Family History of Dementia Predicts Worse Neuropsychological Functioning Among HIV-Infected Persons

Abstract

HIV-negative individuals with a family history of dementia (FHD) are more likely to develop dementia than those without a FHD. Whether FHD increases risk for neuropsychological (NP) impairment in HIV+ persons is unknown. As part of a multi-site study into HIV-Associated Neurocognitive Disorders (HAND), we captured FHD with a free-response, self-report question, and assessed NP performance with a comprehensive battery of tests. We examined HIV+ persons with (n=190) and without (n=916) self-reported FHD. Despite the fact that the FHD group had factors typically associated with better NP performance (e.g., higher CD4 counts and estimated verbal IQ [VIQ]), persons with FHD had significantly worse NP ability than those without FHD as measured by a Global Deficit Score (GDS) (FHD mean=0.66; No FHD mean=0.55; p<0.05). Thus, FHD appears to be a risk factor for HAND; the mechanism(s) underlying how FHD contributes to NP impairment among HIV+ persons warrants study.

Major Depressive Disorder, Cognitive Symptoms, and Neuropsychological Performance among Ethnically Diverse HIV+ Men and Women

“…Details of the neuropsychological battery along with normative sources are presented in the Appendix. The classification of these particular tests into specific domains was theoretically, rather than empirically derived (e.g., factor analysis), to maintain consistency with previous studies that have successfully used these categorizations to detect HIV-related deficits with acceptable sensitivity (Antinori et al, 2007; Byrd et al, 2011; Carey et al, 2004; Cherner et al, 2010; Devlin et al, 2012; Fellows et al, 2012; Heaton et al, 2010, 1995; Heaton, 2011; Moore et al, 2011; Rippeth et al, 2004; Ryan et al, 2005; Woods et al, 2004). All assessments were administered by trained staff and reviewed by a clinical neuropsychologist for quality assurance.…”

Planning deficits in HIV-associated neurocognitive disorders: Component processes, cognitive correlates, and implications for everyday functioning

“…All told, impaired executive functions are detected in approximately 50% of HIV+ individuals with neurocognitive impairment (Heaton et al, 2011). Executive dysfunction can emerge early in the course of infection (Moore et al, 2011), and the severity of impairment tends to increase with advancing HIV disease (Reger et al, 2002). Although there is no single prototypical pattern of neurocognitive impairment in HIV, it has been argued that executive dysfunction may be a cardinal feature of HAND in the cART era (Dawes et al, 2008).…”

Lower CSF A? is Associated with HAND in HIV-Infected Adults with a Family History of Dementia

“…This is in contrast to studies that have shown that abnormal biomarker concentrations (particularly Aβ-42) are more likely in patients who have a family history of AD particularly via maternal inheritance [39]. While future research should determine FHD in a more objective format, perhaps via confirmation with clinicians of family members, this study and others [24] provide support for the use of self-report FHD as an easy to gather and inexpensive proxy for familial risk/genotype for dementia.…”

“…When participants were unable to provide all of this information, they were coded as not having FHD to avoid overestimation. Participants who were adopted and could not provide information about their family history were excluded [24]. …”

“…Furthermore, gathering FHD may capture familial neurodegenerative conditions for which genetic correlates or screenings are not available. A study in adults with HIV found that those who reported a FHD had poorer cognitive performance [24], however no biomarkers were examined in that study.…”