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. 2015 Feb;21(1):56-65.
doi: 10.1007/s13365-014-0296-9. Epub 2014 Nov 18.

Factors related to HIV-associated neurocognitive impairment differ with age

Gary B Fogel  1 , Susanna L Lamers, Andrew J Levine, Miguel Valdes-Sueiras, Michael S McGrath, Paul Shapshak, Elyse J Singer
Affiliations

Factors related to HIV-associated neurocognitive impairment differ with age

Gary B Fogel et al. J Neurovirol. 2015 Feb.

Abstract

Over 50% of HIV-infected (HIV+) persons are expected to be over age 50 by 2015. The pathogenic effects of HIV, particularly in cases of long-term infection, may intersect with those of age-related illnesses and prolonged exposure to combined antiretroviral therapy (cART). One potential outcome is an increased prevalence of neurocognitive impairment in older HIV+ individuals, as well as an altered presentation of HIV-associated neurocognitive disorders (HANDs). In this study, we employed stepwise regression to examine 24 features sometimes associated with HAND in 40 older (55-73 years of age) and 30 younger (32-50 years of age) HIV+, cART-treated participants without significant central nervous system confounds. The features most effective in generating a true assessment of the likelihood of HAND diagnosis differed between older and younger cohorts, with the younger cohort containing features associated with drug abuse that were correlated to HAND and the older cohort containing features that were associated with lipid disorders mildly associated with HAND. As the HIV-infected population grows and the demographics of the epidemic change, it is increasingly important to re-evaluate features associated with neurocognitive impairment. Here, we have identified features, routinely collected in primary care settings, that provide more accurate diagnostic value than a neurocognitive screening measure among younger and older HIV individuals.

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Conflict of interest statement

Conflict of Interest: The authors, Gary B. Fogel, Susanna L. Lamers, Andrew J. Levine, Miguel Valdes-Sueiras, Michael S. McGrath, Paul Shapshak, Elyse J. Singer declare that they have no conflict of interest.

Figures

Fig. I
Fig. I. Histogram of Patient Age
The bar graph shows the distribution of age in the two categories (younger vs. older) given a threshold at 53 years of age.
Fig. II
Fig. II. Multiple Regression Plots
A) HAND relative to the output of three stepwise regressions (fitted HAND) for 1) all patients, 2) the young cohort, and 3) the old cohort being examined. B). Global deficit score relative to the output of three stepwise regressions (fitted global deficit score) for 1) all patients, 2) the young cohort, and 3) the old cohort being examined.
See this image and copyright information in PMC

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