Finally, as shown in Table 4, AST/ALT ratio >2 was associated with a 2-fold higher risk of incident cognitive impairment in the minimally adjusted model (OR 2.05; 95% CI 1.16, 3.60), and this relationship was mildly attenuated adjusting for risk factors (OR 1.86; 95% CI 0.81, 4.25 in Model 4). Here, GPT is linked to Cognitive impairment.