Effect of hospitalization on cognitive and physical function in people with HIV

Hospitalization contributes to cognitive and physical decline among older adults. We aimed to determine the impact of hospitalization on cognitive and physical function among people with HIV (PWH).

Participants who had been hospitalized and had cognitive or physical function assessments were included. Cognitive function (a composite of Z -scores for three cognitive tests; NPZ3), gait speed, and grip strength slope differences before and after hospitalization were adjusted for potential confounding variables.

Of 892 participants, 208 had ≥1 hospitalization: 198 had NPZ3 scores and 197 had gait/grip measures. The median age was 58 years, 37% were Black, and 14% Hispanic; median CD4 was 656 cells/mm 3 , 94% had HIV-1 <200 copies/ml. The NPZ-3 slope difference after vs. before hospitalization was -0.071 per year (95% CI = -0.167, 0.026), with significant difference among those admitted for 3-6 days (-0.177 [95% CI -0.336, -0.018]) but not <3 or >6 days. The grip strength slope difference was -0.626 kg per year (95% CI -1.749, 0.497), with significant decline among those admitted for 3-6 days (-1.60 kg per year [95% CI -3.04, -1.52], P  = 0.03) but not <3 or >6 days. The gait speed increase was significant among those admitted for 3-6 days (0.044 m/s [0.005,0.083], P  = 0.03) but not for those with <3 or >6 days.

Intermediate duration of hospitalization was associated with modest declines in posthospitalization cognitive function (predominantly psychomotor performance) and grip strength.