Abstract
Human immunodeficiency virus (HIV) dementia remains as an important cause of neurological morbidity among HIV-seropositive (HIV+) individuals. Differences in the neuropsychological profiles between older and younger HIV+ individuals have not been examined extensively. The objective of this study was to examine the neuropsychological test performance between old and young HIV+ individuals (a) with and without cognitive impairment (total cohort) and (b) with dementia. One hundred thirty-three older (age ≥ 50 years) HIV+ individuals and 121 younger (age 20 to 39 years) HIV+ individuals were evaluated with a standardized neuropsychological test battery. Differences between age groups in the mean z score for each neuropsychological test were determined. The older HIV+ (total) cohort had greater impairment in tests of verbal memory (P = .006), visual memory (P < .002), verbal fluency (P = .001), and psychomotor speed (P < .001) compared to the young HIV+ (total) cohort. After adjusting for differences in education, older HIV+ patients with dementia (n = 31) had a greater deficit in the Trail Making test Part B (P = 0.02) compared to younger HIV+ patients with dementia (n = 15). Age was associated with lower performance in tests of memory, executive functioning, and motor performance in older HIV+ individuals with and without cognitive impairment (total cohort), compared to younger HIV+ individuals. Among HIV+ patients with dementia, age may be associated with greater impairment in a test of executive functioning. These differences could be a result of advanced age itself or age-associated comorbidities such as coexisting cerebrovascular or neurodegenerative disease.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Becker JT, Lopez OL, Dew MA, Aizenstein HJ (2004). Prevalence of cognitive disorders differs as a function of age in HIV virus infection. AIDS 18: S11-S18.
Cherner M, Ellis R, Lazzaretto D, Young C, Mindt MR, Atkinson JH, Grant I, Heaton RK. (2004). Effects of HIV-1 infection and aging on neurobehavioral functioning: preliminary findings. AIDS 18: S27-S34.
Chiulli SJ, Haaland KY, Larue A, Garry PJ. (1995). Impact of age on Drawing the Rey-Osterrieth Figure. Clin Neuropsychol 9: 219–224.
Concha M, Selnes OA, McArthur JC, Nance-Sproson T, Updike ML, Royal W, Solomon L, Vlahov D. (1995). Normative data for a brief neuropsychological test battery in a cohort of injecting drug users. Int J Addict 30: 823–841.
Gancher S. (1997). Scales for the assessment of movement disorders. In: Handbook of neurologic rating scales. Herndon R (ed). New York: NY: Demos Vermande, pp 81–123.
Grigsby J, Kaye K, Shetterly SM, Baxter J, Morgenstern NE, Hamman RF. (2002). Prevalence of disorders of executive cognitive functioning among the elderly: findings from the San Luis Valley Health and Aging Study. Neuroepidemiology 21: 213–220.
Heaton RK, Avitable N, Grant I, Matthews CG. (1999). Further crossvalidation of regression-based neuropsychological norms with an update for the Boston Naming Test. J Clin Exp Neuropsychol 21: 572–582.
Heaton RK, Grant I, Matthews CG. (1991). Comprehensive norms for an expanded Halstead-Reitan Battery: demographic corrections, research findings, and clinical applications. Odessa: Psychological Assessment Resources.
Hinkin C, Cummings JL, Vangorp WG, Satz P, Mitrushina M, Freeman D. (1990). Frontal subcortical features of normal aging—an empirical analysis. Can J Aging Rev Can Vieillisse 9: 104–119.
Hinkin CH, Castellon SA, Atkinson JH, Goodkin K. (2001). Neuropsychiatric aspects of HIV infection among older adults. J Clin Epidemiol 54(Suppl 1): S44-S52.
Hotelling H. (1947). Multivariate quality control. In: Techniques of statistical analysis. Eisenhart C, Hastay MW, Wallis WA (eds). New York, NY: McGraw-Hill.
Janssen RS, Cornblath DR, Epstein LG, Foa RP, McArthur JC, Price RW, Asbury AK, Beckett A, Benson DF, Bridge TP, Leventhal CM, Satz P, Saykin AJ, Sidtis JJ, Tross S. (1991). Nomenclature and research case definitions for neurological manifestations of human immunodeficiency virus type-1 (HIV-1) infection. Report of a Working Group of the American Academy of Neurology AIDS Task Force. Neurology 41: 778–785.
Janssen RS, Nwanyanwu OC, Selik RM, Stehr-Green JK. (1992). Epidemiology of human immunodeficiency virus encephalopathy in the United States. Neurology 42: 1472–1476.
Kissel EC, Pukay-Martin ND, Bornstein RA. (2005). The relationship between age and cognitive function in HIV-infected men. J Neuropsychiatry Clin Neurosci 17: 180–184.
Park HL, O’Connell JE, Thomson RG. (2003). A systematic review of cognitive decline in the general elderly population. Int J Geriatr Psychiatry 18: 1121–1134.
Royall DR, Chiodo LK, Polk MJ. (2003). Executive dyscontrol in normal aging: normative data, factor structure, and clinical correlates. Curr Neurol Neurosci Rep 3: 487–493.
Sadek JR, White DA, Taylor KI, Paulsen JS, Johnson SA, Salmon DP, Delapena JH, Heaton RK, Grant I. (2004). Retrograde amnesia in dementia: comparison of HIV-associated dementia, Alzheimer’s disease, and Huntington’s disease. Neuropsychology 18: 692–699.
Sanchez Rodriguez JL, Rodriguez AM. (2003). Normal aging and AIDS. Arch Gerontol Geriatr 36: 57–65.
Schmidt M. (1996). Rey Auditory and Verbal Learning Test: a handbook. Los Angeles: Western Psychological Services.
Schmitt FA, Bigley JW, McKinnis R, Logue PE, Evans RW, Drucker JL. (1988). Neuropsychological outcome of zidovudine (AZT) treatment of patients with AIDS and AIDS-related complex. N Engl J Med 319: 1573–1578.
Shenkin SD, Bastin ME, Macgillivray TJ, Deary IJ, Starr JM, Rivers CS, Wardlaw JM. (2005). Cognitive correlates of cerebral white matter lesions and water diffusion tensor parameters in community-dwelling older people. Cerebrovasc Dis 20: 310–318.
The Dana Consortium on Therapy for HIV Dementia and Related Cognitive Disorders. (1996). Clinical confirmation of the American Academy of Neurology algorithm for HIV-1 associated cognitive/motor disorder. Neurology 47: 1247–1253.
Tombaugh TN, Kozak J, Rees L. (1999). Normative data stratified by age and education for two measures of verbal fluency: FAS and animal naming. Arch Clin Neuropsychol 14: 167–177.
Valcour V, Shikuma C, Shiramizu B, Watters M, Poff P, Selnes O, Holck P, Grove J, Sacktor N. (2004). Higher frequency of dementia in older HIV-1 individuals: the Hawaii Aging with HIV-1 Cohort. Neurology 63: 822–827.
Valcour VG, Shikuma CM, Shiramizu BT, Williams AE, Watters MR, Poff PW, Grove JS, Selnes OA, Sacktor NC. (2005). Diabetes, insulin resistance, and dementia among HIV-1-infected patients. J Acquir Immune Defic Syndr 38: 31–36.
Wilkie FL, Goodkin T, Khamis L, van Zuilen MH, Lee D, Lecusay R, Concha M, Symes S, Suarez P, Eisdorfer C. (2003). Cognitive functioning in younger and older HIV-1-infected adults. J Acquir Immune Defic Syndr 33: S93-S105.
Author information
Authors and Affiliations
Corresponding author
Additional information
This works was supported by grants 1 U54NS43049, P20 RR 11091 (NCRR), G12 RR/AI 03061 (NCRR), and MH 71150.
Rights and permissions
About this article
Cite this article
Sacktor, N., Skolasky, R., Selnes, O.A. et al. Neuropsychological test profile differences between young and old human immunodeficiency virus-positive individuals. Journal of NeuroVirology 13, 203–209 (2007). https://doi.org/10.1080/13550280701258423
Received:
Revised:
Accepted:
Issue Date:
DOI: https://doi.org/10.1080/13550280701258423