Depression, lifestyle factors and cognitive function in people living with HIV and comparable HIV-negative controls

De Francesco, D, Underwood, J, Bagkeris, E, Boffito, M, Post, FA, Mallon, PWG, Vera Rojas, J H, Williams, I, Anderson, J, Johnson, M, Sabin, C A and Winston, A (2019) Depression, lifestyle factors and cognitive function in people living with HIV and comparable HIV-negative controls. HIV Medicine. ISSN 1464-2662

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Abstract

Objectives
We investigated whether differences in cognitive performance between people living with HIV (PLWH) and comparable HIV‐negative people were mediated or moderated by depressive symptoms and lifestyle factors.

Methods
A cross‐sectional study of 637 ‘older’ PLWH aged ≥ 50 years, 340 ‘younger’ PLWH aged < 50 years and 276 demographically matched HIV‐negative controls aged ≥ 50 years enrolled in the Pharmacokinetic and Clinical Observations in People over Fifty (POPPY) study was performed. Cognitive function was assessed using a computerized battery (CogState). Scores were standardized into Z‐scores [mean = 0; standard deviation (SD) = 1] and averaged to obtain a global Z‐score. Depressive symptoms were evaluated via the Patient Health Questionnaire (PHQ‐9). Differences between the three groups and the effects of depression, sociodemographic factors and lifestyle factors on cognitive performance were evaluated using median regression. All analyses accounted for age, gender, ethnicity and level of education.

Results
After adjustment for sociodemographic factors, older and younger PLWH had poorer overall cognitive scores than older HIV‐negative controls (P < 0.001 and P = 0.006, respectively). Moderate or severe depressive symptoms were more prevalent in both older (27%; P < 0.001) and younger (21%; P < 0.001) PLWH compared with controls (8%). Depressive symptoms (P < 0.001) and use of hashish (P = 0.01) were associated with lower cognitive function; alcohol consumption (P = 0.02) was associated with better cognitive scores. After further adjustment for these factors, the difference between older PLWH and HIV‐negative controls was no longer significant (P = 0.08), while that between younger PLWH and older HIV‐negative controls remained significant (P = 0.01).

Conclusions
Poorer cognitive performances in PLWH compared with HIV‐negative individuals were, in part, mediated by the greater prevalence of depressive symptoms and recreational drug use reported by PLWH.

Item Type: Article
Additional Information: On behalf of the Pharmacokinetic and Clinical Observations in People over Fifty (POPPY) study
Schools and Departments: Brighton and Sussex Medical School > Global Health and Infection
Subjects: R Medicine > RC Internal medicine > RC0109 Infectious and parasitic diseases
Depositing User: Jaime Vera Rojas
Date Deposited: 13 Feb 2019 12:16
Last Modified: 13 Feb 2019 12:16
URI: http://srodev.sussex.ac.uk/id/eprint/81925

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