Objective: As individuals infected with HIV experience increasingly longer lifespans with successful antiretroviral therapy, the risk of incident age-related morbidities across several different organ systems, including the brain, may also rise. The present study aimed to determine the combined effects of age and HIV infection on the risk for incident neurocognitive disorders. Method: A total of 146 neurocognitively normal participants were enrolled at baseline into one of four groups based on age (younger group <40 years [M = 31.5 ± 0.8], older group ≥50 years [M = 56.4 ± 0.6]) and HIV serostatus resulting in 24 younger HIV-seronegative (HIV−), 27 younger HIV-seropositive (HIV+), 39 older HIV−, and 56 older HIV+ individuals. All participants were administered a standardized clinical neuropsychological battery at baseline and follow-up [14.3 (±0.2) months later]. Results: A logistic regression showed a significant main effect of HIV serostatus in predicting the likelihood of incident neurocognitive disorders (p < .05), but there was no main effect of age or ageXHIV interaction (p>.10). Specifically, 15.7 percent of the HIV+ individuals had an incident neurocognitive disorder as compared to 3.2 percent of the HIV- group (odds ratio = 4.6 [1.2, 32.6]). Among older HIV+ adults, lower baseline cognitive reserve, prospective memory, and verbal fluency each predicted incident neurocognitive disorders at follow-up. Conclusion: HIV infection confers a nearly 5-fold risk for developing a neurocognitive disorder over approximately one year. Individuals with lower cognitive reserve and mild weaknesses in higher-order neurocognitive functions such as prospective memory may be targeted for closer clinical monitoring and preventative measures.
Combined Effects of Older Age and HIV Disease on the One-Year Incidence of Neurocognitive Disorders
D Sheppard, S Woods, M Bondi, P Gilbert, P Massman; A-14
Combined Effects of Older Age and HIV Disease on the One-Year Incidence of Neurocognitive Disorders. Arch Clin Neuropsychol 2015; 30 (6): 491. doi: 10.1093/arclin/acv047.14
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