Animal Naming Test Linked to Patient-Reported Outcomes, Frailty in Older Adults With, Without CLD

cirrhosis of the liver
Liver with cirrhosis, computer illustration. Cirrhosis is a consequence of chronic liver disease characterized by fibrosis and scarring of tissue.
Researchers assessed the clinical associations of animal naming test results in older adults with and without chronic liver disease.

Animal naming test (ANT) performance is associated with patient-reported outcomes and frailty in older adults with and without chronic liver disease (CLD), according to study results published in Clinical and Translational Gastroenterology.

Patients with CLD are known to have cognitive dysfunction, which may lead to care complexity, frailty, and poor patient-reported outcomes. The ANT is a 1-minute tool for detecting cognitive dysfunction and can be used to predict hepatic encephalopathy in patients with cirrhosis.

For the study, researchers evaluated ANT performance in 6661 older Americans with cirrhosis, with noncirrhosis CLD, and without CLD, who were enrolled in the 2010-2016 Health and Retirement Survey. Using the survey data, researchers examined the association between ANT and simplified ANT (S-ANT1) lower than 10 (adjusted for age and education) and health status, health care use, basic and instrumental activities of daily living, and frailty measures (hand grip and walk speed).

Study participants had a mean age of 75 years, more than 50% were women, and 85% were White.

Researchers found that CLD or cirrhosis was not independently associated with ANT. For both patients with and without CLD, poor ANT performance was related to poor health status and frailty. An S-ANT lower than 10 was associated with fair to poor self-reported health (odds ratio [OR], 1.37; 95% CI, 1.20-1.56), hospitalizations (incidence rate ratio [IRR], 1.14; 95% CI, 1.03-1.26), and care hours received (IRR, 2.39; 95% CI, 1.79-3.19). S-ANT lower than 10 was also associated with disability regarding activities of daily living (OR, 1.31; 95% CI, 1.13-1.51), disability regarding instrumental activities of daily living (OR, 1.85; 95% CI, 1.59-2.14), time to walk 2.5 m (IRR, 1.23; 95% CI, 1.17-1.29), and weaker hand grip (IRR, 0.94; 95% CI, 0.92-0.96).

“In this study of a representative population-based sample of older Americans, we show that although poor ANT performance was not specific to CLD or cirrhosis, ANT was associated with poor [patient-reported outcomes], physical frailty, and disability for all patients, especially those with CLD and cirrhosis,” the study authors noted.

Disclosure: One study author declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures. 


Tapper EB, Kenney B, Nikirk S, Levine DA, Waljee AK. Animal naming test is associated with poor patient-reported outcomes and frailty in people with and without cirrhosis: A prospective cohort study. Clin Transl Gastroenterol. 2022;13(1):e00447. doi: 10.14309/ctg.0000000000000447