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Frequency and Correlates of Subjective Cognitive Impairment in HIV Disease

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Abstract

The increasing prevalence of older adults living with HIV has raised growing concerns about a possible rise in the incidence of neurocognitive disorders due to HIV and other age-related factors. In typical aging, subjective cognitive impairment (SCI) among individuals with normal neurocognitive functioning may be an early manifestation of an incipient neurocognitive disorder. The current study examined the frequency and correlates of SCI in 188 HIV-infected adults without performance-based neurocognitive deficits or a current psychiatric disorder and 133 HIV seronegative comparison participants. All participants completed the Prospective and Retrospective Memory Questionnaire and Profile of Mood States Confusion/Bewilderment scale. Consistent with the diagnostic criteria proposed by Jessen et al. (Alzheimers Dement 10(6):844–852, 2014), participants were classified with SCI if their scores on either of the self-reported measures was greater than 1.5 SD above the normative mean. A logistic regression controlling for current mood complaints and lifetime history of substance use disorders revealed that HIV infection increased the odds of SCI (odds ratio= 4.5 [1.6, 15.4], p = 0.004). Among HIV+ individuals, SCI was associated with lower performance-based learning and delayed memory scores (Cohen’s d range 0.41–0.42.) and poorer global everyday functioning (odds ratio= 8.5 [2.6, 15.9]), but not HIV disease severity (ps > 0.10). In a sample of individuals without neurocognitive impairment or elevated mood symptoms, HIV disease was associated with a nearly fivefold increased odds of SCI compared to seronegative individuals, which may indicate an increased risk for developing major neurocognitive disorders as these HIV+ individuals age.

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Acknowledgements

The authors have no financial conflicts of interest related to this work. This study was supported by NIH Grants R01-MH073419 and P30-MH62512. The authors are grateful to the UC San Diego HIV Neurobehavioral Research Program (HNRP) Group (I. Grant, PI) for their infrastructure support of the parent R01. In particular, we thank Donald Franklin, Dr. Erin Morgan, Clint Cushman, and Stephanie Corkran for their assistance with data processing, Marizela Verduzco for her assistance with study management, Drs. Scott Letendre and Ronald J. Ellis for their assistance with the neuromedical aspects of the parent project, and Dr. J. Hampton Atkinson and Jennifer Marquie Beck and their assistance with participant recruitment and retention. 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 United States Government. The authors thank the study volunteers for their participation.

Funding

This study was funded by NIH Grants R01-MH073419 and P30-MH62512.

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Authors and Affiliations

  1. Department of Psychology, University of Houston, Houston, TX, 77004-5022, USA

    David P. Sheppard & Paul J. Massman

  2. Department of Psychology, University of Houston, 126 Heyne Building, Suite 239D, Houston, TX, 77004-5022, USA

    Steven Paul Woods

  3. 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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Correspondence to Steven Paul Woods.

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David P. Sheppard declares that he has no conflict of interest. Steven Paul Woods declares that he has no conflict of interest. Paul J. Massman declares that he has no conflict of interest. Paul E. Gilbert declares that he has no conflict of interest.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Sheppard, D.P., Woods, S.P., Massman, P.J. et al. Frequency and Correlates of Subjective Cognitive Impairment in HIV Disease. AIDS Behav 23, 617–626 (2019). https://doi.org/10.1007/s10461-018-2297-9

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