Mental Health and Cognitive Performance Among Older People Living with HIV in Georgia

Abstract

Introduction: Highly effective antiretroviral therapy has increased the life expectancy of people living with HIV (PLWH), resulting in an increase in noncommunicable diseases, including cognitive and mental health disorders. Published literature on cognitive performance in older PLWH is scarce in low- and middle-income countries, including Georgia. Our study aimed to assess mental health and cognitive performance and identify associated factors among PLWH aged ≥40 years.

Methods: Primary mental health and behavior assessments included the Drug Use Disorder Identification Test, the Alcohol Use Disorder Identification Test, the Beck Depression Inventory (BDI), and the General Anxiety Disorder 7 (GAD-7). Cognitive assessments included the Montreal Cognitive Assessment (MoCA); Trail Making Tests A and B; verbal fluency; Stroop 1, 2, and 3; and Grooved Pegboard. Univariate and multivariable regression analyses were performed to identify factors associated with cognitive performance.

Results: Our sample included 125 PLWH (78 men, 47 women). Drug use-related problems or drug dependence was observed in 36% and hazardous or harmful alcohol consumption among 23%. Mild to extreme depressive symptoms were observed among 51% and mild to severe anxiety among 47%. A MoCA score <26 was observed among 89%. Multivariable regression analyses showed higher mean scores on the Stroop Test 3 associated with higher scores on the GAD-7 (β=.40; 95% CI, 0.12-0.68) and BDI (β=.70; 95% CI, 0.17-1.2). No other associations were observed.

Conclusion: This study shows high percentages of psychiatric and cognitive morbidities among older PLWH in Georgia. Longitudinal studies should be conducted to evaluate cognitive performance and associated factors among older PLWH in Georgia.

Keywords: Aging; Cognition; HIV; Mental Health; Noncommunicable; PLWH.