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Elevated rates of mild cognitive impairment in HIV disease

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Abstract

With the rising number of individuals in their 50s and 60s who are infected with HIV, concerns have emerged about possible increases in the rates of non-HIV-associated dementias. The current study examined the prevalence of mild cognitive impairment (MCI) in older HIV-infected adults, since MCI is an intermediate state between typical cognitive aging and dementia that emerges in this age range. Participants included 75 adults with HIV disease aged 50 years and older who were on combination antiretroviral therapy (cART) and had undetectable plasma viral loads and 80 demographically similar HIV-seronegative comparison subjects. Participants completed a research neuropsychological evaluation that was used to classify MCI according to the comprehensive diagnostic scheme described by Bondi et al. (J Alzheimers Dis 42:275–289, 2014). HIV-infected persons were over seven times more likely to have an MCI designation (16 %) than their seronegative counterparts (2.5 %). Within the HIV+ cohort, MCI had minimal overlap with diagnoses of asymptomatic neurocognitive impairment and was significantly associated with older age, lower Karnofsky Scale of Performance Scores, and mild difficulties performing instrumental activities of daily living (iADLs). HIV infection in older adults is associated with a notably elevated concurrent risk of MCI, which may increase the likelihood of developing non-HIV-associated dementias as this population ages further.

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Acknowledgments

The San Diego HIV Neurobehavioral Research Program [HNRP] group is affiliated with the University of California, San Diego; the Naval Hospital, San Diego; and the Veterans Affairs San Diego Healthcare System; and includes the following: Director: Igor Grant, M.D.; Co-Directors: J. Hampton Atkinson, M.D., Ronald J. Ellis, M.D., Ph.D., and J. Allen McCutchan, M.D.; Center Manager: Thomas D. Marcotte, Ph.D.; Jennifer Marquie-Beck, M.P.H.; Melanie Sherman; Neuromedical Component: Ronald J. Ellis, M.D., Ph.D. (P.I.), J. Allen McCutchan, M.D., Scott Letendre, M.D., Edmund Capparelli, Pharm.D., Rachel Schrier, Ph.D., Debra Rosario, M.P.H., Neurobehavioral Component: Robert K. Heaton, Ph.D. (P.I.), Mariana Cherner, Ph.D., Jennifer E. Iudicello, Ph.D., David J. Moore, Ph.D., Erin E. Morgan, Ph.D., Matthew Dawson; Neuroimaging Component: Terry Jernigan, Ph.D. (P.I.), Christine Fennema-Notestine, Ph.D., Sarah L. Archibald, M.A., John Hesselink, M.D., Jacopo Annese, Ph.D., Michael J. Taylor, Ph.D.; Neurobiology Component: Eliezer Masliah, M.D. (P.I.), Cristian Achim, M.D., Ph.D., Ian Everall, FRCPsych., FRCPath., Ph.D. (Consultant); Neurovirology Component: Douglas Richman, M.D., (P.I.), David M. Smith, M.D.; International Component: J. Allen McCutchan, M.D., (P.I.); Developmental Component: Cristian Achim, M.D., Ph.D.; (P.I.), Stuart Lipton, M.D., Ph.D.; Participant Accrual and Retention Unit: J. Hampton Atkinson, M.D. (P.I.); Data Management Unit: Anthony C. Gamst, Ph.D. (P.I.), Clint Cushman (Data Systems Manager); Statistics Unit: Ian Abramson, Ph.D. (P.I.), Florin Vaida, Ph.D., Reena Deutsch, Ph.D., Anya Umlauf, M.S.. David P. Sheppard, Jennifer E. Iudicello, Mark W. Bondi, Katie L. Doyle, Erin E. Morgan, Paul J. Massman, Paul E. Gilbert, and Steven Paul Woods 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 US Government. The authors thank Marizela Cameron and P. Katie Riggs for their help with study management and Donald Franklin and Stephanie Corkran for their help with data processing. This study was supported by NIH grants R01-MH073419, T32-DA31098, L30-DA0321202, P30-MH62512, and K24-AG026431.

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Authors and Affiliations

  1. Department of Psychology, University of Houston, Houston, TX, USA

    David P. Sheppard, Paul J. Massman & Steven Paul Woods

  2. Department of Psychiatry, University of California San Diego, La Jolla, CA, USA

    Jennifer E. Iudicello, Mark W. Bondi, Erin E. Morgan & Steven Paul Woods

  3. Psychology Service, VA San Diego Healthcare System, San Diego, CA, USA

    Mark W. Bondi

  4. Joint Doctoral Program in Clinical Psychology, San Diego State University - University of California San Diego, San Diego, CA, USA

    Katie L. Doyle & Paul E. Gilbert

  5. Department of Psychology, San Diego State University, San Diego, CA, USA

    Paul E. Gilbert

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  1. David P. Sheppard
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Sheppard, D.P., Iudicello, J.E., Bondi, M.W. et al. Elevated rates of mild cognitive impairment in HIV disease. J. Neurovirol. 21, 576–584 (2015). https://doi.org/10.1007/s13365-015-0366-7

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