Interaction Effects between HIV and Aging on Selective Neurocognitive Impairment.
HIV infection and aging are each associated with neurocognitive impairment (NCI). This study examined the combined effects of HIV infection and aging on NCI. We performed a cross-sectional survey among 345 HIV-infected and 345 HIV-uninfected participants aged at least 40 years. The International HIV Dementia Scale (IHDS) and Chinese version of Mini-mental State Examination (MMSE) were administered to screen for NCI. HIV-infected individuals had higher prevalence of NCI than uninfected individuals (46.7% vs 15.1% for IHDS using cut-off of ≤ 10; 17.1% vs 2.6% for MMSE). Significant main effects of HIV and age were observed on IHDS and MMSE composite scores and all domains except for HIV on attention and calculation. Significant interaction effects between HIV and age were observed on motor speed, orientation, registration and recall, and mainly attributed to the inferior performance of HIV-infected patients aged over 60 years. Among HIV-infected individuals, in multivariable logistic models, older age, depressive symptoms and history of nevirapine treatment were associated with NCI using both IHDS and MMSE, whereas lower education current smoker and current CD4 ≥ 800 cells/μL were associated only with NCI using IHDS, and hypertension was associated only with NCI using MMSE. Findings suggest that HIV and older age may confer interactive effects on cognitive function in several domains with older HIV-infected adults experiencing greater NCI, which requires further longitudinal investigation. Furthermore, HIV early diagnosis and treatment may prevent or reverse NCI, but extra attention should be given to adverse effects including metabolic changes associated with long-term treatment.
['Ding|Yingying|Y|', 'Lin|Haijiang|H|', 'Shen|Weiwei|W|', 'Wu|Qionghai|Q|', 'Gao|Meiyang|M|', 'He|Na|N|']
D015526:AIDS Dementia Complex D000328:Adult D000368:Aged D000369:Aged, 80 and over D000375:Aging D003072:Cognition Disorders D003430:Cross-Sectional Studies D005260:Female D015658:HIV Infections D006801:Humans D008297:Male D008875:Middle Aged D009483:Neuropsychological Tests D015995:Prevalence
HIV Neurocognitive impairment Older age Accelerated aging CD4 count China