Aging Linked to Neurocognitive Impairment in HIV Patients

Aging is associated with neurocognitive impairment among individuals with human immunodeficiency virus (HIV), especially in relation to episodic memory and motor function, according to a recent study.

In the Multicenter AIDS Cohort Study, the researchers evaluated 5086 participants with HIV. A total of 2278 participants were HIV-seropostive, and 2808 were seronegative.
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The researchers assessed the effects of aging and HIV infection based on disease stage with interaction on 5 neurocognitive domains: information processing speed, executive function, episodic memory, working memory, and motor function. A subanalysis was conducted to control for duration of serostatus, comorbidities, and other factors that affect cognition. Additionally, linear mixed models for longitudinal data were used to conduct analyses.

After controlling for comorbidities and time since seroconversion, results indicated that significant, direct, negative effects of aging had been observed in all 5 neurocognitive domains. The researchers observed similar effects on information processing speed, executive function, motor function, and working memory among patients with late-stage HIV disease progression. Deleterious interaction effects were observed in relation to episodic memory and motor function.

“A greater than expected effect of aging on episodic memory and motor function with advanced stages of HIV infection suggests that these two domains are most susceptible to the progression of neurocognitive impairment caused by aging in individuals with HIV,” the researchers concluded. “This deficit pattern suggests differential damage to the hippocampus and basal ganglia (specifically nigrostriatal pathways). Older individuals with HIV infection should be targeted for regular screening for HIV-associate neurocognitive disorder, particularly with tests referable to the episodic memory and motor domains.”

—Christina Vogt

Reference:

Goodkin K, Miller EN, Cox C, et al. Effect of ageing on neurocognitive function by stage of HIV infection: evidence from the Multicenter AIDS Cohort Study. The Lancet HIV. 2017;4(9):e411-e422. http://dx.doi.org/10.1016/S2352-3018(17)30098-X.