently associated with cognitive function (MoCA), while disease duration was also independently associated with static balance performance (beta = 0.08, p = 0.002). Conclusions: These findings indicate statistically significant associations between cognitive function, static balance, and fatigue severity, whereas no significant associations were observed with dynamic balance or physical activity. These relationships should be interpreted as associative rather than causal and suggest that cognitive status may be clinically relevant when evaluating balance performance and fatigue burden in patients with cirrhosis.