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Association of long-term patterns of depressive symptoms and attention/executive function among older men with and without human immunodeficiency virus

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Abstract

Older HIV-infected men are at higher risk for both depression and cognitive impairments, compared to HIV-uninfected men. We evaluated the association between longitudinal patterns of depressive symptoms and attention/executive function in HIV-infected and HIV-uninfected men aged 50+ years to understand whether HIV infection influenced the long-term effect of depression on attention/executive function. Responses to the Center for Epidemiologic Studies—Depression scale and attention/executive function tests (Trail Making Test Part B and Symbol Digit Modalities Test) were collected semiannually from May 1986 to April 2015 in 1611 men. Group-based trajectory models, stratified by HIV status, were used to identify latent patterns of depressive symptoms and attention/executive function across 12 years of follow-up. We identified three depression patterns for HIV-infected and HIV-uninfected men (rare/never 50.0 vs. 60.6%, periodically depressed 29.6 vs. 24.5%, chronic high 20.5 vs.15.0%, respectively) and three patterns of attention/executive function for HIV-infected and HIV-uninfected men (worst-performing 47.4 vs. 45.1%; average 41.9 vs. 47.0%; best-performing 10.7 vs. 8.0%, respectively). Multivariable logistic regression models were used to assess associations between depression patterns and worst-performing attention/executive function. Among HIV-uninfected men, those in the periodically depressed and chronic high depressed groups had higher odds of membership in the worst-performing attention/executive function group (adjusted odds ratio [AOR] = 1.45, 95% CI 1.04, 2.03; AOR = 2.25, 95% CI 1.49, 3.39, respectively). Among HIV-infected men, patterns of depression symptoms were not associated with patterns of attention/executive function. Results suggest that HIV-uninfected, but not HIV-infected, men with chronic high depression are more likely to experience a long-term pattern of attention/executive dysfunction.

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Acknowledgments

The authors would like to thank all MACS participants and Alden Gross and Ms. Natalie Kelso for their expertise.

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Authors and Affiliations

  1. Departments of Epidemiology, Johns Hopkins University Center on Aging and Health, Johns Hopkins Bloomberg School of Public Health, 2024 E. Monument Street, Baltimore, MD, 21205, USA

    Nicole M. Armstrong, Lisa P. Jacobson & Alison G. Abraham

  2. International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA

    Pamela J. Surkan

  3. Departments of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA

    Glenn J. Treisman

  4. Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA

    Ned C. Sacktor & Cynthia Munro

  5. Cousins Center for Psychoneuroimmunology, UCLA Semel Institute for Neuroscience, UCLA David Geffen School of Medicine, Los Angeles, CA, USA

    Michael R. Irwin

  6. Departments of Psychiatry and Biobehavioral Sciences, UCLA David Geffen School of Medicine, Los Angeles, CA, USA

    Michael R. Irwin

  7. Departments of Psychiatry and Behavioral Sciences and Medicine: Infectious Diseases, Feinberg School of Medicine, Chicago, IL, USA

    Linda A. Teplin

  8. Departments of Behavioral and Community Health, University of Pittsburgh Medical Center, Pittsburgh, PA, USA

    Ron Stall

  9. Department of Psychiatry, Rush University Medical Center, Chicago, IL, USA

    Eileen M. Martin

  10. Psychiatry, Psychology, and Neurology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA

    James T. Becker

  11. Neurology, UCLA David Geffen School of Medicine, Los Angeles, CA, USA

    Andrew J. Levine

  12. Department of Ophthalmology, Johns Hopkins School of Medicine, Baltimore, MD, USA

    Alison G. Abraham

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  1. Nicole M. Armstrong
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Corresponding author

Correspondence to Nicole M. Armstrong.

Ethics declarations

The study protocol was approved at all collaborating institutions’ IRBs, and participants provided written informed consent.

Funding

This study was supported by the National Institutes of Health (1R03MH10396-01). An additional source of support for MACS included the Center for AIDS Research, Johns Hopkins University (P30AI094189). NMA was supported by fellowship from the Epidemiology and Biostatistics of Aging Training Grant (5T32AG000247).

Data in this manuscript were collected by the Multicenter AIDS Cohort Study (MACS): MACS (principal investigators): Johns Hopkins University Bloomberg School of Public Health (Joseph Margolick), U01-AI35042; Northwestern University (Steven Wolinsky), U01-AI35039; University of California, Los Angeles (Roger Detels), U01-AI35040; University of Pittsburgh (Charles Rinaldo), U01-AI35041; and the Center for Analysis and Management of MACS, Johns Hopkins University Bloomberg School of Public Health (Lisa Jacobson), UM1-AI35043. The MACS is funded primarily by the National Institute of Allergy and Infectious Diseases (NIAID), with additional co-funding from the National Cancer Institute (NCI), the National Institute on Drug Abuse (NIDA), and the National Institute of Mental Health (NIMH). Targeted supplemental funding for specific projects was also provided by the National Heart, Lung, and Blood Institute (NHLBI) and the National Institute on Deafness and Communication Disorders (NIDCD). MACS data collection is also supported by UL1-TR001079 (JHU ICTR) from the National Center for Advancing Translational Sciences (NCATS), a component of the National Institutes of Health (NIH), and NIH Roadmap for Medical Research.

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The contents of this publication are solely the responsibility of the authors and do not represent the official views of the National Institutes of Health (NIH), Johns Hopkins ICTR, or NCATS. The MACS website is located at http://aidscohortstudy.org/.

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The authors declare that they have no conflicts of interest.

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Armstrong, N.M., Surkan, P.J., Treisman, G.J. et al. Association of long-term patterns of depressive symptoms and attention/executive function among older men with and without human immunodeficiency virus. J. Neurovirol. 23, 558–567 (2017). https://doi.org/10.1007/s13365-017-0527-y

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