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Abnormal cognitive aging in people with HIV: evidence from data integration between two countries' cohort studies
Htein Linn Aung1,2, Thomas M Gates1,3, Limin Mao4
1Departments of Neurology and HIV Medicine, St Vincent's Hospital and Peter Duncan Neurosciences Unit, St Vincent's Centre for Applied Medical Research, Sydney.
AIDS (London, England)
|April 26, 2022
Summary
Older people with HIV (PWH) experience accelerated cognitive aging and a higher risk of neurocognitive impairment (NCI). Integrating data from multiple studies enhances the power to detect these effects in HIV cognitive aging research.
Area of Science:
- Neuroscience
- Gerontology
- Infectious Diseases
Background:
- Cognitive aging in people with HIV (PWH) is not well understood due to previous research limitations.
- Inconsistent findings necessitate larger, longitudinal studies to clarify cognitive aging patterns in PWH.
Purpose of the Study:
- To determine the effect of abnormal cognitive aging on neurocognitive impairment (NCI) in people with HIV (PWH).
- To address limitations of previous studies by integrating data from two large longitudinal cohorts.
Main Methods:
- Integrated data from the Australian HIV and Brain Ageing Research Program (N=102) and the CNS HIV Antiretroviral Therapy Effects Research (CHARTER) study (N=924).
- Utilized a standardized neuropsychological test battery to define NCI using a demographically corrected global deficit score (≥0.5 = impaired).
- Employed a generalized linear mixed-effect model to assess the cross-sectional and longitudinal effects of age group and time on NCI, adjusting for covariates.
Main Results:
- Older PWH (≥50 years) had a significantly higher odds of NCI (OR=1.83) and increased risk of NCI over time (OR=1.66) compared to younger PWH (<50 years).
- Factors associated with higher NCI risk included non-white ethnicity, comorbidities, greater cognitive symptoms, abnormal creatinine levels, plasma viral load >200 copies/ml, and being from the Australian cohort.
Conclusions:
- Data integration is a viable strategy to increase sample size and statistical power for studying cognitive aging in PWH.
- Abnormal cognitive aging significantly increases the risk of neurocognitive impairment in people with HIV.
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