Journal of NeuroVirology

, Volume 23, Issue 4, pp 558–567 | Cite as

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

  • Nicole M. ArmstrongEmail author
  • Pamela J. Surkan
  • Glenn J. Treisman
  • Ned C. Sacktor
  • Michael R. Irwin
  • Linda A. Teplin
  • Ron Stall
  • Eileen M. Martin
  • James T. Becker
  • Cynthia Munro
  • Andrew J. Levine
  • Lisa P. Jacobson
  • Alison G. Abraham


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.


Depression Human immunodeficiency virus Aging Attention/executive function 



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

Compliance with ethical standards

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


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.

Role of funder/sponsor

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

Conflict of interest

The authors declare that they have no conflicts of interest.

Supplementary material

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Table S1 (DOCX 13 kb).
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Table S2 (DOCX 12 kb).
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Table S3 (DOCX 13 kb).
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Table S4 (DOCX 12 kb).
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Figure S1 (DOCX 23 kb).


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Copyright information

© Journal of NeuroVirology, Inc. 2017

Authors and Affiliations

  • Nicole M. Armstrong
    • 1
    Email author
  • Pamela J. Surkan
    • 2
  • Glenn J. Treisman
    • 3
  • Ned C. Sacktor
    • 4
  • Michael R. Irwin
    • 5
    • 6
  • Linda A. Teplin
    • 7
  • Ron Stall
    • 8
  • Eileen M. Martin
    • 9
  • James T. Becker
    • 10
  • Cynthia Munro
    • 4
  • Andrew J. Levine
    • 11
  • Lisa P. Jacobson
    • 1
  • Alison G. Abraham
    • 1
    • 12
  1. 1.Departments of EpidemiologyJohns Hopkins University Center on Aging and Health, Johns Hopkins Bloomberg School of Public HealthBaltimoreUSA
  2. 2.International HealthJohns Hopkins Bloomberg School of Public HealthBaltimoreUSA
  3. 3.Departments of Psychiatry and Behavioral SciencesJohns Hopkins University School of MedicineBaltimoreUSA
  4. 4.NeurologyJohns Hopkins University School of MedicineBaltimoreUSA
  5. 5.Cousins Center for Psychoneuroimmunology, UCLA Semel Institute for NeuroscienceUCLA David Geffen School of MedicineLos AngelesUSA
  6. 6.Departments of Psychiatry and Biobehavioral SciencesUCLA David Geffen School of MedicineLos AngelesUSA
  7. 7.Departments of Psychiatry and Behavioral Sciences and Medicine: Infectious DiseasesFeinberg School of MedicineChicagoUSA
  8. 8.Departments of Behavioral and Community HealthUniversity of Pittsburgh Medical CenterPittsburghUSA
  9. 9.Department of PsychiatryRush University Medical CenterChicagoUSA
  10. 10.Psychiatry, Psychology, and NeurologyUniversity of Pittsburgh Medical CenterPittsburghUSA
  11. 11.NeurologyUCLA David Geffen School of MedicineLos AngelesUSA
  12. 12.Department of OphthalmologyJohns Hopkins School of MedicineBaltimoreUSA

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