How all-type dementia risk factors and modifiable risk interventions may be relevant to the first-generation aging with HIV infection?

Aung, Htein Linn; Kootar, Scherazad; Gates, Thomas M.; Brew, Bruce J.; Cysique, Lucette A.

doi:10.1007/s41999-019-00164-6

Cited by 10 publications

(15 citation statements)

References 131 publications

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“…Evidence of premature cognitive ageing in a cohort that is optimally treated and is representative of the multiple comorbidities found in a community sample has serious public health ramifications. As age is the number one factor for all‐type dementia, it will be very important to follow this kind of cohort into their 70s, the age at which the dementia risk increases exponentially in the general population [6]. More worryingly, at the global level, because PLHIV who have this level of healthcare and cART access, and low AIDS proportion are in the minority [58], it can be expected that in less healthy PLHIV, the premature ageing effect may be even larger, as would be the dementia risk [13].…”

Section: Discussionmentioning

confidence: 99%

“…With ageing, neurological and psychological health is becoming increasingly relevant for PLHIV. First, cognitive ageing may be premature among PLHIV because of persistent immune activation and inflammation along with an increased prevalence of other age‐related comorbidities [especially cardiovascular diseases (CVD) and stroke], all of which are known risk factors for dementia in the general population [6]. Second, age is the number one risk factor for cognitive decline and dementia in the general population [7] and even mild evidence of premature cognitive ageing could have serious public health implications for the ageing HIV epidemic.…”

Section: Introductionmentioning

confidence: 99%

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Cognitive ageing is premature among a community sample of optimally treated people living with HIV

Aung

Bloch

Vincent³

et al. 2020

HIV Medicine

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Objectives Evidence of premature cognitive ageing amongst people living with HIV (PLHIV) remains controversial due to previous research limitations including underpowered studies, samples with suboptimal antiretroviral access, varying rate of virological control, high rate of AIDS, over‐representation of non‐community samples, and inclusion of inappropriate controls. The current study addresses these limitations, while also considering mental health and non‐HIV comorbidity burden to determine whether PLHIV showed premature cognitive ageing compared with closely comparable HIV‐negative controls. Methods This study enrolled 254 PLHIV [92% on antiretroviral therapy; 84% with HIV RNA < 50 copies/mL; 15% with AIDS) and 72 HIV‐negative gay and bisexual men [mean (SD) age = 49 (10.2) years] from a single primary care clinic in Sydney, Australia. Neurocognitive function was evaluated with the Cogstate Computerized Battery (CCB) at baseline and 6 months after. Linear mixed‐effects (LME) models examined main and interaction effects of HIV status and chronological age on the CCB demographically uncorrected global neurocognitive z‐score (GZS), adjusting for repeated testing, and then adjusting sequentially for HIV disease markers, mental health and comorbidities. Results HIV status and age interacted with a lower GZS (β = −0.43, P < 0.05). Higher level of anxiety symptoms (β = −0.11, P < 0.01), historical AIDS (β = −0.12, P < 0.05) and historical HIV brain involvement (β = −0.12, P < 0.05) were associated with lower GZS. Conclusions We found a robust medium‐sized premature ageing effect on cognition in a community sample with optimal HIV care. Our study supports routine screening of cognitive and mental health among PLHIV aged ≥ 50 years.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Cognitive ageing is premature among a community sample of optimally treated people living with HIV

Aung

Bloch

Vincent³

et al. 2020

HIV Medicine

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“…Previous studies in HIV and aging have found that HIV may lead to premature, accentuated and even accelerated aging [ 8 ]. Age-related conditions such as cardiovascular diseases (CVD), frailty, chronic renal disease and stroke were observed at a higher rate and at an earlier age among PLHIV than age-matched people without HIV even when accounting for lifestyle factors [ 6 , 9 , 10 ].…”

Section: Introductionmentioning

confidence: 99%

Is There Any Evidence of Premature, Accentuated and Accelerated Aging Effects on Neurocognition in People Living with HIV? A Systematic Review

et al. 2020

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Despite evidence of premature, accentuated and accelerated aging for some age-related conditions such as cardiovascular diseases in people living with HIV (PLHIV), the evidence for these abnormal patterns of aging on neurocognition remains unclear. Further, no systematic review has been dedicated to this issue. Using PRISMA guidelines, we searched standard databases (PubMed, EMBASE, CINAHL and PsycINFO). Articles were included if they analyzed and reported the effect of age on neurocognition among PLHIV as one of their major findings, if they were conducted in the combination anti-retroviral therapy era (after 1996) and published in a peer-reviewed journal in English. Quality appraisal was conducted using the Joanna Briggs Institute (JBI) appraisal tools. To systematically target the abnormal patterns of neurocognitive aging, we define premature cognitive aging as significant interaction effect of HIV status and age on cross-sectional neurocognitive test performance covering both the normal and abnormal performance range; accentuated cognitive aging as significant interaction effect of HIV status and age on cross-sectional neurocognitive impairment (NCI) rate, thus covering the abnormal performance range only; accelerated cognitive aging as significant interaction effect of HIV status and age on longitudinal neurocognitive test performance or incidence of NCI. Because these definitions require an age-comparable HIV-negative (HIV−) control group, when no controls were included, we determined the range of the age effect on neurocognitive test performance or NCI among PLHIV. A total of 37 studies originating from the US (26), UK (2), Italy (2), Poland (2), China (2), Japan (1), Australia (1), and Brazil (1) were included. Six studies were longitudinal and 14 included HIV- controls. The quality appraisal showed that 12/37 studies neither used an age-matched HIV- controls nor used demographically corrected cognitive scores. A meta-analysis was not possible because study methods and choice of neurocognitive measurement methods and outcomes were heterogeneous imposing a narrative synthesis. In studies with an HIV- control sample, premature neurocognitive aging was found in 45% of the cross-sectional analyses (9/20), while accelerated neurocognitive aging was found in 75% of the longitudinal analyses (3/4). There was no evidence for accentuated aging, but this was tested only in two studies. In studies without an HIV- control sample, the age effect was always present but wide (NCI OR = 1.18–4.8). While large sample size (> 500) was associated with abnormal patterns of cognitive aging, most of the studies were under powered. Other study characteristics such as longitudinal study design and higher proportion of older participants were also associated with the findings of abnormal cognitive aging. There is some support for premature and accelerated cognitive aging among PLHIV in the existing literature especially among large and longitudinal studies and those with higher proportion of older samples. Future HIV and cognitive aging studies need to harmonize neuropsychological measurement methods and outcomes and use a large sample from collaborative multi-sites to generate more robust evidences.

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“…Gylce Eloisa Cabreira Panitz Cruz 2 , Daniela Fillipa Batista Cardoso 3 , Eduardo Sérgio da Silva 4 , Renata Cristina da Penha Silveira 5 , Alexandre Ernesto Silva 6 , João Luís Alves Apóstolo 7…”

Section: Diagnóstico Tardio Do Vírus Da Imunodeficiência Humana E Da unclassified

“…Evidências com base em uma corte na Holanda, estimou, que a proporção de idosos (maiores de 50 anos) entre pessoas que vivem com HIV aumentaria até 73% em 2030. Em alguns países, como os EUA e o Brasil, a proporção já ultrapassou 50% 6 .…”

Section: Introductionunclassified

Diagnóstico tardio do Vírus da Imunodeficiência Humana e da Síndrome da Imunodeficiência Adquirida em Idosos

Cruz¹,

Cardoso²,

Silva

et al. 2019

Revenf

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As pessoas idosas, diagnosticadas tardiamente, tem maior risco de desenvolver AIDS. Com a contagem de CD4 inferior a 200 células/ml3, elas apresentam em média mais chances de morrer no primeiro ano após o diagnóstico. Neste sentido, o objetivo desta revisão de escopo é mapear evidências relativas aos fatores associados e de risco do diagnóstico tardio de HIV/AIDS em pessoas idosas, mas especificamente, esta revisão quer dar resposta às seguintes questões: Quais são os fatores associados do diagnóstico tardio de HIV/AIDS em pessoas idosas? Quais são os fatores de riscos do diagnóstico tardio de HIV/AIDS em pessoas idosas? Que contexto o diagnóstico tardio de HIV/AIDS em pessoas idosas foi realizado? Esta revisão será orientada pela metodologia do Joanna Briggs Institute, que assentará na estratégia de definição dos participantes, conceito e contexto. Os resultados serão apresentados pelo resumo lógico e descritivo, apresentados, como um mapa de dados extraídos dos artigos e alinhado com o objetivo e as perguntas da revisão de escopo. Espera-se que esta revisão de escopo contribua para a análise compreensiva das práticas de cuidados à saúde das pessoas idosas.

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How all-type dementia risk factors and modifiable risk interventions may be relevant to the first-generation aging with HIV infection?

Cited by 10 publications

References 131 publications

Cognitive ageing is premature among a community sample of optimally treated people living with HIV

Cognitive ageing is premature among a community sample of optimally treated people living with HIV

Is There Any Evidence of Premature, Accentuated and Accelerated Aging Effects on Neurocognition in People Living with HIV? A Systematic Review

Diagnóstico tardio do Vírus da Imunodeficiência Humana e da Síndrome da Imunodeficiência Adquirida em Idosos

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