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. 2015;29(5):656-77.
doi: 10.1080/13854046.2015.1077995. Epub 2015 Aug 26.

Does Older Age Confer an Increased Risk of Incident Neurocognitive Disorders Among Persons Living with HIV Disease?

David P Sheppard  1 , Steven Paul Woods  1   2 , Mark W Bondi  3   4 , Paul E Gilbert  5 , Paul J Massman  1 , Katie L Doyle  6 ; HIV Neurobehavioral Research Program Group
Collaborators, Affiliations

Does Older Age Confer an Increased Risk of Incident Neurocognitive Disorders Among Persons Living with HIV Disease?

David P Sheppard et al. Clin Neuropsychol. 2015.

Abstract

Objective: This study aimed to determine the combined effects of age and HIV infection on the risk of incident neurocognitive disorders.

Method: A total of 146 neurocognitively normal participants were enrolled at baseline into one of four groups based on age (≤ 40 years and ≥ 50 years) and HIV serostatus resulting in 24 younger HIV-, 27 younger HIV+, 39 older HIV-, and 56 older HIV+ individuals. All participants were administered a standardized clinical neuropsychological battery at baseline and 14.3 ± .2 months later.

Results: A logistic regression predicting incident neurocognitive disorders from HIV, age group, and their interaction was significant (χ(2)[4] = 13.56, p = .009), with a significant main effect of HIV serostatus (χ(2)[1] = 5.01, p = .025), but no main effect of age or age by HIV interaction (ps > .10). Specifically, 15.7% of the HIV+ individuals had an incident neurocognitive disorder as compared to 3.2% of the HIV- group (odds ratio = 4.8 [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.

Conclusions: Independent of age, HIV infection confers a nearly fivefold risk for developing a neurocognitive disorder over approximately one year. Individuals with lower cognitive reserve and mild weaknesses in higher-order neurocognitive functions may be targeted for closer clinical monitoring and preventative measures.

Keywords: Aging; HIV; Hepatitis C.; Incidence; Neuropsychology.

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Conflict of interest statement

The authors have no financial conflicts of interest related to this work. The views expressed in this article are those of the authors and do not reflect the official policy or position of the Department of the Navy, Department of Defense, nor the United States Government.

Figures

Figure 1
Figure 1
Flow diagram of study enrollment at baseline, retention at 14-month follow-up, exclusions based on baseline neurocognitive impairment, and the final cohort of participants with and without incident neurocognitive disorders.
Figure 2
Figure 2
Incidence of syndromic and subsyndromic neurocognitive disorders at 14-month follow-up for younger and older individuals with and without HIV disease.
Figure 3
Figure 3
Incidence of syndromic and subsyndromic neurocognitive disorder at 14-month follow-up for individuals with and without with Hepatitis C virus infection.
See this image and copyright information in PMC

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