Assessment of Cognitive Impairment in Adults Living with HIV

Research Objectives: To Investigate How HIV Impacts Cognitive Impairment in Older Adults

Design: A cross-sectional study of HIV+/- participants who completed a cognitive evaluation session were included. We hypothesized, older HIV+ participants would be at greater risk for cognitive impairment than older HIV‒ participants.

Setting: University research lab in Philadelphia, Pennsylvania

Participants: 48 adults, HIV+ (n=23) and HIV‒ (n= 25), mean age: 60, were 83% men. Most were White (54%) or Black/African American (44%), and the majority completed college (42%) or graduate school (27%). HIV+ participants were frequency matched to HIV‒ participants based on age, gender, and education level.

Interventions: N/A

Main Outcome Measures: Cognitive impairment was assessed using the Montreal Cognitive Assessment-MoCA (subdomains included visuospatial/executive function, naming, memory, attention, language, abstraction, delayed recall, and orientation), Color Trails, Hopkins Verbal Learning, Action Verbal Fluency, and Digit Symbol Coding and compared by 2-sample t-tests between HIV+/‒ participants. For HIV+ participants, the International HIV Dementia Scale-IHDS results were also collected.

Results: Overall MoCA score, cognitive function in HIV+ participants (22.4 ± 4.1) was significantly lower than in HIV‒ participants (26.2 ± 3.3, p=0.001). HIV+ participants had lower scores in MoCA domains of attention (4.7 ± 1.5 vs 5.6± 0.9, p=0.009), language (1.8 ± 1.1 vs 2.5 ± 0.7, p= 0.01), and delayed recall (2.4 ± 1.8 vs 3.6± 1.6, p= 0.02). Scores for Color Trails (54.29 ± 26.48 vs 39.28 ± 15.44, p=0.02), (110.6 ± 60.44 vs 75.71 ± .32.31, p-value of .01) indicated impairment in Visuospatial/Executive processing. Action Verbal scores (15.7 ± 5.85 vs 19.56 ± 5.34, p-value of .02) support MoCA-language (1.80 ± 1.08 vs 2.52 ± 0.73, p-value of .01). Multiple regressions were run between IHDS and MoCA. When combined with age/ education variables the IHDS can predict MoCA scores (r2 = .72).

Conclusions: Overall, HIV+ participants scored lower than controls. MoCA/ IHDS are good measures of cognitive impairment in this population when supported by other cognitive assessments. HIV+ participants are at greater risk of cognitive impairment in visuospatial/executive function, language, and delayed recall.

Author(s) Disclosures: N/A