1. Abnormal cognitive aging in people with HIV: evidence from data integration between two countries' cohort studies
- Author
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Htein Linn Aung, Thomas M. Gates, Limin Mao, Bruce J. Brew, Sean B. Rourke, and Lucette A. Cysique
- Subjects
Cohort Studies ,Aging ,Infectious Diseases ,Cross-Sectional Studies ,Cognitive Aging ,Immunology ,Australia ,Immunology and Allergy ,Humans ,HIV Infections - Abstract
Previous research has shown inconsistent results on whether cognitive aging is abnormal in people with HIV (PWH) because of low sample size, cross-sectional design, and nonstandard neuropsychological methods. To address these issues, we integrated data from two longitudinal studies: Australian HIV and Brain Ageing Research Program ( N = 102) and CNS HIV Antiretroviral Therapy Effects Research (CHARTER) study ( N = 924) and determined the effect of abnormal aging on neurocognitive impairment (NCI) among PWH.Both studies used the same neuropsychological test battery. NCI was defined based on demographically corrected global deficit score (≥0.5 = impaired). Both studies also assessed comorbidities, neuropsychiatric conditions and functional status using similar tools. To determine the cross-sectional and longitudinal effects of age on the risk of NCI, a generalized linear mixed-effect model tested main and interaction effects of age group (young,50 vs. old, ≥50) and time on NCI adjusting the effects of covariates.Older PWH had 83% higher chance of NCI compared with younger PWH [odds ratio (OR) = 1.83 (1.15-2.90), P 0.05]. Older participants also had a greater risk of increases in NCI over the follow-up [OR = 1.66 (1.05-2.64), P 0.05] than younger participants. Nonwhite ethnicity ( P 0.05), having a contributing ( P 0.05) or confounding ( P 0.001) comorbidity, greater cognitive symptoms ( P 0.001), and abnormal creatinine level ( P 0.05), plasma viral load greater than 200 copies/ml ( P 0.05), being from the Australian cohort ( P 0.05) were also associated with a higher risk of NCI.Data integration may serve as a strategy to increase sample size and study power to better assess abnormal cognitive aging effect in PWH, which was significant in the current study.
- Published
- 2022