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. 2022 Feb;36(2):367-387.
doi: 10.1080/13854046.2021.1967449. Epub 2021 Aug 25.

Racial differences in health and cognition as a function of HIV among older adults

April D Thames  1   2 , Rodolfo Nunez  1 , George M Slavich  3 , Michael R Irwin  3 , Damla Senturk  4
Affiliations

Racial differences in health and cognition as a function of HIV among older adults

April D Thames et al. Clin Neuropsychol. 2022 Feb.

Abstract

The present study investigated the contribution of health risk factors (using the Charlson Comorbidity Index [CCI]) on cognitive outcomes in a sample of 380 HIV-positive (HIV+; n = 221) and HIV-seronegative (HIV-; n = 159) African American and European American adults aged 50+.

Participants were recruited from HIV clinics and community advertisements. HIV status was confirmed by serological testing. Self-report and chart history review was used to gather information about medical ssscomorbidities. The Charlson Comorbidity Index (CCI) was used to create a comorbidity score. Participants were administered a brief cognitive test battery.

As expected, health risks were greater among those with HIV. There was a HIV × Race interaction on CCI scores, such that in the HIV + group, European Americans had significantly higher CCI scores (M = 3.74; SD = 2.1) than African American HIV + participants (M = 2.70; SD = 1.9). However, in the HIV - group, African Americans had significantly higher CCI scores (M = 2.20; SD = 1.1) than HIV - European American participants (M = 1.80; SD = 1.2). Also, consistent with hypotheses, across the entire sample CCI score was significantly associated with global cognition (β = -.24, p = .02).

Study results underscore the importance of considering HIV serostatus in studies examining racial disparities in health, and how multiple medical risks relate to cognitive outcomes. Neuropsychologists evaluating patients living with HIV should consider how the presence of multiple medical comorbidities may contribute to the course of cognitive decline as people age.

Keywords: Charlson Comorbidity Index; HIV; cognition; race.

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Figures

Figure 1.
Figure 1.
Charlson comorbidity score by HIV status and race group (N = 380). Bars represent mean Charlson Comorbidity index score.
Figure 2.
Figure 2.
Charlson comorbidity score and mean-level global cognitive performance (N = 380). regression line represented in the dashed line. each data point represents mean level of global neurocognitive performance by Charlson comorbidity score.
See this image and copyright information in PMC

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