Cognitive impairment and neurocognitive profiles among people living with HIV and HIV- negative individuals older over 50 years: a comparison of IHDS, MMSE and MoCA

Abstract

Background The aim of our study was to examine potential differences in the assessment of neurocognitive impairment (NCI) using cognitive screening tools between PLWH and HIV-negative individuals, as well as to compare the neurocognitive profiles. Methods This was baseline evaluation of Pudong HIV Aging Cohort, including 465 people living with HIV (PLWH) and 465 HIV-negative individuals aged over 50 years matched by age (± 3 years), sex and education. NCI was assessed using the Chinese version of Mini-mental State Examination (MMSE), the International HIV Dementia Scale (IHDS) and Beijing version of Montreal Cognitive Assessment (MoCA). Results In total, 258 (55.5%), 91 (19.6%), and 273 (58.7%) of PLWH were classified as having NCI by the IHDS, MMSE, and MoCA, compared to 90 (19.4%), 25 (5.4%), 135 (29.0%) of HIV-negative individuals, respectively (all p < 0.05); such associations Only MMSE revealed sex difference in NCI prevalence among PLWH. PLWH showed a larger overlap of NCI detected by IHDS, MMSE, and MoCA than HIV-negative people. Regarding cognitive domains, IHDS-motor and psychomotor speeds and MoCA-executive function showed the greatest disparities between two groups. In multivariable analysis, older age and more depressive symptoms were positively associated with NCI regardless of the screening tools or HIV serostatus. Conclusion PLWH display a higher prevalence of NCI and distinct neurocognitive profiles compared to HIV-negative individuals, despite viral suppression. Our data support that older PLWH tend to have deficits in multiple cognitive domains simultaneously. It is advisable to utilize the cognitive screening tools in conjunction to reveal complex patterns of cognitive deficits among PLWH, especially older PLWH.