1. Cognitive differences associated with HIV serostatus and antiretroviral therapy use in a population-based sample of older adults in South Africa.
- Author
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Asiimwe SB, Farrell M, Kobayashi LC, Manne-Goehler J, Kahn K, Tollman SM, Kabudula CW, Gómez-Olivé FX, Wagner RG, Montana L, Berkman LF, Glymour MM, and Bärnighausen T
- Subjects
- Adult, Aged, Cohort Studies, Cross-Sectional Studies, HIV Seronegativity, HIV Seropositivity, Humans, Literacy, Longitudinal Studies, Male, Middle Aged, South Africa, Aging psychology, Anti-Retroviral Agents therapeutic use, Cognition, HIV Infections drug therapy, HIV Infections psychology, Rural Population
- Abstract
Previous clinical studies have reported adverse cognitive outcomes for people living with HIV (PLWH), but there are no population-based studies comparing cognitive function between older PLWH and comparators without HIV in sub-Saharan Africa. We analyzed baseline data of 40 + years-old participants in "Health and Aging in Africa: A Longitudinal Study of an INDEPTH Community in South Africa" (HAALSI) cohort. We measured cognition using a battery of conventional instruments assessing orientation, immediate- and delayed-recall, and numeracy (N = 4560), and the Oxford Cognitive Screen [OCS]-Plus, a novel instrument for low-literacy populations, assessing memory, language, visual-spatial ability, and executive functioning (N = 1997). Linear regression models comparing cognitive scores between participants with and without HIV were adjusted for sex, education, age, country of birth, father's occupation, ever-consumed alcohol, and asset index. PLWH scored on average 0.06 (95% CI 0.01-0.12) standard deviation (SD) units higher on the conventional cognitive function measure and 0.02 (95% CI - 0.07 to 0.04) SD units lower on the OCS-Plus measure than HIV-negative participants. We found higher cognitive function scores for PLWH compared to people without HIV when using a conventional measure of cognitive function but not when using a novel instrument for low-literacy settings.
- Published
- 2020
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