الفهرس 
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Abstract
Many studies were conducted on chronic liver disease and relation between chronic liver disease, cognitive impairment and health related quality of life.
The aim of the present study was to explore the neurocognitive impairment in patients with chronic liver disease and the relationship between cognitive impairment and HRQOL.
Worldwide, chronic liver disease (CLD) is a major cause of morbidity and mortality, with 2 million individuals dying of liver disease each year.
Irrespective of various causes for CLD, the central nervous system is usually involved and affected in patients with CLD. This influence can cause altered mental function, deviations in psychomotility, and/or hepatic coma connected with irreversible brain damage depending on its degree of severity.
CLD has been regularly connected with psychiatriccomorbidity, particularly mood disorders (depression and anxiety), personality changes, sleep disturbance and other behavior and cognitive deficits.
Therefore, there is a vital need to assess and monitor the cognitive functions and depression in chronic liver disease patients for the early identification and for proper treatment as both these illnesses are curable and treatable.
The present study was conducted on 120 patients diagnosed with chronic liver disease of various etiologies with a mean age35.6±9.3 years.
Cognitive functions were assessed by the MMSE and WAIS-4. All patients included in our study were subjected to Semistructured medical Sheet including age, sex, occupation,medical history, current drugs, thoroughabdominalandneurologicalexamination, Laboratory investigations, abdominalultrasonography, the neuropsychologicalassessment and applying the WHOQOL- Breef questionnaire .
The results of our study were summarized in the following
As regard the etiology of chronic liver disease,50 patients had HCV (41.7%) ,37 patients had HBV (30.8%)and 31patients had NAFLD (25.9%).
There was a statistical significant lower mean of all MMSE domains (orientation, registration, attention & calculation, recall, and language) among females with p-value <0.05 than males .the total score in females was( 25.8) while in males was (28.5).
There was statistical significant negative correlation with p-value <0.05 between age and all MMSE domains. that means being younger in age will be associated with increase in MMSE scores in all domains.
The percentage of the patients with CLD having normal cognitive function were(72.5% ), 87 patients whereas ( 27.5%) percentage,33 patients with chronic liver disease had cognitive impairment and (44.2%) 53patients had attention and memory dysfunction detected by applying WAIS- 4 (in the domains of general information and letter- number sequencing).
The percentage of the patients with CLD due to HCV (57.6%) 19 patients whereas (39.4%) 13 patients having HBV had cognitive dysfunction .
The percentage of the patients with CLD due to HCV(43.4%) 23patients whereas(32.1% ) 17 patients due to HBV had attention and memory dysfunction.
Females (66.7%) had poor cognitive function than males (33.3%) in the current study.
There was a statistical significant lower mean of psychological, and social domains of quality of life among cases with cognitive impairment with p-value <0.05.
There was no statistical significant difference between cases with cognitive impairment withp-value >0.05 as regards other quality of life domains( Physical health and Environment).
There was statistical significant positive correlation with p-value <0.05 between cognition dysfunction score and psychological domain of quality of life.
As females (66.7%) had poor cognitive functions than males (33.3%) and there is positive correlation between cognitive impairment and reduced quality of life, quality of life ( mostly psychological and social domain ) are affected in females more than males.