Journal of NeuroVirology

, Volume 23, Issue 2, pp 239–249 | Cite as

Association of midlife smoking status with change in processing speed and mental flexibility among HIV-seropositive and HIV-seronegative older men: the Multicenter AIDS Cohort Study

  • Wajiha Z. Akhtar-Khaleel
  • Robert L. Cook
  • Steve Shoptaw
  • Eric N. Miller
  • Ned Sacktor
  • Pamela J. Surkan
  • Jim Becker
  • Linda A. Teplin
  • Rebecca J. Beyth
  • Catherine Price
  • Michael Plankey
Article

Abstract

Smoking is a potential risk factor for age-related cognitive decline. To date, no study has examined the association between smoking and cognitive decline in men living with human immunodeficiency virus (HIV). The aim of this present study is to examine whether smoking status and severity in midlife is associated with a rate of decline in cognitive processing speed among older HIV-seropositive and HIV-seronegative men who have sex with men. Data from 591 older HIV-seropositive and HIV-seronegative men who have sex with men from the Multicenter AIDS Cohort Study were examined. All participants had information on smoking history collected before age 50 years and at least 5 years of follow-up after age 50. Smoking history was categorized as never smoker, former smoker, and current smoker and cumulative pack years was calculated. The raw scores of three neuropsychological tests (Trail Making A, Trail Making B, and Symbol Digit Modalities tests) were log transformed (Trail Making A and B) and used in linear mixed models to determine associations between smoking history and at least subsequent 5-year decline in cognitive processing speed. There were no significant differences in the rates of neurological decline among never smokers, former smokers, and current smokers. Findings were similar among HIV-seropositive participants. However, an increase of 5 pack-years was statistically significantly associated with a greater rate of decline in the Trail Making Test B score and Composite Score (β −0.0250 [95% CI, −0.0095 to −0.0006] and −0.0077 [95% CI, −0.0153 to −0.0002], respectively). We found no significant association between smoking treated as a categorical variable (never smoked, former smoker, or current smoker) and a small change in every increase of 5 pack-years on measures of psychomotor speed and cognitive flexibility. To optimize healthy aging, interventions for smoking cessation should be tailored to men who have sex with men.

Keywords

HIV Neuropsychological test Smoking Neurocognition 

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Copyright information

© Journal of NeuroVirology, Inc. 2016

Authors and Affiliations

  • Wajiha Z. Akhtar-Khaleel
    • 1
  • Robert L. Cook
    • 1
  • Steve Shoptaw
    • 2
  • Eric N. Miller
    • 3
  • Ned Sacktor
    • 4
  • Pamela J. Surkan
    • 5
  • Jim Becker
    • 6
  • Linda A. Teplin
    • 7
  • Rebecca J. Beyth
    • 8
  • Catherine Price
    • 9
  • Michael Plankey
    • 10
  1. 1.Department of Epidemiology, College of Public Health and Health Professions and College of MedicineUniversity of FloridaGainesvilleUSA
  2. 2.David Geffen School of Medicine, Departments of Family Medicine and PsychiatryUniversity of CaliforniaLos AngelesUSA
  3. 3.Semel Institute for NeuroscienceUniversity of CaliforniaLos AngelesUSA
  4. 4.Department of NeurologyThe Johns Hopkins University School of MedicineBaltimoreUSA
  5. 5.Department of International Health, Johns Hopkins Bloomberg School of Public HealthBaltimoreUSA
  6. 6.Department of Psychiatry, Neurology, and PsychologyUniversity of PittsburghPittsburghUSA
  7. 7.Departments of Psychiatry and Behavioral Sciences, Feinberg School of MedicineNorthwestern UniversityChicagoUSA
  8. 8.Malcom Randall VA Medical CenterGainesvilleUSA
  9. 9.Department of Clinical and Health PsychologyUniversity of FloridaGainesvilleUSA
  10. 10.Department of Medicine, Division of Infectious DiseasesGeorgetown University Medical CenterWashingtonUSA

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